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Galantamine Achieves Sustained Cognitive Benefits for Alzheimer's Patients: Presented at AGS

By Roberta Friedman, PhD

BALTIMORE, MD -- May 17, 2003 -- Galantamine achieved better cognitive benefits than donepezil for Alzheimer's patients treated for one year, according to findings reported here on May 15^th at the 2003 Annual Scientific Meeting of the American Geriatrics Society.

Roger Bullock, MD, director and principal investigator of the Kingshill Research Centre in Swindon, U.K., said this study is the first head-to-head comparison of galantamine and donepezil in patients with Alzheimer's disease. The unblinded study randomised all patients, although raters remained blinded as to treatment, Dr. Bullock said.

Ninety-four patients received galantamine, and 88 received donepezil. Two-thirds of patients ended up taking the most effective dose of each agent (donepezil, 10 mg a day, and galantamine 24 mg a day).

Study participants had moderate to severe Alzheimer's disease, according to the criteria of the National Institute of Neurological and Communicative Disorders and Stroke and the Alzheimer's Disease and Related Diseases Association (NINCDS-ARDA). Their cognitive decline had been progressive for at least 12 months. Both groups had similar scores on the Mini Mental State Exam (MMSE) similarly on entry.

"Early improvement, then tailing off" was noted for both agents on the Bristol Activities of Daily Living Scale, a measure of dementia progression. The Scale asks caregivers to rate patients as "a bit better," "the same," or "a bit worse," on activities such as cooking, self care, and handling money.

Galantamine patients showed less deterioration on the MMSE, Dr. Bullock said, and performed better on average than those on donepezil throughout the year of treatment.

Significantly more galantamine patients had either maintained or improved scores on the MMSE at year end, compared with those on donepezil (55.2% and 32.5% respectively [P<0.005]). Among patients who scored between 12 and 18 on the test, 57.9% and 29.9%, respectively, had a maintained or improved response on the MMSE at week 52.

The safety and tolerability of the two drugs is equivalent, with similar rates of nausea and vomiting, Dr. bullock said. At 52 weeks, rates of treatment discontinuation did not differ between the groups.

This trial was funded by Janssen Pharmaceutical Products L.P.


[Study title: Galantamine (Reminyl) Demonstrates Greater Treatment Response Than Donepezil (Aricept) In 52 weeks of Active Treatment of Patients with Alzheimer's Disease: A Responder Analysis. Abstract P252.]

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