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Strategies for Continued Successful Treatment in Patients with 
Alzheimer’s Disease: An Overview of Switching Between Pharmacological Agents

INTRODUCTION: Alzheimer’s disease (AD) is the most common cause of dementia, characterized by a progressive decline in cognition and function. Current treatment options for AD include the cholines-terase inhibitors (ChEIs) donepezil, galantamine, and rivastigmine, as well as the N-methyl-D-aspartate...

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Autores principales: Blesa, Rafael, Toriyama, Kazuhiro, Ueda, Kengo, Knox, Sean, Grossberg, George
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Bentham Science Publishers 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6142408/
https://www.ncbi.nlm.nih.gov/pubmed/29895249
http://dx.doi.org/10.2174/1567205015666180613112040
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author Blesa, Rafael
Toriyama, Kazuhiro
Ueda, Kengo
Knox, Sean
Grossberg, George
author_facet Blesa, Rafael
Toriyama, Kazuhiro
Ueda, Kengo
Knox, Sean
Grossberg, George
author_sort Blesa, Rafael
collection PubMed
description INTRODUCTION: Alzheimer’s disease (AD) is the most common cause of dementia, characterized by a progressive decline in cognition and function. Current treatment options for AD include the cholines-terase inhibitors (ChEIs) donepezil, galantamine, and rivastigmine, as well as the N-methyl-D-aspartate receptor antagonist memantine. Treatment guidelines recommend the use of ChEIs as the standard of care first-line therapy. Several randomized clinical studies have demonstrated the benefits of ChEIs on cogni-tion, global function, behavior and activities of daily living. However, patients may fail to achieve sus-tained clinical benefits from ChEIs due to lack/loss of efficacy and/or safety, tolerability issues, and poor adherence to the treatment. The purpose of this review is to explore the strategies for continued successful treatment in patients with AD. METHODS: Literature search was performed for articles published in PubMed and MEDLINE, using pre-specified search terms. Articles were critically evaluated for inclusion based on their titles, abstracts, and full text of the publication. RESULTS AND CONCLUSION: The findings of this review indicate that dose up-titration and switching between ChEIs may help to improve response to ChEI treatment and also address issues such as lack/loss of effica-cy or safety/tolerability in patients with AD. However, well-designed studies are needed to provide robust evidence.
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spelling pubmed-61424082018-10-04 Strategies for Continued Successful Treatment in Patients with 
Alzheimer’s Disease: An Overview of Switching Between Pharmacological Agents Blesa, Rafael Toriyama, Kazuhiro Ueda, Kengo Knox, Sean Grossberg, George Curr Alzheimer Res Article INTRODUCTION: Alzheimer’s disease (AD) is the most common cause of dementia, characterized by a progressive decline in cognition and function. Current treatment options for AD include the cholines-terase inhibitors (ChEIs) donepezil, galantamine, and rivastigmine, as well as the N-methyl-D-aspartate receptor antagonist memantine. Treatment guidelines recommend the use of ChEIs as the standard of care first-line therapy. Several randomized clinical studies have demonstrated the benefits of ChEIs on cogni-tion, global function, behavior and activities of daily living. However, patients may fail to achieve sus-tained clinical benefits from ChEIs due to lack/loss of efficacy and/or safety, tolerability issues, and poor adherence to the treatment. The purpose of this review is to explore the strategies for continued successful treatment in patients with AD. METHODS: Literature search was performed for articles published in PubMed and MEDLINE, using pre-specified search terms. Articles were critically evaluated for inclusion based on their titles, abstracts, and full text of the publication. RESULTS AND CONCLUSION: The findings of this review indicate that dose up-titration and switching between ChEIs may help to improve response to ChEI treatment and also address issues such as lack/loss of effica-cy or safety/tolerability in patients with AD. However, well-designed studies are needed to provide robust evidence. Bentham Science Publishers 2018-10 2018-10 /pmc/articles/PMC6142408/ /pubmed/29895249 http://dx.doi.org/10.2174/1567205015666180613112040 Text en © 2018 Bentham Science Publishers https://creativecommons.org/licenses/by-nc/4.0/legalcode This is an open access article licensed under the terms of the Creative Commons Attribution-Non-Commercial 4.0 International Public License (CC BY-NC 4.0) (https://creativecommons.org/licenses/by-nc/4.0/legalcode), which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.
spellingShingle Article
Blesa, Rafael
Toriyama, Kazuhiro
Ueda, Kengo
Knox, Sean
Grossberg, George
Strategies for Continued Successful Treatment in Patients with 
Alzheimer’s Disease: An Overview of Switching Between Pharmacological Agents
title Strategies for Continued Successful Treatment in Patients with 
Alzheimer’s Disease: An Overview of Switching Between Pharmacological Agents
title_full Strategies for Continued Successful Treatment in Patients with 
Alzheimer’s Disease: An Overview of Switching Between Pharmacological Agents
title_fullStr Strategies for Continued Successful Treatment in Patients with 
Alzheimer’s Disease: An Overview of Switching Between Pharmacological Agents
title_full_unstemmed Strategies for Continued Successful Treatment in Patients with 
Alzheimer’s Disease: An Overview of Switching Between Pharmacological Agents
title_short Strategies for Continued Successful Treatment in Patients with 
Alzheimer’s Disease: An Overview of Switching Between Pharmacological Agents
title_sort strategies for continued successful treatment in patients with 
alzheimer’s disease: an overview of switching between pharmacological agents
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6142408/
https://www.ncbi.nlm.nih.gov/pubmed/29895249
http://dx.doi.org/10.2174/1567205015666180613112040
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