Edwards Keith R, Hershey Linda, Wray Laura, Bednarczyk Edward M, Lichter David, Farlow Martin, Johnson Stewart
Alzheimer's Diagnostic and Treatment Center, Neurological Research Center, Bennington, Vt. 05201, USA.
Dement Geriatr Cogn Disord. 2004;17 Suppl 1:40-8. doi: 10.1159/000074681.
Observations on the neurochemistry of dementia with Lewy bodies (DLB) have suggested that cholinesterase inhibitors (ChEIs) might be beneficial in treating some clinical symptoms of DLB. A 24-week, multicenter open-label study was designed to assess the safety and efficacy of the ChEI galantamine in patients with DLB, and an interim analysis of results was performed at 12 weeks. Efficacy analyses were performed on data from 25 patients. Scores on the Neuropsychiatric Inventory (NPI-12) improved (decreased) by 7.52 points over the 12 weeks (marginally significant, p = 0.061). NPI-12 scores decreased by half in 12 of the 25 patients. Highly significant improvement was observed in scores on the NPI-4 subscale (delusions, hallucinations, apathy, and depression: p = 0.003). Scores on the Clinician's Global Impression of Change (CGIC) improved by 0.95 points (significant, p = 0.02). Improvements also were found in secondary efficacy variables, including cognitive, functional, activities of daily living, sleep and confusion assessments. Motor scores, as measured by the UPDRS motor subscale, showed mild improvement, which demonstrates that galantamine has no adverse effect on parkinsonian symptoms. Adverse events generally were transient and of mild-to-moderate intensity. Two of the 25 patients discontinued galantamine because of nausea and anorexia. One serious adverse event was recorded, but it was judged to be unrelated to the study medication.
对路易体痴呆(DLB)神经化学的观察表明,胆碱酯酶抑制剂(ChEIs)可能有助于治疗DLB的某些临床症状。一项为期24周的多中心开放标签研究旨在评估ChEI加兰他敏对DLB患者的安全性和疗效,并在12周时进行了中期结果分析。对25名患者的数据进行了疗效分析。在12周内,神经精神科问卷(NPI - 12)评分改善(降低)了7.52分(接近显著,p = 0.061)。25名患者中有12名患者的NPI - 12评分降低了一半。在NPI - 4子量表(妄想、幻觉、淡漠和抑郁)评分中观察到高度显著的改善(p = 0.003)。临床医生总体印象变化量表(CGIC)评分提高了0.95分(显著,p = 0.02)。在次要疗效变量方面也发现了改善,包括认知、功能、日常生活活动、睡眠和意识模糊评估。由统一帕金森病评定量表运动子量表测量的运动评分显示有轻度改善,这表明加兰他敏对帕金森症状没有不良影响。不良事件一般为短暂性,强度为轻度至中度。25名患者中有2名因恶心和厌食停用了加兰他敏。记录到1例严重不良事件,但判定与研究用药无关。