The prediction of response to galantamine treatment in patients with mild to
moderate Alzheimer's disease.
Author(s): Ohnishi T, Sakiyama Y, Okuri Y, Kimura Y, Sugiyama N, Saito T, Takahashi M,
Kobayashi T(1).
Affiliation(s): Author information:
(1)Scientific Affairs Division, CNS Science Department, Janssen Pharmaceutical
K.K., 5-2, Nishi-kanda 3-chome, Chiyoda-ku, Tokyo 101-0065, Japan.
tohnish8@its.jnj.com.
Publication date & source: 2014, Curr Alzheimer Res. , 11(2):110-8
The prediction of efficacy in long-term treatment of acetylcholinesterase
inhibitors (AChEIs) is a major clinical issue, although no consistently strong
predictive factors have emerged thus far. The present analyses aimed to identify
factors for predicting long-term outcome of galantamine treatment. Analyses were
conducted with data from a 24 weeks randomized, double-blind, placebo controlled
trial to evaluate the efficacy and the safety of galantamine in the treatment of
303 patients with mild to moderate AD. Patients were divided into responders (4
or more point improvement of ADAScog scores at 24 weeks of treatment) and
non-responders. We explored whether patients' background (e.g. sex, age, and
duration of disease) and scores of cognitive scales at early stage, are relevant
to the long-term response to AChEIs. Predictive values were estimated by the
logistic regression model. The responder rate was 31.7%. We found that changes in
scores of ADAS-J cog subscales between week 4 and baseline, especially word
recognition, can be a good variable to predict subsequent response to
galantamine, with approximately 75% of predictive performance. Characteristics of
patients, including demographic characteristics, severity of disease and
neuropsychological features before treatment were poorly predictive. The present
study indicate that initial response to galantamine administration in patients
with mild to moderate AD seems to be a reliable predictor of response of
consequent galantamine treatment. Patients who show improvement of episodic
memory function during the first 4 weeks of galantamine administration may be
likely to particularly benefit from galantamine treatment.
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