Long-term tacrine (Cognex) treatment: Effects on nursing homeplacement and mortality
D. Knopman
Bok Engelsk 1996
| Utgitt | 1996
|
|---|---|
| Omfang | Side 166- 177
|
| Opplysninger | Objective: To assess the possible association between tacrine(Cognex, manufactured by Parke-Davis, Morris Plains, NJ) dose andlikelihood of nursing home placement (NHP) or death in patients withAD. Design: A 30-week, randomized, double-blind, placebo-controlled,parallel-group multicenter clinical trial involving 663 patients,after which patients were treated openly and followed up a minimum of2 gears later. Patients: At baseline, outpatients were at least 50years of age, met criteria for probable AD, with baseline Mini-MentalState Examination scores between 10 and 26 (inclusive), wereotherwise healthy, and had a caregiver who could provide assessmentsand ensure medication compliance. Interventions: Randomizedassignment to placebo or one of three ascending dosage regimens oftacrine over 30 weeks, followed by open label treatment for allpatients who began the double-blind trial. Outcome measures: NHP anddeath were examined using logistic regression. Results: Patients whoremained on tacrine and were receiving doses > 80 mg/d or, 120 mg/dwere less likely to have entered a nursing home than patients onlower doses (odds ratios > 2.7, 2.8, respectively.) There was a bendfor lower mortality for patients receiving > 120 mg/d (p = 0.063).Conclusions: Treatment with tacrine at doses > 80 mg/d was associatedwith a reduced likelihood of NHP. These data demonstrate thattacrine's 30-week effects on cognitive function and clinicians'global ratings may generalize to effects on a major milestone of AD.Future studies should attempt to replicate these findingsprospectively.
|
| Emner |
