Donepezil preserves cognition and global function in patients with severe Alzheimer disease

Black, Sandra E.; Doody, Rachelle S.; Li, H; McRae, Thomas; Jambor, K M; Xu, Yichen; Sun, Yijun; Perdomo, Carlos; Richardson, Sharon

doi:10.1212/01.wnl.0000266627.96040.5a

Cited by 208 publications

(181 citation statements)

References 23 publications

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“…The available prescribing information does not provide specific safety information relating to severe AD. However, existing clinical data indicate that its profile is similar to that shown in mild to moderately severe AD, (Winblad et al, 2006;Black et al, 2007).…”

Section: Distribution Of Adverse Eventsmentioning

confidence: 82%

“…In spite of this, the AChEIs may differ in their individual profiles, as the SPCs report agitation as a common AE (1-10%) with donepezil and rivastigmine treatment but rare with galantamine (0.01-0.1%) (Aricept SPC, 2007;Reminyl Tablets SPC, 2007;Exelon Capsules SPC, 2008). Furthermore, AChEIs have not consistently demonstrated a specific benefit on agitation in dementia (Gauthier et al, 2002;Holmes et al, 2004;Sink et al, 2005;Black et al, 2007;Howard et al, 2007).…”

Section: Agitationmentioning

confidence: 99%

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A review comparing the safety and tolerability of memantine with the acetylcholinesterase inhibitors

Jones¹

2010

Int J Geriat Psychiatry

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Objective: Alzheimer's disease (AD) is prevalent among elderly people, who often have comorbid conditions, and may be prescribed multiple medications. Drug safety and tolerability is paramount in maximising efficacy and optimising patient and carer quality of life, as patients are vulnerable to adverse events (AEs) and/or compliance difficulties. The two principal categories of drug used in the treatment of AD are the acetylcholinesterase inhibitors (AChEIs) and the NMDA-receptor antagonist, memantine. This paper reviews the most recent safety data for memantine in comparison with the AChEIs. Design: Review of most recent safety/tolerability data for memantine and AChEIs, derived from metaanalyses, pooled analyses, European SPCs and EMEA publications. Results: Memantine was found to have a favourable tolerability profile when used as monotherapy or in combination with other agents. AChEIs were found to be fairly well tolerated. All treatments commonly or very commonly produce dizziness and/or headache. AChEIs are associated with many more types of AEs than memantine, particularly in the gastrointestinal category. Agitation is a less common AE when comparing memantine treatment to placebo, but just as common when comparing AChEI treatment to placebo. Withdrawals in memantine-treated groups are comparable to placebo, and more common in AChEI-treated groups compared to placebo. Overall, drug-drug interactions, contraindications and warnings were fewer for memantine than AChEIs. Conclusions: In both the clinical and naturalistic setting, memantine displays a safety and tolerability profile that is favourable and distinct from that of AChEIs. Safety and tolerability profiles should be given careful consideration when selecting treatment for AD patients.

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Section: Distribution Of Adverse Eventsmentioning

confidence: 82%

Section: Agitationmentioning

confidence: 99%

A review comparing the safety and tolerability of memantine with the acetylcholinesterase inhibitors

Jones¹

2010

Int J Geriat Psychiatry

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“…Three randomized controlled trials of cholinesterase inhibitors involving patients with moderate to severe Alzheimer disease [49][50][51] and 2 randomized controlled trials involving only patients with severe Alzheimer disease 52,53 suggested that this class of medication improves cognition, function, behaviour and global measures. The consensus conference recommends their use in patients with severe Alzheimer disease.…”

Section: Management Of Cognitive Declinementioning

confidence: 99%

“…52,53 The review suggested that effects noted in patients with severe Alzheimer disease were similar to those in patients with mild to moderate dementia, although this statement was based on only 2 trials. 49,50 Despite modest improvements in cognition and function, there is no evidence that cholinesterase inhibitors delay placement of patients in long-term care facilities.…”

Section: Management Of Cognitive Declinementioning

confidence: 99%

Diagnosis and treatment of dementia: 6. Management of severe Alzheimer disease

Herrmann¹,

Gauthier²

2008

Canadian Medical Association Journal

118

125

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“…Black et al 34 showed that participants with severe AD improved global function, as evidenced by a significant benefit on the CIBIC+ (P = .047) and maintained cognitive function with donepezil treatment for at least 6 months as shown on the SIB compared with an approximate 10% decline from baseline in participants receiving placebo. The benefits of donepezil over placebo were not evident on measures of ADL and behavior in this population.…”

mentioning

confidence: 99%

Donepezil: A Review of Pharmacological Characteristics and Role in the Management of Alzheimer Disease

Szigeti¹,

Zeb²,

Ahmed³

2017

CMGer

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ABSTRACT:We reviewed the literature on the pharmacological characteristics and role of donepezil in Alzheimer disease. We performed an evidence-based review of randomized controlled trials by searching sources such as PubMed, MEDLINE, Google Scholar, and Clinical Key. In total, 18 randomized clinical trials were identified. In amnestic mild cognitive impairment (MCI), data showed that donepezil delays progression to Alzheimer disease. However, for mild-to-moderate and moderate-to-severe Alzheimer disease, it proved effective in slowing cognitive and global function decline. Discontinuation of donepezil results in acceleration of disease progression. The effects of donepezil on behavioral symptoms have shown mixed outcomes. Donepezil is the standard of care in Alzheimer disease as it is well tolerated and has self-limiting gastrointestinal adverse effects. In amnestic MCI, off-label use of donepezil can be considered after risk stratification of conversion to Alzheimer disease.

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Donepezil preserves cognition and global function in patients with severe Alzheimer disease

Abstract: Patients with severe AD demonstrated greater efficacy compared to placebo on measures of cognition and global function.

Cited by 208 publications

References 23 publications

A review comparing the safety and tolerability of memantine with the acetylcholinesterase inhibitors

A review comparing the safety and tolerability of memantine with the acetylcholinesterase inhibitors

Diagnosis and treatment of dementia: 6. Management of severe Alzheimer disease

Donepezil: A Review of Pharmacological Characteristics and Role in the Management of Alzheimer Disease

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