Donepezil, galantamine and rivastigmine and progression to memantine add-on therapy in Alzheimer's disease: a nationwide cohort study emulating a target trial in the Brazilian Unified Health System

Background. Donepezil, galantamine and rivastigmine are dispensed free of charge to people with mild to moderate Alzheimer's disease in the Brazilian Unified Health System (SUS), but their comparative long-term effectiveness in routine care is unknown. Under the national clinical protocol, memantine is added to a cholinesterase inhibitor (ChEI) when the disease reaches the moderate stage, so memantine add-on can serve as a marker of clinical progression. Methods. Nationwide new-user cohort study emulating a target trial in which adults with Alzheimer's disease eligible for a ChEI would be rand

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