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Title: Continuous Galantamine Therapy Slows Cognitive Decline In Alzheimer's Disease for Up to 3 Years

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Archives of Neurology 2004;61:252-256.
02/18/2004 09:37:00 AM
By Elda Hauschildt

Continuous therapy with galantamine slows cognitive decline in patients with Alzheimer's disease for up to 3 years, research in the United States indicates. Galantamine, an acetylcholinesterase inhibitor, was tested at a dosage of 24 mg/day in 194 patients with mild to moderate Alzheimer's disease. Patients had scores of 11 to 24 on the Mini-Mental State Examination and had already participated in 1 of 2 double-blind, placebo-controlled galantamine trials. Patients treated with galantamine maintained cognitive function at pre-treatment baseline levels for the first 12 months of therapy. At end-point of 36 months, their cognitive decline was delayed by approximately 18 months in comparison with decline predicted in untreated patients. "Almost 80% of patients who received galantamine continuously for 36 months seemed to demonstrate cognitive benefits compared with those predicted for untreated patients," say researchers led by Murray Raskind, MD, of the Veterans Affairs Puget Sound Health Care System, Seattle, Washington. "These findings suggest that galantamine slows the clinical progression of Alzheimer's," the researchers explain. The study cohort included 184 white patients, 6 blacks, 3 Mexican Americans and 1 Asian patient. Approximately 57% were women; mean age was 76.1 years. Cognitive decline was gradual in onset, progressing over at least 6 months. None of the participants exhibited clinical evidence of cognitive impairment other than Alzheimer's. Patients who received galantamine continuously for 36 months increased a mean of 10.2 points on the Alzheimer's Disease Assessment Scale. This represented approximately 50% smaller cognitive decline than that predicted for untreated patients. Of 194 patients, 61.3% completed 36 months of treatment. Patients who discontinued galantamine therapy before 36 months declined at a rate similar to those completing treatment. The drug was well tolerated over 36 months. Most adverse events were mild to moderate in intensity, the most common being psychiatric disorders (agitation, insomnia and depression) characteristic of elderly Alzheimer's patients followed up for 3 years. The most common severe adverse events were pneumonia (3.7%), falls (3.4%) and injury (3.1%).

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