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Donepezil ‘beneficial in severe Alzheimer’s’


Donepezil appears to be of continued benefit in patients with severe Alzheimer’s disease, research published in the New England Journal of Medicine suggests.

The drug, which has been recommended in patients with mild-moderate disease, is associated with cognitive benefits greater than the minimum clinically important difference over a year, the trial reveals.

The researchers say that the findings could result in twice as many Alzheimer’s patients across the world receiving treatment. It is of particular note as patent protection for Pfizer’s Aricept (donepezil) has recently ended in some markets.

Study lead author Professor Robert Howard, from King’s College London Institute of Psychiatry in the UK, told BBC News: “For the first time, we have robust and compelling evidence that treatment with these drugs can continue to help patients at more severe stages.

“Patients who continued taking donepezil were about four months ahead in how they were able to remember, communicate and perform daily tasks than those who stopped taking the drugs.”

The trail involved 295 patients with moderate or severe Alzheimer’s disease who had used donepezil for at least 3 months. Participants were assigned to continue donepezil therapy, discontinue donepezil, start memantine or memantine placebo, or receive both donepezil plus memantine.

Patients continued on donepezil achieved Standardized Mini-Mental State Examination (SMMSE) scores 1.9 points higher than those who discontinued donepezil. Patients assigned to memantine scored 1.2 SMMSE points higher those given memantine placebo. Donepezil plus memantine was not significantly better than memantine alone.

New England Journal of Medicine

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