Skip to main content
Top
Published in: Journal of Neural Transmission 4/2009

01-04-2009 | Dementias - Original Article

Efficacy and safety of natural acetylcholinesterase inhibitor huperzine A in the treatment of Alzheimer’s disease: an updated meta-analysis

Authors: Bai-song Wang, Hao Wang, Zhao-hui Wei, Yan-yan Song, Lu Zhang, Hong-zhuan Chen

Published in: Journal of Neural Transmission | Issue 4/2009

Login to get access

Abstract

The objective of this study was to provide an updated meta-analysis of the efficacy and safety of huperzine A (HupA) in Alzheimer’s disease (AD). We searched for randomized trials comparing HupA with placebo in the treatment of AD. The primary outcome measures were mini-mental state examination (MMSE) and activities of daily living scale (ADL). Data were extracted from four randomized clinical trials and analyzed using standard meta-analysis and meta-regression methods. Oral administration of HupA for 8–24 weeks (300–500 μg daily) led to significant improvements in MMSE and ADL. The results of meta-regression showed that the estimated effect size of MMSE and ADL was increased over the treatment time. Most adverse events were cholinergic in nature and no serious adverse events occurred. Huperzine A is a well-tolerated drug that could significantly improve cognitive performance and ADL in patients with AD.
Literature
go back to reference Bai DL, Tang XC, He XC (2000) Huperzine A, a potential therapeutic agent for treatment of Alzheimer’s disease. Curr Med Chem 7:355–374PubMed Bai DL, Tang XC, He XC (2000) Huperzine A, a potential therapeutic agent for treatment of Alzheimer’s disease. Curr Med Chem 7:355–374PubMed
go back to reference Chen MJ, Gao ZX, Deng HY, Liu FG (2000) A multi-center, double-blind clinical trial of huperzine-A in capsules and tablets for treating patients with Alzheimer disease. Chin J New Drugs Clin Rem 19:10–12 Chen MJ, Gao ZX, Deng HY, Liu FG (2000) A multi-center, double-blind clinical trial of huperzine-A in capsules and tablets for treating patients with Alzheimer disease. Chin J New Drugs Clin Rem 19:10–12
go back to reference Dong HT, Jin YG, Bai Y (2002) 11 cases of Alzheimer’s disease treated by acupuncture. Acta Universitatis Traditionis Medicalis Sinensis Pharmacologiaeque Shanghai 16:26–28 Dong HT, Jin YG, Bai Y (2002) 11 cases of Alzheimer’s disease treated by acupuncture. Acta Universitatis Traditionis Medicalis Sinensis Pharmacologiaeque Shanghai 16:26–28
go back to reference Follmann D, Elliott P, Suh I, Cutler J (1992) Variance imputation for overviews of clinical trials with continuous response. J Clin Epidemiol 45:769–773PubMedCrossRef Follmann D, Elliott P, Suh I, Cutler J (1992) Variance imputation for overviews of clinical trials with continuous response. J Clin Epidemiol 45:769–773PubMedCrossRef
go back to reference Folstein M, Folstein S, McHugh P (1975) The mini-mental state examination. J Psychiatr Res 12:189–198PubMedCrossRef Folstein M, Folstein S, McHugh P (1975) The mini-mental state examination. J Psychiatr Res 12:189–198PubMedCrossRef
go back to reference Giacobini E (2004) Cholinesterase inhibitors: new roles and therapeutic alternatives. Pharmacol Res 50:433–440PubMedCrossRef Giacobini E (2004) Cholinesterase inhibitors: new roles and therapeutic alternatives. Pharmacol Res 50:433–440PubMedCrossRef
