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P1‐460: Effect of switching treatment with galantamine in patients with mild‐to‐moderate Alzheimer's disease
Author(s) -
Hwang Taeyoung
Publication year - 2010
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1016/j.jalz.2010.05.1016
Subject(s) - galantamine , donepezil , medicine , activities of daily living , alzheimer's disease , cognition , psychology , cholinesterase , dementia , disease , psychiatry
Background: The purpose of this study is to investigate the effect of switching treatment with galantamine in patients with Alzheimer’s disease (AD) who showed a lack of efficacy to other cholinesterase inhibitor (ChEI). Methods: Seventy patients with probable AD of mild-to-moderate severity were recruited for this 52-week, single-blind, prospective study. A total of 66 patients satisfied the criteria for the Intent-to-treat (ITT) analysis, and were classified into two groups, the drug-naı̈ve group (n 1⁄4 42) and the switched group (n 1⁄4 24). The switched group targeted patients who had shown a lack of efficacy after at least 6 months of treatment with donepezil. The primary outcome measures were the response rate after 26 weeks of treatment and the change on a Korean version of the Alzheimer’s Disease Assessment Scale-cognitive subscale (K-ADAS-cog). Secondary outcomes were measured using a Korean version of the Mini-Mental State Examination (K-MMSE), Seoul-Activities of Daily Living (S-ADL), Seoul-Instrumental Activities of Daily Living (S-IADL) and Korean version of the Neuropsychiatric Inventory (K-NPI). Results: There were no significant between-group differences in the response rate to galantamine (71.4% for the naı̈ve group vs. 58.3% for the switched group; c 1⁄4 1.178, df 1⁄4 1, p 1⁄4 0.277) and the adjusted change on the cognitive scales (K-ADAScog, K-MMSE) and non-cognitive scales (S-IADL, S-ADL, and K-NPI) at each point of evaluation. Stratification analysis by severity showed that if the duration of illness is constant, the probability of response is significantly higher in the naı̈ve group than in the switched group only at moderate severity (c 1⁄4 4.09, df 1⁄4 1, p-value 1⁄4 0.043; multiple logistic regression for the adjustment of between-group difference in duration of illness), but not at mild severity. Conclusions: The findings of this study suggest that previous exposure to other ChEI does not preclude the effect of switching treatment with galantamine on cognition, function, and behavior in the treatment of patients with mild-to-moderate AD, while switching treatment with galantamine may be more effective in the earlier stages of AD.