To print: Select File and then Print from your browser's menu --------------------------------------------------------------------------------------- Title: Gender and Genotype Influence Alzheimer's Disease Progression and Response to Rivastigmine: Presented at AAT URL: http://www.pslgroup.com/dg/21DC92.htm Doctor's Guide March 2, 2008
By Rachel Parratt HONG KONG -- March 2, 2008 -- Women who are homozygous for wild-type (wt/wt) butyrycholinesterase (BuChE) have higher rates of progression from amnestic mild cognitive impairment (MCI) to Alzheimer's disease (AD) compared with wt/wt BuChE-homozygous men, according to a placebo-controlled study of the drug rivastigmine (Exelon). Results from a post-hoc analysis of 490 out of the 1,018 participants in the Investigation in the Delay to Diagnosis of AD with Exelon (InDDEx) were presented here at the 10th International Hong Kong/Springfield Pan-Asian Symposium on Advances in Alzheimer Therapy (AAT). The study demonstrated that rate of progression to AD in women with the BuChE wt/wt genotype was associated with higher rates of disease progression and functional decline (30.0%) compared with men with the same genotype (13.9%). Howard Feldman, MD, Professor and Head, Division of Neurology, University of British Columbia, Vancouver, British Columbia, Canada, presented these findings on February 29. The rate of progression to AD in BuChE wt/wt women was significantly reduced by rivastigmine treatment compared with placebo (12.9% vs 30.0%, P = .014). No significant treatment effect on disease progression was observed in men for either the BuChE wt/wt or BuChE K-variant (BuChE-K) genotypes. Whole-brain ventricular expansion, whole-brain atrophy rates, and changes in baseline for Alzheimer's Disease Assessment Scale-cognitive subscale (ADAS-cog) score were also significantly reduced in BuChE wt/wt women treated with rivastigmine compared with those treated with placebo. Mean values for ventricular expansion were 3.6 cm3/year (standard deviation [SD] 5.1) versus 5.7 cm3/year (SD 6.4, P = .04); brain atrophy rates were -0.6 cm3/year (SD 11.2) versus -5.4 cm3/year (SD 13.1, P = .04); ADAS-cog mean scores were -3.0 (SD 8.4) versus -4.1 (SD 10.8, P < .05). Functional decline, measured by Alzheimer's Disease Cooperative Study - Activities of Daily Living, in BuChE wt/wt women receiving rivastigmine was reduced significantly at 42 and 48 months versus in those given placebo (P < .05). The InDDEx study was a randomised, placebo-controlled, 3- to 4-year study investigating the effect of rivastigmine (3 to 12 mg/day) on time to clinical diagnosis of AD in participants with amnestic MCI.(1) "BuChE and acetylcholinesterase inhibition with rivastigmine significantly reduces rates of progression to AD and losses in activities of daily living," Dr. Feldman concluded. "These data suggest that rivastigmine may have disease-modifying effects in women with the BuChE wt/wt genotype." This research was funded by Novartis Pharma AG. REFERENCE: Feldman HH, et al. Lancet Neurol 2007;6:501-12. [Presentation title: The Influence of Gender and Butyrycholinesterase Genotype on Disease Progression on Response to Rivastigmine in Amnestic Mild Cognitive Impairment. Poster 14F] --------------------------------------------------------------------------------------------- Copyright © 1999 P\S\L Consulting Group Inc. All rights reserved. Republication or redistribution of P\S\L content is expressly prohibited without the prior written consent of P\S\L. P\S\L shall not be liable for any errors, omissions or delays in this content or any other content on its sites, newsletters or other publications, nor for any decisions or actions taken in reliance on such content. --------------------------------------------------------------------------------------------- This news story was printed from *Doctor's Guide to the Internet* located at http://www.docguide.com --------------------------------------------------------------------------------------- Return to News Story Page This site is maintained by webmaster@pslgroup.com Please contact us with any comments, problems or bugs. All contents Copyright (c) 1998 P\S\L Consulting Group Inc. All rights reserved.