go back to reference Lawton MP, Brody EM (1969) Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist 9:179–186PubMed Lawton MP, Brody EM (1969) Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist 9:179–186PubMed
go back to reference Little JT, Walsh S, Aisen PS (2008) An update on huperzine A as a treatment for Alzheimer’s disease. Expert Opin Investig Drugs 17:209–215PubMedCrossRef Little JT, Walsh S, Aisen PS (2008) An update on huperzine A as a treatment for Alzheimer’s disease. Expert Opin Investig Drugs 17:209–215PubMedCrossRef
go back to reference Liu FG, Fang YS, Gao ZX, Zhou JD, Su ML (1995) Double-blind control treatment of huperzine-A and placebo in 28 patients with Alzheimer disease. Chin J Pharmacoepidemiol 4:196–197 Liu FG, Fang YS, Gao ZX, Zhou JD, Su ML (1995) Double-blind control treatment of huperzine-A and placebo in 28 patients with Alzheimer disease. Chin J Pharmacoepidemiol 4:196–197
go back to reference Ma X, Tan C, Zhu D, Gang DR, Xiao P (2007) Huperzine A from Huperzia species—an ethnopharmacolgical review. J Ethnopharmacol 113:15–34PubMedCrossRef Ma X, Tan C, Zhu D, Gang DR, Xiao P (2007) Huperzine A from Huperzia species—an ethnopharmacolgical review. J Ethnopharmacol 113:15–34PubMedCrossRef
go back to reference Mazurek A (2000) An open-label trial of huperzine A in the treatment of Alzheimer’s disease. Altern Ther Health Med 5:97–98 Mazurek A (2000) An open-label trial of huperzine A in the treatment of Alzheimer’s disease. Altern Ther Health Med 5:97–98
go back to reference Normand SLT (1999) Meta-analysis: formulating, evaluating, combining, and reporting. Stat Med 18:321–359PubMedCrossRef Normand SLT (1999) Meta-analysis: formulating, evaluating, combining, and reporting. Stat Med 18:321–359PubMedCrossRef
go back to reference Rogers SL, Doody RS, Hohs RC, Friedhoff LT, Donepezil Study Group (1998a) Donepezil improves cognition and global function in Alzheimer disease: a 15-week, double-blind placebo-controlled study. Arch Intern Med 158:1021–1031PubMedCrossRef Rogers SL, Doody RS, Hohs RC, Friedhoff LT, Donepezil Study Group (1998a) Donepezil improves cognition and global function in Alzheimer disease: a 15-week, double-blind placebo-controlled study. Arch Intern Med 158:1021–1031PubMedCrossRef
go back to reference Rogers SL, Farlow MR, Doody RS, Mohs R, Friedhoff LT (1998b) A 24-week, double-blind, placebo-controlled trial of donepezil in patients with Alzheimer’s disease. Neurology 50:136–145PubMed Rogers SL, Farlow MR, Doody RS, Mohs R, Friedhoff LT (1998b) A 24-week, double-blind, placebo-controlled trial of donepezil in patients with Alzheimer’s disease. Neurology 50:136–145PubMed
go back to reference Schneider LS (2001) Assessing outcomes in Alzheimer disease. Alzheimer Dis Assoc Disord 15:S8–S18PubMedCrossRef Schneider LS (2001) Assessing outcomes in Alzheimer disease. Alzheimer Dis Assoc Disord 15:S8–S18PubMedCrossRef
go back to reference Tang XC, De Sarno P, Sugaya K, Giacobini E (1989) Effect of huperzine A, a new cholinesterase inhibitor, on the central cholinergic system of the rat. J Neurosci Res 24:276–285PubMedCrossRef Tang XC, De Sarno P, Sugaya K, Giacobini E (1989) Effect of huperzine A, a new cholinesterase inhibitor, on the central cholinergic system of the rat. J Neurosci Res 24:276–285PubMedCrossRef
