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P2‐033: ASSOCIATION BETWEEN LATER DISCONTINUATION OF DONEPEZIL AND PENTAGON COPYING TASK IN AD PATIENTS: A RANDOMIZED CONTROLLED TRIAL IN JAPAN
Author(s) -
Kamei Tetsumasa,
Kobayashi Hiroyuki,
Nishimoto Shohei
Publication year - 2019
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.2019.06.1255
Subject(s) - discontinuation , donepezil , medicine , randomized controlled trial , tolerability , outpatient clinic , clinical trial , physical therapy , pediatrics , dementia , disease , adverse effect
below baseline level after 9 months’ treatment. We conducted an observational study to see whether the STEP regimen, a sequential therapy based on the evolvement of pattern defined by traditional Chinese medicine, combined with CT (CT+STEP) is better than CT alone (CT-STEP).Methods: This is a real-world study in which all participants were sampled in memory clinics at local hospitals. AD patients involved were selected from the outpatient registration systems. In CT+STEP group, donepezil was used for mild to severe AD patients but memantine for moderate and severe AD patients, meanwhile plus the STEP regimen. Outcome measures included mini-mental state examination (MMSE), neuropsychiatric inventory (NPI), activities of daily living (ADLs) as well as clinical dementia rating (CDR). Results: A total of 162 AD patients with baseline data were involved, of which 110 received the CT+STEP. At 12 months, the MMSE remained stable in the CT+STEP group, while the CT-STEP group showed a significant decrease, with a 4.00 points of difference from baseline (95% CI: 2.53 to 5.46, P < 0.001) and a 3.54 points of difference between two groups (95%CI: 1.77 to 5.32, P< 0.001). In the first 6 months of treatment, there was no significant difference in NPI between the two groups, but at 9 and 12 months, significant differences were found (4.76, 95%CI: -0.08 to 9.62, P1⁄40.001) and 3.89 (95%CI: -1.60 to 9.39, P1⁄4 0.003), respectively, which appeared to be time-dependent. Conclusions: The STEP regimen with conventional therapies has a certain synergistic effect on the improvement of symptoms for AD, which not only maintains cognitive stability relatively, but also plays a role in neuropsychiatric symptoms at least within a year.