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Galantamine treatment in Alzheimer’s disease: response and long-term outcome in a routine clinical setting
BACKGROUND: In the absence of long-term, placebo-controlled studies of cholinesterase inhibitors in Alzheimer’s disease (AD), analysis of the results of open-label trials becomes crucial. This study aimed to explore the three-year effects of galantamine treatment, as well as subgroups of response an...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Dove Medical Press
2011
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3191869/ https://www.ncbi.nlm.nih.gov/pubmed/22003296 http://dx.doi.org/10.2147/NDT.S24196 |
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author | Wallin, Åsa K Wattmo, Carina Minthon, Lennart |
author_facet | Wallin, Åsa K Wattmo, Carina Minthon, Lennart |
author_sort | Wallin, Åsa K |
collection | PubMed |
description | BACKGROUND: In the absence of long-term, placebo-controlled studies of cholinesterase inhibitors in Alzheimer’s disease (AD), analysis of the results of open-label trials becomes crucial. This study aimed to explore the three-year effects of galantamine treatment, as well as subgroups of response and adherence to treatment. METHODS: Two hundred and eighty patients with a clinical diagnosis of AD were included in the prospective, open-label, multicenter Swedish Alzheimer Treatment Study, and received galantamine treatment. Efficacy measures included cognitive tests, ie, the Mini-Mental State Examination (MMSE) and Alzheimer’s Disease Assessment Scale Cognitive Subscale (ADAS-cog), functional rating (Instrumental Activities of Daily Living Scale [IADL]), and global rating. Assessments were carried out before treatment and every six months for a period of three years. K-means cluster analysis was used to identify response subgroups. RESULTS: After three years of treatment, the mean change from baseline was 2.6 points in MMSE and 5.6 points in ADAS-cog scores. Globally, half of the patients improved or remained unchanged for two years. Cluster analysis identified two response clusters. Cluster 1 included patients with low ability in ADAS-cog and IADL scores at baseline. Even though the patients in cluster 1 were older and less educated, they responded better at six months compared with patients in cluster 2. Cluster 2 included patients with better ADAS-cog and IADL scores at baseline. Patients in cluster 2 had a higher frequency of the APOE ɛ4 allele, a slower pretreatment progression rate, and remained in the study longer than those in cluster 1. Three-year completers (n = 129, 46%) received higher doses of galantamine compared with dropouts. CONCLUSION: AD patients who received long-term galantamine treatment were cognitively and globally stabilized. Subgroup response analysis identified a better short-term response in older patients with lower cognitive and functional abilities at baseline, a faster pretreatment progression rate, and a lower incidence of the APOE ɛ4 allele. The galantamine dose was higher in the population of completers. |
format | Online Article Text |
id | pubmed-3191869 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2011 |
publisher | Dove Medical Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-31918692011-10-14 Galantamine treatment in Alzheimer’s disease: response and long-term outcome in a routine clinical setting Wallin, Åsa K Wattmo, Carina Minthon, Lennart Neuropsychiatr Dis Treat Original Research BACKGROUND: In the absence of long-term, placebo-controlled studies of cholinesterase inhibitors in Alzheimer’s disease (AD), analysis of the results of open-label trials becomes crucial. This study aimed to explore the three-year effects of galantamine treatment, as well as subgroups of response and adherence to treatment. METHODS: Two hundred and eighty patients with a clinical diagnosis of AD were included in the prospective, open-label, multicenter Swedish Alzheimer Treatment Study, and received galantamine treatment. Efficacy measures included cognitive tests, ie, the Mini-Mental State Examination (MMSE) and Alzheimer’s Disease Assessment Scale Cognitive Subscale (ADAS-cog), functional rating (Instrumental Activities of Daily Living Scale [IADL]), and global rating. Assessments were carried out before treatment and every six months for a period of three years. K-means cluster analysis was used to identify response subgroups. RESULTS: After three years of treatment, the mean change from baseline was 2.6 points in MMSE and 5.6 points in ADAS-cog scores. Globally, half of the patients improved or remained unchanged for two years. Cluster analysis identified two response clusters. Cluster 1 included patients with low ability in ADAS-cog and IADL scores at baseline. Even though the patients in cluster 1 were older and less educated, they responded better at six months compared with patients in cluster 2. Cluster 2 included patients with better ADAS-cog and IADL scores at baseline. Patients in cluster 2 had a higher frequency of the APOE ɛ4 allele, a slower pretreatment progression rate, and remained in the study longer than those in cluster 1. Three-year completers (n = 129, 46%) received higher doses of galantamine compared with dropouts. CONCLUSION: AD patients who received long-term galantamine treatment were cognitively and globally stabilized. Subgroup response analysis identified a better short-term response in older patients with lower cognitive and functional abilities at baseline, a faster pretreatment progression rate, and a lower incidence of the APOE ɛ4 allele. The galantamine dose was higher in the population of completers. Dove Medical Press 2011 2011-09-30 /pmc/articles/PMC3191869/ /pubmed/22003296 http://dx.doi.org/10.2147/NDT.S24196 Text en © 2011 Wallin et al, publisher and licensee Dove Medical Press Ltd. This is an Open Access article which permits unrestricted noncommercial use, provided the original work is properly cited. |
spellingShingle | Original Research Wallin, Åsa K Wattmo, Carina Minthon, Lennart Galantamine treatment in Alzheimer’s disease: response and long-term outcome in a routine clinical setting |
title | Galantamine treatment in Alzheimer’s disease: response and long-term outcome in a routine clinical setting |
title_full | Galantamine treatment in Alzheimer’s disease: response and long-term outcome in a routine clinical setting |
title_fullStr | Galantamine treatment in Alzheimer’s disease: response and long-term outcome in a routine clinical setting |
title_full_unstemmed | Galantamine treatment in Alzheimer’s disease: response and long-term outcome in a routine clinical setting |
title_short | Galantamine treatment in Alzheimer’s disease: response and long-term outcome in a routine clinical setting |
title_sort | galantamine treatment in alzheimer’s disease: response and long-term outcome in a routine clinical setting |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3191869/ https://www.ncbi.nlm.nih.gov/pubmed/22003296 http://dx.doi.org/10.2147/NDT.S24196 |
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