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Title: IPA MEETING: Aricept Effective In Long-Term Treatment Of Alzheimer's
URL: http://www.pslgroup.com/dg/121B92.htm
Doctor's Guide
August 18, 1999


VANCOUVER, BC -- Aug. 18, 1999 -- Cognition and functional abilities of patients with mild to moderate Alzheimer's disease (AD) treated with Aricept (donepezil) are enhanced over an extended period of time compared to patients treated with placebo, according to study results presented for the first time at the ninth International Psychogeriatric Association meeting being held in Vancouver this week.

Aricept, the first and only medication approved in Canada for the treatment of mild to moderate AD, was also confirmed as having long-term beneficial effects on patients' activities of daily living over a one-year period.

The long-term effects of Aricept were assessed during a 52-week multicentre, double blind, placebo-controlled trial, involving 286 patients with mild to moderate AD in five Northern European countries. These patients were randomly divided to receive once-a-day Aricept or placebo for one year. The Aricept group received 5 mg of Aricept for 28 days followed by 10 mg daily for the remainder of the trial.

"This study is unique in that Aricept efficacy and safety were measured against placebo for one year," said principal investigator Dr. Bengt Winblad, professor, department of neuroscience and family medicine at the Karolinska Institute, Huddinge, Sweden. "These results advance the previously published data supporting the long term benefit of this drug. They confirm that the clinical benefits of Aricept are sustained over time and that treatment is also well tolerated over the long-term."

Key Results:
-- The observed improvement over baseline in global function was significant among Aricept-treated patients at weeks 24, 36 and 52 as measured on the Gottfries, Brane and Steen (GBS) scale.
-- Statistically significant improvement in cognition over baseline was observed at weeks 24, 36 and 52 weeks in patients receiving Aricept, as measured by the Mini Mental State Evaluation (MMSE) scores.
-- After one year, at week 52, Aricept-treated patients showed less decline in activities of daily living (ADL) as measured by the Progressive Deterioration Scale (PDS) scores.

"This is certainly more good news for Canadian Alzheimer's disease patients and their caregivers," said Dr. Sandra Black, head of neurology at Sunnybrook and Women's College Health Sciences Centre of Toronto and an AD investigator.

"Alzheimer's disease is not a normal part of ageing. It is a degenerative disease that can be kept in check or delayed for some time," Dr. Black explained. "To give people the best chance to maintain their current level of activities, treatment should be considered as soon as you think a patient has AD and preferably early in the disease course."

"These results are encouraging to document the effects of Aricept over a longer time period," said Dr. François Primeau, psychogeriatrician at St. Mary's Hospital, Montreal. "As with diseases like cancer, we can now provide patients and their caregivers with an extended quality of life by delaying or preventing deterioration of their condition. We may not have a cure but we can significantly impact on the cost of care by delaying institutionalisation."

The annual cost of caring for patients with Alzheimer's disease in Canada increases with the severity of the disease. A 1998 study showed that patients in the early to mild stages of AD cost $9,451 CDN to treat and care for on an annual basis. In contrast, the cost to treat and care for patients with severe AD rises four-fold to $36,794 CDN. As a patient's condition deteriorates, institutionalisation becomes the largest cost component accounting for as much as 84 per cent of the cost of care, according to the study.

Recently updated Canadian guidelines for the diagnosis and treatment of Alzheimer's disease recommend that a trial course of Aricept be prescribed to informed and willing patients with mild to moderate dementia due to probable AD, when there is no contraindication.

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