go back to reference Thompson SG, Higgins JP (2002) How should meta-regression analyses be undertaken and interpreted? Stat Med 21:1559–1573PubMedCrossRef Thompson SG, Higgins JP (2002) How should meta-regression analyses be undertaken and interpreted? Stat Med 21:1559–1573PubMedCrossRef
go back to reference Van Houwelingen HC, Arends LR, Stijnen T (2002) Advanced methods in meta-analysis: multivariate approach and meta-regression. Stat Med 21:589–624PubMedCrossRef Van Houwelingen HC, Arends LR, Stijnen T (2002) Advanced methods in meta-analysis: multivariate approach and meta-regression. Stat Med 21:589–624PubMedCrossRef
go back to reference Ved HS, Koenig ML, Dave JR, Doctor BP (1997) Huperzine A, a potential therapeutic agent for dementia, reduces neuronal cell death caused by glutamate. Neuroreport 8:963–968PubMedCrossRef Ved HS, Koenig ML, Dave JR, Doctor BP (1997) Huperzine A, a potential therapeutic agent for dementia, reduces neuronal cell death caused by glutamate. Neuroreport 8:963–968PubMedCrossRef
go back to reference Wang R, Yan H, Tang XC (2006) Progress in studies of huperzine A, a natural cholinesterase inhibitor from Chinese herbal medicine. Acta Pharmacol Sin 27:1–26PubMedCrossRef Wang R, Yan H, Tang XC (2006) Progress in studies of huperzine A, a natural cholinesterase inhibitor from Chinese herbal medicine. Acta Pharmacol Sin 27:1–26PubMedCrossRef
go back to reference Whitehead A (2002) Meta-analysis of controlled clinical trial. Wiley, ChichesterCrossRef Whitehead A (2002) Meta-analysis of controlled clinical trial. Wiley, ChichesterCrossRef
go back to reference Wong DM, Greenblatt HM, Dvir H, Carlier PR, Han YF, Pang YP, Silman I, Sussman JL (2003) Acetylcholinesterase complexed with bivalent ligands related to huperzine a: experimental evidence for species-dependent protein-ligand complementarity. J Am Chem Soc 125:363–373PubMedCrossRef Wong DM, Greenblatt HM, Dvir H, Carlier PR, Han YF, Pang YP, Silman I, Sussman JL (2003) Acetylcholinesterase complexed with bivalent ligands related to huperzine a: experimental evidence for species-dependent protein-ligand complementarity. J Am Chem Soc 125:363–373PubMedCrossRef
go back to reference Xu SS, Gao ZX, Weng Z, Du ZM, Xu WA, Yang JS, Zhang ML, Tong ZH, Fang YS, Chai XS, Li SL (1995) Efficacy of tablet huperzine A on memory, cognition, and behavior in Alzheimer’s disease. Acta Pharmacol Sin 16:391–395 Xu SS, Gao ZX, Weng Z, Du ZM, Xu WA, Yang JS, Zhang ML, Tong ZH, Fang YS, Chai XS, Li SL (1995) Efficacy of tablet huperzine A on memory, cognition, and behavior in Alzheimer’s disease. Acta Pharmacol Sin 16:391–395
go back to reference Xu SS, Cai ZY, Qu ZW, Yang RM, Cai YL, Wang GQ, Su XQ, Zhong XS, Cheng RY, Xu WA, Li JX, Feng B (1999) Huperzine-A in capsules and tablets for treating patients with Alzheimer disease. Acta Pharmacol Sin 20:486–490 Xu SS, Cai ZY, Qu ZW, Yang RM, Cai YL, Wang GQ, Su XQ, Zhong XS, Cheng RY, Xu WA, Li JX, Feng B (1999) Huperzine-A in capsules and tablets for treating patients with Alzheimer disease. Acta Pharmacol Sin 20:486–490
go back to reference Yan H, Tang XC (2006) Review on clinical application of huperzine A in China. Chin J New Drugs Clin Rem 25:682–687 Yan H, Tang XC (2006) Review on clinical application of huperzine A in China. Chin J New Drugs Clin Rem 25:682–687
