Early promise for dementia drug

Encouraging short-term results of a randomised trial in this weeks issue of THE LANCET suggest that the drug galantamine could offer therapeutic benefits to people with Alzheimers disease with cerebrovascular disease and in those with probable vascular dementia.

Vascular dementiadementia caused by multiple strokes or other cerebrovascular damageis the second commonest form of dementia after Alzheimers disease (AD); furthermore, vascular factors contribute to the development of dementia in many patients with AD. The drug galantamine has been shown to offer benefit (in relation to cognition, behaviour, and in improving daily living activities) in patients with AD. Timo Erkinjuntti from Helsinki University Central Hospital, Finland, and colleagues report results from an international study which investigated the effects of galantamine in patients with a diagnosis of probable vascular dementia or AD combined with cerebrovascular disease.

Around 600 patients were randomly assigned galantamine 24 mg/day or placebo in a multicentre, 6-month trial. Primary endpoints were cognition (assessed by the AD assessment scale, cognitive subscale [ADAS-cog]) and global functioning (clinicians interview-based impression of change plus caregiver input [CIBIC-plus]). Daily living activities and behavioural symptoms were also assessed.

After six months, patients given galantamine improved by 1.7 points on the ADAS-cog scale, whereas those on placebo deteriorated by an average of 1 point. 74% of patients given galantamine were stable according to the CIBIC-plus scale compared with 59% of patients given placebo. Activities of daily living and behavioural symptoms were also significantly improved compared with placebo.

Timo Erkinjuntti comments: Galantamine, being equally effective in dementia due to Alzheimers disease and in dementia due to cerebrovascular disease, provides a treatment option to a broad range of patients for whom little pharmaco

Contact: Richard Lane

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