Treatment with Reminyl® (galantamine hydrobromide) may slow the progression of mild to moderate Alzheimer’s disease by 50 to 60 percent when used continuously for 48 months, according to a new study presented at the 156th Annual Meeting of the American Psychiatric Association.
The data showed that more than 12 percent of patients did not deteriorate at all. While the remaining patients showed varying degrees of deterioration, the investigators concluded that it was less than would be expected in an untreated Alzheimer’s disease population. With 240 patients evaluated over the full 48 months, this is the largest long-term study of its kind.
“This study provides additional evidence that long-term therapy with Reminyl can have long-term benefits, by delaying the natural rate of decline,” said Luc Truyen, M.D., Ph.D., Senior Director, Clinical Development, CNS, Johnson & Johnson Pharmaceutical Research & Development (J&JPRD), and a study co-author. “For participants in this four-year study, cognitive decline was significantly delayed compared to the natural rate of decline in untreated patients.”
Dr. Truyen noted that Alzheimer’s disease typically progresses over the course of 10 years, and that the data showed continuous benefit from Reminyl during the entire four-year period.
The study consisted of open-label extensions of two double-blind, placebo- controlled trials. Patients received 24 to 32 mg of Reminyl daily during the initial three to six month blinded portions of the research; during the open-label extensions, the 240 patients received 24 mg of Reminyl every day.
The research focused on patients’ cognitive performance, which includes the ability to think, reason and learn. Among participants receiving Reminyl, scores on the cognitive portion of the Alzheimer’s Disease Assessment Scale (ADAS-cog) deteriorated 12.8 points. This compares to an expected decline of 24 to 36 points for untreated patients, based on the Stern equation, a standard measurement of cognitive decline in people with Alzheimer’s disease.
Reminyl is thought to inhibit an enzyme that breaks down acetylcholine — a neurotransmitter in the brain that plays a key role in memory and learning. In addition, it is believed that Reminyl modulates the brain’s nicotinic receptors, to which acetylcholine binds. The clinical significance of these mechanisms is unknown.
“These findings should give Alzheimer’s disease patients and caregivers hope that the progression of symptoms in this disabling disorder can be slowed for many sufferers, an important consideration as families and patients focus on getting the most out of the time they have,” said Gordon Wilcock, Professor of Care of The Elderly, University of Bristol, UK, and a study investigator.