Importance of high-quality evidence regarding the use of Bacopa monnieri in dementia.
Alzheimer’s disease
Bacopa monnieri
Brahmi
dementia
evidence based medicine
high-quality evidence
mild cognitive impairment
Journal
Frontiers in aging neuroscience
ISSN: 1663-4365
Titre abrégé: Front Aging Neurosci
Pays: Switzerland
ID NLM: 101525824
Informations de publication
Date de publication:
2023
2023
Historique:
received:
30
12
2022
accepted:
13
02
2023
entrez:
20
3
2023
pubmed:
21
3
2023
medline:
21
3
2023
Statut:
epublish
Résumé
Bacopa monnieri (BM), a commonly used herb, has shown neuroprotective effects in animal and In the present study, we did a narrative review of the current challenges in designing clinical trials of BM in dementia and their evidence-based recommendations. Many facets of the BM trials need improvement, especially effect size and sample size estimation. Current assessment and outcomes measures need a more holistic approach and newer scales for diagnosing and monitoring prodromal AD. The stringent guidelines in CONSORT and STROBE are often considered difficult to implement for clinical trials in ayurvedic medications like BM. However, adherence to these guidelines will undoubtedly improve the quality of evidence and go a long way in assessing whether BM is efficacious in treating AD/prodromal AD patients and other neurodegenerative dementias. Future studies on BM should implement more randomized controlled trials (RCTs) with an appropriate sample size of accurately diagnosed AD/prodromal AD patients, administering a recommended dosage of BM and for a pre-specified time calculated to achieve adequate power for the study. Researchers should also develop and validate more sensitive cognitive scales, especially for prodromal AD. BM should be evaluated in accordance with the same rigorous standards as conventional drugs to generate the best quality evidence.
Sections du résumé
Background
UNASSIGNED
Bacopa monnieri (BM), a commonly used herb, has shown neuroprotective effects in animal and
Methods
UNASSIGNED
In the present study, we did a narrative review of the current challenges in designing clinical trials of BM in dementia and their evidence-based recommendations.
Results
UNASSIGNED
Many facets of the BM trials need improvement, especially effect size and sample size estimation. Current assessment and outcomes measures need a more holistic approach and newer scales for diagnosing and monitoring prodromal AD. The stringent guidelines in CONSORT and STROBE are often considered difficult to implement for clinical trials in ayurvedic medications like BM. However, adherence to these guidelines will undoubtedly improve the quality of evidence and go a long way in assessing whether BM is efficacious in treating AD/prodromal AD patients and other neurodegenerative dementias.
Conclusion
UNASSIGNED
Future studies on BM should implement more randomized controlled trials (RCTs) with an appropriate sample size of accurately diagnosed AD/prodromal AD patients, administering a recommended dosage of BM and for a pre-specified time calculated to achieve adequate power for the study. Researchers should also develop and validate more sensitive cognitive scales, especially for prodromal AD. BM should be evaluated in accordance with the same rigorous standards as conventional drugs to generate the best quality evidence.
Identifiants
pubmed: 36936504
doi: 10.3389/fnagi.2023.1134775
pmc: PMC10014812
doi:
Types de publication
Journal Article
Review
Langues
eng
Pagination
1134775Informations de copyright
Copyright © 2023 Agarwal, Mishra, Gupta, Srivastava, Basheer, Sharma and Vishnu.
Déclaration de conflit d'intérêts
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
Références
Sci Rep. 2021 Jan 12;11(1):596
pubmed: 33436817
Phytomedicine. 1996 Jan;2(3):193-8
pubmed: 23194615
J Ayurveda Integr Med. 2021 Jul-Sep;12(3):556-561
pubmed: 34362605
J Neurol. 2010 Nov;257(11):1822-31
pubmed: 20535493
Ann Neurosci. 2017 May;24(2):111-122
pubmed: 28588366
JAMA. 2000 May 24-31;283(20):2701-11
pubmed: 10819955
Ann Intern Med. 2006 Mar 7;144(5):364-7
pubmed: 16520478
Philos Trans R Soc Lond B Biol Sci. 2011 Jun 27;366(1572):1889-95
pubmed: 21576146
Medicines (Basel). 2017 Nov 22;4(4):
pubmed: 29165401
J R Soc Med. 2013 May;106(5):196-8
pubmed: 23761529
J Altern Complement Med. 2005 Jun;11(3):385-90
pubmed: 15992219
J Alzheimers Dis. 2011;26 Suppl 3:369-77
pubmed: 21971476
JAMA. 2004 Feb 4;291(5):599-604
pubmed: 14762039
Int J Ayurveda Res. 2011 Jan;2(1):48-52
pubmed: 21897643
Birth. 2002 Mar;29(1):1-9
pubmed: 11843784
Zhong Xi Yi Jie He Xue Bao. 2012 Oct;10(10):1077-83
pubmed: 23073189
J Prev Alzheimers Dis. 2017;4(1):12-15
pubmed: 29188854
Psychopharmacol Bull. 1983;19(3):448-50
pubmed: 6635122
Health Technol Assess. 2003;7(1):1-76
pubmed: 12583822
J Ethnopharmacol. 2014;151(1):528-35
pubmed: 24252493
Complement Ther Med. 2019 Jun;44:68-82
pubmed: 31126578
Interact J Med Res. 2022 Aug 1;11(2):e38542
pubmed: 35612544
Perspect Clin Res. 2013 Jan;4(1):49-52
pubmed: 23533982
J Clin Exp Hepatol. 2022 Jan-Feb;12(1):256-257
pubmed: 34413585
Continuum (Minneap Minn). 2019 Feb;25(1):14-33
pubmed: 30707185
Lancet. 2017 Dec 16;390(10113):2673-2734
pubmed: 28735855
Curr Neuropharmacol. 2013 May;11(3):315-35
pubmed: 24179466
Phytother Res. 2021 Oct;35(10):5668-5679
pubmed: 34254371
Phytomedicine. 2007 May;14(5):301-8
pubmed: 17442556
Indian J Med Ethics. 2023 Jan-Mar;VIII(1):61-64
pubmed: 36694399
Alzheimer Dis Assoc Disord. 2010 Jul-Sep;24(3):269-77
pubmed: 20683184
Ann Intern Med. 2002 Jun 4;136(11):817-25
pubmed: 12044130
Innov Clin Neurosci. 2017 Feb 01;14(1-2):30-39
pubmed: 28386519
Alzheimers Res Ther. 2021 Mar 25;13(1):64
pubmed: 33766132
Am J Geriatr Psychiatry. 2017 Sep;25(9):1009-1011
pubmed: 28522120
Alzheimers Dement. 2017 Feb;13(2):186-195
pubmed: 27702619
Indian J Gastroenterol. 2018 Jul;37(4):374-375
pubmed: 30168072
Int J Ayurveda Res. 2010 Jan;1(1):41-6
pubmed: 20532097
Curr Neurol Neurosci Rep. 2009 Sep;9(5):359-67
pubmed: 19664365
Alzheimers Res Ther. 2018 Sep 11;10(1):90
pubmed: 30205840