Ging-Yuek Robin Hsiung1, Howard H Feldman. 1. University of British Columbia, Division of Neurology, Department of Medicine, S162 -2211 Wesbrook Mall, Vancouver, BC, V6T 2B5, Canada. hsiung@interchange.ubc.ca
Abstract
BACKGROUND: Moderate-to-severe stage Alzheimer's disease (AD) is a clinically diagnosable entity that represents a substantial burden to our healthcare system in terms of its prevalence, symptomatology, caregiver stress and economics. OBJECTIVE: In this paper, we review the data from currently available clinical trials aimed at treatment of this later stage of the disease. METHODS: A literature search was performed and published randomized controlled trials (RCTs) in which the majority of the study population consisted of Alzheimer patients in the moderate-to-severe stage were selected for review. RESULTS: A total of nine RCTs were identified in which the study population consisted of mainly moderate-to-severe AD patients. The results from these studies suggest that memantine and donepezil, individually or in combination, provide measurable global, cognitive and behavioral benefits in AD patients. CONCLUSION: Pharmacological treatment of moderate-to-severe AD patients can be beneficial. However, cost-benefit data are limited, and the long-term effects and the optimal duration of treatment as patients continue to progress to more severe stages are unknown and require further investigation.
BACKGROUND: Moderate-to-severe stage Alzheimer's disease (AD) is a clinically diagnosable entity that represents a substantial burden to our healthcare system in terms of its prevalence, symptomatology, caregiver stress and economics. OBJECTIVE: In this paper, we review the data from currently available clinical trials aimed at treatment of this later stage of the disease. METHODS: A literature search was performed and published randomized controlled trials (RCTs) in which the majority of the study population consisted of Alzheimerpatients in the moderate-to-severe stage were selected for review. RESULTS: A total of nine RCTs were identified in which the study population consisted of mainly moderate-to-severe ADpatients. The results from these studies suggest that memantine and donepezil, individually or in combination, provide measurable global, cognitive and behavioral benefits in ADpatients. CONCLUSION: Pharmacological treatment of moderate-to-severe ADpatients can be beneficial. However, cost-benefit data are limited, and the long-term effects and the optimal duration of treatment as patients continue to progress to more severe stages are unknown and require further investigation.
Authors: Antoni Camins; Felix Junyent; Ester Verdaguer; Carlos Beas-Zarate; Argelia E Rojas-Mayorquín; Daniel Ortuño-Sahagún; Mercè Pallàs Journal: Pharmaceuticals (Basel) Date: 2009-12-15