Xing_2025_Medicine.(Baltimore)_104_e42744

This study evaluates the efficacy, safety, and economics of galantamine in the treatment of Alzheimer disease (AD) patients, and to provide evidence-based reference for optimizing drug selection, dosing strategies, and reimbursement policies in clinical practice. We used galantamine, systematic review, cost, and their synonym as keywords. The PubMed, Web of Science, Cochrane Library, China National Knowledge Infrastructure, Weipu, Wanfang database, and Health Technology Assessment organization websites were searched to retrieve studies regarding galantamine for the treatment of AD from database creation to September 20, 2023. We extracted information and pooled the results of the studies for qualitative analyses instead of quantitative meta-analysis. This study incorporated 39 reports. Regarding effectiveness, galantamine significantly improved cognitive function, living capacity, mental behavior, and global functioning of the AD patients compared with the placebo. However, based on available data, it was not possible to infer whether galantamine was more effective than the other acetylcholinesterase inhibitor drugs. AD patients treated with galantamine showed a higher incidence of adverse gastrointestinal effects compared to those treated with placebo. Galantamine showed a higher incidence of adverse gastrointestinal effects than donepezil but a lower rate than rivastigmine. Regarding economics, compared with the placebo and non-pharmacological treatments, galantamine prolonged the duration of full-time care and in some cases even reduced the overall cost of galantamine use. Galantamine showed good efficacy, cost-effectiveness, and mild adverse effects in the treatment of patients with AD by prolonging the duration of full-time care and saving the cost compared with the placebo and non-pharmacological.