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Title: Galantamine Showing Early Promise In Some Dementias

URL: http://www.thelancet.com/journal/vol359/iss931
14/abs/llan.359.9314.original_research.20762.1

Lancet 2002; 359: 1283-90. "Efficacy of galantamine in probable vascular dementia and Alzheimer's disease combined with cerebrovascular disease: a randomised trial"
04/11/2002 07:03:00 PM
By Harvey McConnell

A multi-center international trial shows galantamine is equally effective in treating patients with dementia due to Alzheimer's disease, cerebrovascular disease, and probable vascular dementia. Dr Timo Erkinjuntti, Memory Research Unit, Department of Clinical Neurosciences, Helsinki University Central Hospital, Helsinki, Finland, investigated the effects of galantamine in patients with a diagnosis of probable vascular dementia or Alzheimer's disease combined with cerebrovascular disease. The randomized trial was carried out in collaboration with clinicians in Britain, Canada, Denmark, France, Germany, Ireland, Israel, The Netherlands and Poland. In Europe, the clinicians note, dementia is more common than stroke, in terms of both incidence and prevalence. Alzheimer's disease (AD) is the most common cause of dementia, followed by the vascular dementias. At the same time, "the prevalence of mixed vascular dementia, Alzheimer's disease with cerebrovascular disease, has been underestimated, particularly in older populations." Galantamine amplifies the acetylcholine response by inhibiting acetylcholinesterase and modulating nicotinic receptors. It has been shown to offer benefit in relation to cognition, behaviour, and in improving daily living in patients with AD. In this study, the researchers investigated the effects of galantamine in patients with a diagnosis of probable vascular dementia or AD combined with cerebrovascular disease. In the double-blind six month trial, 396 patients were randomly assigned galantamine 24 mg/day and 196 received placebo. Primary endpoints were cognition assessed by the AD assessment scale, cognitive subscale (ADAS-cog) and global functioning--clinician's interview-based impression of change plus caregiver input (CIBIC-plus). Behavior and daily living also were assessed. The clinicians found that after six months, patients given galantamine improved by 1.7 points on the ADAS-cog scale, while those on placebo deteriorated by an average of one point. In addition, 74 percent of patients given galantamine were stable according to the CIBIC-plus scale compared with 59 percent of patients given placebo. Behavior and daily living also were significantly improved in treatment patients compared with those on placebo. Dr Erkinjuntti concluded: "Galantamine, being equally effective in dementia due to Alzheimer's disease, and in dementia due to cerebrovascular disease, provides a treatment option to a broad range of patients for whom little pharmacological help has been available. "We found that galantamine provides an effective symptomatic treatment for patients with these disorders, offering a range of therapeutic effects that will give important benefits to patients with dementia."

http://www.thelancet.com/journal/vol359/iss931
14/abs/llan.359.9314.original_research.20762.1

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