Knopman D S
University of Minnesota Medical School, Minneapolis, USA.
Geriatrics. 1998 Sep;53 Suppl 1:S31-4.
This brief overview will describe some of the current anti-Alzheimer's disease (AD) agents. The relevance of the cholinergic deficit in AD is well-established. Cholinesterase inhibitor (CEI) drugs represent the only FDA-approved primary treatment options for AD as of April 1998. Modest efficacy for AD now has been shown in well-designed clinical trials for six separate CEI agents. Only two, tacrine and donepezil, are currently on the market in the United States, but several others, including rivastigmine (ENA-713), metrifonate, and physostigmine-CR could be available by the end of 1998. Three other treatment strategies are being pursued. Estrogen replacement therapy as a treatment for AD in postmenopausal women is under active investigation. Analogously, clinical studies provide evidence that individuals using anti-inflammatory agents have a lower probability of developing AD. The success of alpha-tocopherol and selegiline in a recently conducted 2-year, double-blinded, placebo-controlled trial supports the hypothesis that oxidative stress plays a role in AD.
本简要概述将介绍一些当前的抗阿尔茨海默病（AD）药物。AD中胆碱能缺陷的相关性已得到充分证实。截至1998年4月，胆碱酯酶抑制剂（CEI）药物是美国食品药品监督管理局（FDA）批准的唯一用于AD的主要治疗选择。在针对六种不同CEI药物进行的精心设计的临床试验中，现已显示出对AD有一定疗效。目前在美国市场上销售的只有他克林和多奈哌齐两种，但包括利凡斯的明（ENA - 713）、美曲膦酯和毒扁豆碱控释制剂在内的其他几种药物可能在1998年底上市。另外三种治疗策略也在探索之中。绝经后女性使用雌激素替代疗法治疗AD正在积极研究中。类似地，临床研究表明使用抗炎药的个体患AD的可能性较低。α-生育酚和司来吉兰在最近一项为期2年的双盲、安慰剂对照试验中的成功支持了氧化应激在AD中起作用的假说。
