Is 30 mL Cerebrolysin a Safe and Effective Drug for Improving Global and Cognitive Function in Patients with Alzheimer's Disease Aged 50 Years and Older with No Significant Comorbidities?

OBJECTIVE: The objective of this selective EBM review is to determine whether or not the use of 30 mL Cerebrolysin is a safe and effective drug for improving global and cognitive function in patients with Alzheimer’s Disease aged 50 years and older with no significant comorbidities. STUDY DESIGN: Systematic review of three randomized controlled trials published between 2001-2006, all English language. DATA SOURCES: Three randomized controlled trials comparing the efficacy of cerebrolysin to placebo in the treatment of individuals ages 50 and over with AD related cognitive and global functioning decline. All articles found using PubMed. OUTCOMES MEASURED: Three randomized controlled studies measured improvement in cognitive and global impairment in patients with AD using a combination of either ADAScog(clinician rated test measuring cognitive function), CIBIC+(clinician based interview of patient to assess global change), or CGI(clinician assessment of mental deterioration). The evaluations cover orientation, memory, language, understanding, behavior, and activities of daily living. Evaluations with the tests mentioned were made under double-blind conditions. RESULTS: Three randomized controlled trials were included in this review. Ruether et al. revealed a significant effect on functional and cognitive decline with 30mL Cerebrolysin. Panisset et al. found a significant relationship between Cerebrolysin and improved global functioning, but no change in cognition between experimental and control groups. Alverez et al. found insignificant effects on both cognition and global functioning. CONCLUSIONS: The results of the three studies represent inconclusive evidence that Cerebrolysin has significant effects on cognition and global functions in patients with AD. One study found significant improvements in cognition and global function, but the other studies found insignificant effects. Further studies are encouraged to develop a definitive relationship.