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- W2009173697 abstract "Patients who present with Alzheimer's disease (AD) or mild cognitive impairment (MCI) due to AD have life expectancies of many years. However, very little controlled data on the effects of ChEIs beyond one year are available. Therefore, randomized, controlled studies of biomarkers, and long-term placebo-controlled studies of ChEIs in AD and MCI were sought. A literature review identified randomized biomarker or long-term placebo-controlled studies of ChEIs in AD or MCI. In a 13-week, randomized study of the ChEIs in 63 AD patients, donepezil markedly elevated CSF acetylcholinesterase enzyme (+215.2%). (Nordberg 2009) Galantamine increased AChE to slightly above the normal range (+51.2%) Rivastigmine produced a decrease (-21.8%). Donepezil significantly increased CSF tau and ptau from baseline. Galantamine increased Aβ1–42 and decreased ptau, both relative to rivastigmine (see figure). Galantamine reduced whole brain atrophy in MCI patients by 33% at two years. (Scheltens 2004) It is not approved or recommended for MCI. Donepezil did not significantly affect whole brain volume at 2.5 years, nor did rivastigmine up to four years. (Jack 2008, Feldman 2007)In randomized, placebo-controlled MCI studies, the ratios of donepezil-treated to placebo-treated patients converting to AD were: .12, .67, .88, 1.75, 1.33, 2.2 at 6, 12, 18, 24, 30 and 36 months. (Petersen 2004) The corresponding ratios for galantamine (24 months) were: .73, .81, .69, .83, and for rivastigmine (48 months): 1.0, .41, 1.53, .66, .91, 1.65, .87, 1.0. (Winblad 2008, Feldman 2007) In controlled two-year studies in AD, donepezil produced a slight cognitive effect (AD Collaborative Group 2004); rivastigmine and donepezil behaved similarly. (Bullock 2005) In a 3 mo head-to-head study in AD, galantamine improved CSF ptau and Aβ1–42 vs rivastigmine. Donepezil worsened tau and ptau." @default.
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- W2009173697 date "2012-07-01" @default.
- W2009173697 modified "2023-09-27" @default.
- W2009173697 title "P1-026: Biomarker and long-term effects of cholinesterase inhibitors in Alzheimer's disease and MCI" @default.
- W2009173697 doi "https://doi.org/10.1016/j.jalz.2012.05.301" @default.
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