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New Alzheimer's Drug Offers Hope for Dementia

  [ 30 votes ]   [ Discuss This Article ] • July 6, 2001

Scientific data presented at the seventeenth World Congress of Neurology show that the new Alzheimer’s drug, ReminylTM, is potentially effective in treating dementia in patients with cerebrovascular disease.

"This study has the potential to make a real impact on the way dementia is treated throughout the world," said Dr. Roger Bullock of the Kingshill Research Centre in Swindon, UK. "If the findings of this study are replicated through further research, physicians will no longer need to hesitate before treating dementia in individuals in whom vascular damage has occurred. Reminyl appears to be effective in treating dementia, whether or not cerebrovascular disease is present."

Reminyl improves memory, orientation, and language skills of patients with vascular dementia or a combination of Alzheimer's disease and cerebrovascular disease ("mixed" dementia) for at least 12 months.

The initial six-month, "double-blind" clinical study involved 592 patients diagnosed with vascular or mixed dementia, and received either 24mg per day of Reminyl (396) or placebo (196).
Of this group, 459 individuals (295 who had taken Reminyl and 164 who had previously received placebo) continued the research for another six months in an "open-label" extension of the study. All participants in the open-label extension took 24mg of Reminyl daily, in two divided doses.

At 12 months, the mental abilities of patients who had received Reminyl for the entire study period were better than when the individuals had commenced treatment.

The mental performance of patients who were originally assigned to take placebo had declined upon completion of the study's initial six months. However, after being switched to Reminyl, these patients' mental abilities improved; after the final six months, their performance was better than at the start of the study.

Over the course of the year, both groups of patients experienced deterioration in their ability to do tasks such as bathing, dressing and housework. However, the decline in the group receiving placebo for the first six months was more than double that of the group receiving Reminyl for the entire year.

In the study, Reminyl delayed emergence of hallucination, delusion, pacing and agitation symptoms in patients receiving active treatment for the entire study period, and alleviated such disturbances in individuals who were switched to Reminyl after six months' of placebo.

Reminyl is different from other Alzheimer's treatments that are currently available. In addition to inhibiting the breakdown of acetylcholine, a chemical in the brain critical to learning and memory, Reminyl has been shown in laboratory research to modulate "nicotinic receptors." It is believed that this results in the increased production of acetylcholine and other important chemicals in the brain.

In the overall study, Reminyl was generally well tolerated by patients. Most side effects were gastrointestinal in nature, of mild to moderate severity, and mainly confined to the period when the dose was being increased. Other research has shown that when the dose is increased at a slower rate, the occurrence of nausea and vomiting is not significantly greater than reported by patients taking placebo.

Results also showed that Reminyl improved or maintained the ability of these individuals to perform normal activities of daily living, such as bathing, dressing and doing housework. However, Reminyl is not yet approved for the treatment of vascular dementia.

Dementia is a decline in memory and intellectual abilities that results in a significantly impaired ability to function. The most common type of dementia is Alzheimer's disease. However, the second most common type is vascular dementia, which often is triggered by one or more strokes and can be caused by uncontrolled hypertension or diabetes.

World-wide incidence of vascular dementia is estimated at six to 12 cases per 1,000 people more than 70 years of age. Many other individuals have a mix of Alzheimer's and cerebrovascular disease. In fact, it is estimated that between 10 and 50 per cent of individuals have either vascular or mixed dementia. Unfortunately, these individuals are often unrecognized or untreated.

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