The Predictive Factors of Good Clinical Response to Cholinesterase Inhibitors in Alzheimer Disease and Mixed Dementia
Status:
Completed
Trial end date:
2013-03-01
Target enrollment:
Participant gender:
Summary
Background and objectives: The aims of this naturalistic study were: to analyze factors which
could be predictive of good response to cholinesterase inhibitors (ChEI), such as: age, sex,
schooling, mild (CDR 1) or moderate Alzheimer's disease (AD),(CDR 2), Apoliprotein epsilon 4
(APOE Ɛ4), among others, in their cognitive and clinical response. We also classified
patients according to their response to Mini mental State of Examination (MMSE). Finally we
saw the polymorphisms of APO E and cytochrome P450 2D6 (CYP2D6) and tried to correlate the
response with different allelic forms of Apo E and among others with wild type homozygotes
(wt/wt) and their polymorphisms (CYP2D6*3,*4, *5, *6 and 10) of CYP 2D6.
Patients and Methods: 129 patients were diagnosed as AD or AD+cerebrovascular disease (CVD)
mild or moderate. After 12 month-treatment, 97 patients completed the study. They were
assessed (four) times. In the first visit, without taking ChEI, after 3, 6 and 12
month-treatment, they were taking donepezil or rivastigmine or galantamine. We also extracted
5 mL of blood sample to genotype the DNA. In each visit, we applied cognitive, functional,
mood and behavior scales. Good responders were defined as those who scored > 2 in MMSE.
Results and Conclusion: In longitudinal analysis, patients with mild AD and good responders
at 3 months were considered good responders at 12 months. We obtained a higher rate of good
responders comparing with other researches (27.8%). There was no correlation between dose,
APOE and CYP 2D6 polymorphisms, although we already obtained clinical results with the dose
dosage of 5mg.