Mintzer J E, Kershaw P
Medical University of South Carolina, N Charleston, South Carolina, USA.
Int J Geriatr Psychiatry. 2003 Apr;18(4):292-7. doi: 10.1002/gps.826.
Acetylcholinesterase inhibitors (AChEIs) can provide benefits at the cognitive, behavioral, and functional levels to patients with Alzheimer's disease (AD). With more AChEIs now available, treatment considerations may include whether the patient has had prior exposure to an AChEI.
To compare the effects of galantamine in patients with AD who were previously exposed to AChEIs with its effects in patients with AD who had no previous exposure, using a post hoc analysis.
Patients in groups treated with galantamine 16 mg/day and 24 mg/day achieved statistically significant improvements in ADAS-cog/11 scores in comparison with those who received placebo (naive: p = 0.003 and 0.005, respectively; prior exposure: p < 0.001 and 0.001, respectively). Similarly, a greater number of patients treated with galantamine 16 mg/day and 24 mg/day exhibited no change or improvement in their CIBIC-plus scores compared to patients who received placebo (naive: p < 0.001 and p = 0.077, respectively; prior exposure: p = 0.005 and p = 0.001, respectively). There were no significant differences in adverse events between naive patients and those with prior exposure to AChEIs.
Galantamine is effective and safe in patients with AD, regardless of previous exposure to AChEIs.
乙酰胆碱酯酶抑制剂(AChEIs)可在认知、行为和功能水平上使阿尔茨海默病(AD)患者获益。随着更多的AChEIs问世,治疗时需要考虑的因素可能包括患者是否曾接触过AChEI。
通过事后分析比较加兰他敏对既往接触过AChEIs的AD患者和未接触过AChEIs的AD患者的疗效。
与接受安慰剂的患者相比,接受16毫克/天和24毫克/天加兰他敏治疗的患者在ADAS-cog/11评分上有统计学显著改善(未接触过:p分别为0.003和0.005;既往接触过:p分别<0.001和0.001)。同样,与接受安慰剂的患者相比,接受16毫克/天和24毫克/天加兰他敏治疗的更多患者在CIBIC-plus评分上无变化或有所改善(未接触过:p分别<0.001和0.077;既往接触过:p分别为0.005和0.001)。未接触过AChEIs的患者与既往接触过AChEIs的患者在不良事件方面无显著差异。
无论患者既往是否接触过AChEIs,加兰他敏对AD患者均有效且安全。