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Rivastigmine for Alzheimer's disease
Birks JS, Grimley Evans J.. The Cochrane database of systematic reviews, 2015-04-10
Topic: Amyloid, tau and blood-test diagnosis
Background Alzheimer's disease is the commonest cause of dementia affecting older people. One of the therapeutic strategies aimed at ameliorating the clinical manifestations of Alzheimer's disease is to enhance cholinergic neurotransmission in the brain by the use of cholinesterase inhibitors to delay the breakdown of acetylcholine released into synaptic clefts. Tacrine, the first of the cholinesterase inhibitors to undergo extensive trials for this purpose, was associated with significant adverse effects including hepatotoxicity.
Key findings
- One of the therapeutic strategies aimed at ameliorating the clinical manifestations of Alzheimer's disease is to enhance cholinergic neurotransmission in the brain by the use of cholinesterase inhibitors to delay the breakdown of acetylcholine released into synaptic clefts.
- Tacrine, the first of the cholinesterase inhibitors to undergo extensive trials for this purpose, was associated with significant adverse effects including hepatotoxicity.
- Other cholinesterase inhibitors, including rivastigmine, with superior properties in terms of specificity of action and lower risk of adverse effects have since been introduced.
- Rivastigmine has received approval for use in 60 countries including all member states of the European Union and the USA.
Why it matters
This review discusses cholinesterase inhibitors, including rivastigmine, which work by delaying the breakdown of acetylcholine to ease Alzheimer's symptoms. It addresses symptom management rather than curing or preventing the disease, and the provided findings do not report specific results.
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Study details
- Participants3,232
- Effect sizeor 9.5; OR 0.68; OR 2.16
- Evidence strengthHigh
How this study scored 73/100
Published in a leading specialty journal, and it is a meta-analysis pooling many studies. We have no data on impact for its field and year, so that was left out: it earned 69 of the 94 points we could judge it on, which is 73 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 9 / 10 | Tier 2 — leading specialty journal (The Cochrane database of systematic reviews) |
| Journal's citation record | 3 / 4 | Cochrane Database of Systematic Reviews: journal h-index 468 (OpenAlex, 2026-10-29) |
| Study design | 12 / 12 | A meta-analysis pooling many studies (from PubMed type “Meta-Analysis”) |
| Strength of evidence | 5 / 5 | Rated “high” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2015 — within 20 year(s) of the newest study here |
| Sample size | 3 / 4 | 3,232 participants |
| Effect reported | 3 / 3 | Effect reported with a statistic (interval, p-value, ratio or similar) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | A review of other studies — randomisation is not credited here |
| Times cited | 5 / 7 | Cited 249 times (OpenAlex, 2026-10-10) |
| Citations per year | 3 / 5 | 19.2 citations a year over 13 year(s) since 2015 |
| Impact for its field and year | — / 6 | No field-weighted citation impact (OpenAlex has none yet) — left out of this score |
| Cited by studies here | 3 / 6 | Cited by 10 other studies in this library |
| Still being cited | 3 / 4 | Cited 63 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 2 / 4 | Last-listed author John Grimley Evans: h-index 27 (OpenAlex, whole career) |
| Institution's track record | 2 / 3 | University of Oxford: institution h-index 2,205 (OpenAlex) |
| Multi-centre collaboration | 0 / 3 | OpenAlex lists 1 institution(s) in 1 country — scores zero (affiliation lists can be incomplete) |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 25858345) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Points | 69 / 94 | Scored on 19 of 20 parts. We have no data for the rest, so they are left out: 69 of the 94 points we could judge it on is 73 out of 100. |
| Total | 73 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
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Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. Check the citation against the original before you use it.
APA 7th
Birks, J. S., & Grimley Evans, J. (2015). Rivastigmine for Alzheimer's disease. The Cochrane database of systematic reviews. https://doi.org/10.1002/14651858.cd001191.pub3
Vancouver
Birks JS, Grimley Evans J. Rivastigmine for Alzheimer's disease. The Cochrane database of systematic reviews. 2015. doi:10.1002/14651858.cd001191.pub3. PMID: 25858345.
BibTeX
@article{birks2015-25858345,
author = {Birks, J. S. and Grimley Evans, J.},
title = {{Rivastigmine for Alzheimer's disease}},
journal = {The Cochrane database of systematic reviews},
year = {2015},
doi = {10.1002/14651858.cd001191.pub3},
pmid = {25858345},
url = {https://doi.org/10.1002/14651858.cd001191.pub3}
}
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