Trials suggest benefit of donepezil in Alzheimer’s
Donepezil (Aricept) might be beneficial for people
with early Alzheimer’s disease for as long as a year, results of two studies
have indicated. In both trials, subjects were randomised to receive either
donepezil 10mg daily or placebo for one year.
The first study was undertaken by Dr Richard Mohs
of the Bronx VA Medical Centre, New York, and colleagues, who measured
the time to clinically evident decline in function in 431 patients. At
the end of the study, more patients who received placebo met the criteria
for clinically evident functional decline than those in the donepezil
group (56 per cent vs 41 per cent).
The median time to clinically evident functional
decline was 208 days in the placebo group (95 per cent confidence interval
[CI] 165 to 232 days) compared with 357 days in the people that received
donepezil (95 per cent CI lower limit 280 days). The authors suggest that
clinicians should aim for stability of symptoms rather than improvement
(Neurology 2001;57:481).
The second study was conducted by Dr Bengt Winblad
from the Karolinska Institute, Stockholm, and colleagues, and involved
286 patients with early Alzheimer’s disease. At weeks 24, 36 and 52, the
donepezil group did significantly better in a global assessment for rating
dementia symptoms than people taking placebo. In addition, the mean change
from baseline on the mini-mental state examination scale in the group
that received donepezil was less than that in the placebo group (ibid,
p489).
Both sets of investigators conclude that donepezil
is an effective treatment when given for one year or, possibly, longer.
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