Document Detail


Is long-term treatment of Alzheimer's disease with cholinesterase inhibitor therapy justified?
MedLine Citation:
PMID:  17953456     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The cholinesterase inhibitors (ChEIs) donepezil, rivastigmine and galantamine are the current mainstays in the drug treatment of Alzheimer's disease (AD). There is convincing evidence that these agents provide at least modest cognitive, behavioural and functional benefit for 6-12 months at all stages of the disease. Longer term benefits cannot be directly examined by placebo-controlled trials. Nevertheless, the results of virtually all open-label extensions of the pivotal trials, studies of patients with AD at different levels of severity and clinical trials using other designs favour treatment over no treatment for periods of up to 5 years. There are plausible biological reasons why ChEIs might be expected to work over a prolonged period of time although, to date, studies using various markers to chart the effects of medication on long-term disease progression have yielded mixed results. The most contentious issue regarding long-term treatment is economic, but the majority of available economic analyses suggest net savings over the long term if patients with AD receive persistent treatment with ChEIs.
Authors:
Ben Seltzer
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Drugs & aging     Volume:  24     ISSN:  1170-229X     ISO Abbreviation:  Drugs Aging     Publication Date:  2007  
Date Detail:
Created Date:  2007-10-23     Completed Date:  2008-01-24     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9102074     Medline TA:  Drugs Aging     Country:  New Zealand    
Other Details:
Languages:  eng     Pagination:  881-90     Citation Subset:  IM    
Affiliation:
Department of Neurology, Harvard Medical School, Boston, Massachusetts, USA. bseltzer@partners.org
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MeSH Terms
Descriptor/Qualifier:
Aged / physiology*
Alzheimer Disease / drug therapy*,  economics,  physiopathology
Cholinesterase Inhibitors / economics,  pharmacology,  therapeutic use*
Clinical Trials as Topic
Humans
Chemical
Reg. No./Substance:
0/Cholinesterase Inhibitors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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