go back to reference Yang JS, Jiang ZH (1996) The clinical report of the effect of huperzine A in treatment of Alzheimer’s disease. Heibei Jing Shen Wei Sheng 9:84–85 Yang JS, Jiang ZH (1996) The clinical report of the effect of huperzine A in treatment of Alzheimer’s disease. Heibei Jing Shen Wei Sheng 9:84–85
go back to reference Yang CY, Lu ZP, Zheng CG (2003) Efficacy and reliability of huperzine A in mild and moderate Alzheimer’s disease. Chin J Clin Rehabil 7:4258–4259 Yang CY, Lu ZP, Zheng CG (2003) Efficacy and reliability of huperzine A in mild and moderate Alzheimer’s disease. Chin J Clin Rehabil 7:4258–4259
go back to reference Zhang HY, Tang XC (2006) Neuroprotective effects of huperzine A: new therapeutic targets for neurodegenerative disease. Trends Pharmacol Sci 27:619–625PubMedCrossRef Zhang HY, Tang XC (2006) Neuroprotective effects of huperzine A: new therapeutic targets for neurodegenerative disease. Trends Pharmacol Sci 27:619–625PubMedCrossRef
go back to reference Zhang ZX, Wang XD, Chen QT, Shu L, Wang JZ, Shan GL (2002) Clinical efficacy and safety of huperzine A in treatment of mild to moderate Alzheimer disease, a placebo-controlled, double-blind, randomized trial. Zhonghua Yi Xue Za Zhi 82:941–944PubMed Zhang ZX, Wang XD, Chen QT, Shu L, Wang JZ, Shan GL (2002) Clinical efficacy and safety of huperzine A in treatment of mild to moderate Alzheimer disease, a placebo-controlled, double-blind, randomized trial. Zhonghua Yi Xue Za Zhi 82:941–944PubMed
go back to reference Zhang ML, Yuan GZ, Yao JJ, Bi P, Ni SQ (2006) Evaluation of clinical effect and safety of huperzine A in treating 52 Alzheimer’s disease. Chin J New Drugs Clin Rem 25:693–695 Zhang ML, Yuan GZ, Yao JJ, Bi P, Ni SQ (2006) Evaluation of clinical effect and safety of huperzine A in treating 52 Alzheimer’s disease. Chin J New Drugs Clin Rem 25:693–695
go back to reference Zhang HY, Zheng CY, Yan H, Wang ZF, Tang LL, Gao X, Tang XC (2008) Potential therapeutic targets of huperzine A for Alzheimer’s disease and vascular dementia. Chem Biol Interact 175:396–402PubMedCrossRef Zhang HY, Zheng CY, Yan H, Wang ZF, Tang LL, Gao X, Tang XC (2008) Potential therapeutic targets of huperzine A for Alzheimer’s disease and vascular dementia. Chem Biol Interact 175:396–402PubMedCrossRef
go back to reference Zhou BR, Xu ZQ, Kuang YF, Deng YH (2004) Curative effect of aspirin for postponing the development of Alzheimer’s disease. Chin J Clin Rehabil 8:3020–3021 Zhou BR, Xu ZQ, Kuang YF, Deng YH (2004) Curative effect of aspirin for postponing the development of Alzheimer’s disease. Chin J Clin Rehabil 8:3020–3021
Metadata
Title
Efficacy and safety of natural acetylcholinesterase inhibitor huperzine A in the treatment of Alzheimer’s disease: an updated meta-analysis
Authors
Bai-song Wang
Hao Wang
Zhao-hui Wei
Yan-yan Song
Lu Zhang
Hong-zhuan Chen
Publication date
01-04-2009
Publisher
Springer Vienna
Published in
Journal of Neural Transmission / Issue 4/2009
Print ISSN: 0300-9564
Electronic ISSN: 1435-1463
DOI
https://doi.org/10.1007/s00702-009-0189-x

Other articles of this Issue 4/2009

Journal of Neural Transmission 4/2009 Go to the issue

Basic Neurosciences, Genetics and Immunology - Original Article

Expression of GluR6 kainate receptor subunit in granular layer of weaver mouse cerebellum