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P3‐297: Stability in cognitive and neurobehavioral assessments between screen and baseline in an Alzheimer's disease trial
Author(s) -
Pendergrass Jo Cara,
Targum Steven D.,
Drake Kristen,
Fosdick Lisa,
Lyketsos Constantine,
Munro Cynthia,
Smith Gwenn S.,
Lozano Andres M.
Publication year - 2015
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.2015.06.1670
Subject(s) - clinical dementia rating , medicine , dementia , clinical trial , rating scale , psychology , disease , developmental psychology
Background:Cholinesterase inhibitors (ChEIs), Donepezil, Galantamine, and Rivastigmine are first-line drugs for the treatment of Alzheimer’s disease (AD) patients. Donepezil and Galantamine inhibit acetylcholinesterase. Rivastigmine can block both acetylcholinesterase and butyrylcholinesterase. ChEIs improve the cognitive function of AD patients. However, ChEIs sometimes cause adverse effects including diarrhea, nausea, vomiting, and bradycardia. We hypothesized that low creatinine clearance (Clcr) should be the risk factor of adverse effects by ChEIs. Usually, ChEIs reduce serum cholinesterase (ChE) levels. Therefore, we examined an association between the reduction of serum ChE levels and Clcr among the AD patients who underwent ChEIs therapy. Methods: Three hundred fifty one AD patients (168 men, 183 women, mean age: 75.8 6 9.6) were enrolled in this study. Body weight (BW), serum creatinine (cr), and serum ChE were examined. Clcr was estimated by the Cockcroft-Gault (CG) equation. The degree of reduction of ChE after ChEIs therapy, Donepezil, Galantamine, or Rivastigmine was also compared. Statistical analysis was performed by using PASW Statistics 18 (SPSS Inc., Chicago, IL, USA), with p < 0.05 considered significant. Results:Average reduction ratio of ChE by ChEIs, Donepezil, Galantamine, and Rivastigmine were 0.865, 0.9435, and 0.6845, respectively (ANOVA, P<0.001). Unexpectedly, there was no correlation between the reduction ratio of ChE and Clcr. Conclusions:There was no correlation between reduction ratio of ChE and Clcr after ChEs therapy. However, Rivastigmine lowered serum ChE most among the three ChEIs. This result implies that serum butyrylcholinesterase was inhibited by Rivastigmine.