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Long-term Benefits of Galantamine Treatment for Patients with Vascular Dementia or Alzheimer's disease

Galantamine therapy given for a longer period, and/or initiated earlier, may provide an increase in cognitive benefits for patients with Alzheimer's disease, say researchers.

Galantamine, an acetylcholinesterase inhibitor, has been shown in a 6-month study to provide cognitive benefits for patients with vascular dementia or Alzheimer's disease with cerebrovascular disease (Alz/cer). A study extension demonstrated that patients receiving galantamine for 12 months may benefit from long-term treatment.

Gary Small, MD, with the University of California, Los Angeles, United States, and colleagues performed a sub-analysis of the trial data to determine if long-term efficacy of galantamine is influenced by dementia type (vascular versus Alz/cer).

In the original study, patients (aged 40 to 90) were randomised to receive galantamine 24 mg/day (n=396) or placebo (n=196) for 6 months. Those who completed the trial were then eligible to enter a 6-month open-label phase during which all patients received galantamine 24 mg/day. Cognitive efficacy was assessed as changes in score on the 11-item Alzheimer's Disease Assessment Scale cognitive subscale (ADAS-cog/11).

Patients with vascular dementia who received galantamine for the entire 12-month period showed significant improvement in cognition scores at study end compared with baseline (mean change, -2.1 ± 0.74). Although these patients had a 4-fold greater improvement at 6 months compared with those who received placebo, the placebo group showed a similar improvement in cognitive function after receiving galantamine for the 6-month extension period.

Alz/cer patients who received galantamine continuously for 12 months maintained baseline cognitive scores at the end of the study period Those who were switched from placebo to galantamine at month 6 showed a significant improvement by month 12, but the cognition level was significantly lower than for those who received galantamine for the entire study period.

"Our study provides evidence that patients with these common subtypes of dementia may benefit from galantamine therapy that is maintained for at least 1 year," the researchers conclude.



CNS Drugs 2003;17:12:905-14. "Galantamine in the treatment of cognitive decline in patients with vascular dementia or Alzheimer's disease with cerebrovascular disease"

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