Long-term tacrine (Cognex) treatment

Knopman, David S.; Schneider, Lon S.; Davis, Kenneth L.; Talwalker, Sheela; Smith, Fraser; Hoover, Toni M.; Gracon, Stephen I.

doi:10.1212/wnl.47.1.166

Cited by 276 publications

(116 citation statements)

References 12 publications

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“…Studies have evaluated the predictors of nursing home placement (NHP), while focusing on the effects of cholinesterase inhibitor use on NHP [33]. Two studies conducted in the U.S. found an inverse relationship between ChEI exposure and NHP; one study found that treatment decreased the risk of NHP [34], and the second study found that treatment with tacrine at doses greater than 80 mg/d was associated with a reduced likelihood of NHP [35]. Beusterien et al found that after controlling for known predictors of NHP such as age, number of co-morbidities and behaveioral disturbances, control participants were almost 3-fold as likely to be admitted to a nursing home than those taking rivastigmine [33].…”

Section: Discussionmentioning

confidence: 99%

Predictors of hospitalization and institutionalization in Medicaid patient populations with Alzheimer’s Disease

Adrienne¹,

Daniel²,

Terri³

et al. 2013

AAD

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Section: Discussionmentioning

confidence: 99%

Predictors of hospitalization and institutionalization in Medicaid patient populations with Alzheimer’s Disease

Adrienne¹,

Daniel²,

Terri³

et al. 2013

AAD

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“…As many as two thirds of patients fail to respond, however (26). Furthermore, it is unclear whether cholinesterase inhibitors exert only temporary effects on the course of AD, causing patients to improve at best to levels observed six to nine months earlier, or slow long-range progression as well (24).…”

Section: Effectiveness Of Current Treatmentmentioning

confidence: 99%

“…This would result in a shift away from institutional care, as has already been modestly demonstrated among patients treated with cholinesterase inhibitors (24). The net effect would be to increase the burden on families by requiring additional years of caregiving.…”

Section: Implications On Future Health Service Needs and Costsmentioning

confidence: 99%

The Public Health Impact of Alzheimer's Disease, 2000–2050: Potential Implication of Treatment Advances

Sloane

Zimmerman

Suchindran

et al. 2002

Annu. Rev. Public Health

396

279

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Key Words public health impact, Alzheimer's disease, Alzheimer's care s Abstract Recent developments in basic research suggest that therapeutic breakthroughs may occur in Alzheimer's disease treatment over the coming decades. To model the potential magnitude and nature of the effect of these advances, historical data from congestive heart failure and Parkinson's disease were used. Projections indicate that therapies which delay disease onset will markedly reduce overall disease prevalence, whereas therapies to treat existing disease will alter the proportion of cases that are mild as opposed to moderate/severe. The public health impact of such changes would likely involve both the amount and type of health services needed. Particularly likely to arise are new forms of outpatient services, such as disease-specific clinics and centers. None of our models predicts less than a threefold rise in the total number of persons with Alzheimer's disease between 2000 and 2050. Therefore, Alzheimer's care is likely to remain a major public health problem during the coming decades.

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“…AD2000, the only randomised controlled double-blind trial to directly address this question for donepezil was negative. 2 Observational studies, following patients who have participated in double-blind or open trials or received open label treatment with tacrine, 3 donepezil, 4 tacrine, donepezil or rivastigmine, 5,6 galantamine, 7 or memantine combined with a cholinesterase inhibitor 8 have reported positive results. These studies have been criticised as they have not involved randomisation, placebo-control or blinding of treatment allocation.…”

Section: Introductionmentioning

confidence: 99%

Nursing home placement in the Donepezil and Memantine in Moderate to Severe Alzheimer's Disease (DOMINO-AD) trial: secondary and post-hoc analyses

Howard

McShane

Lindesay

et al. 2015

The Lancet Neurology

134

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This version available at: http://eprints.lse.ac.uk/64656/ Available in LSE Research Online: December 2015 LSE has developed LSE Research Online so that users may access research output of the School. Copyright © and Moral Rights for the papers on this site are retained by the individual authors and/or other copyright owners. Users may download and/or print one copy of any article(s) in LSE Research Online to facilitate their private study or for non-commercial research. You may not engage in further distribution of the material or use it for any profit-making activities or any commercial gain. You may freely distribute the URL (http://eprints.lse.ac.uk) of the LSE Research Online website. This document is the author's final accepted version of the journal article. There may be differences between this version and the published version. You are advised to consult the publisher's version if you wish to cite from it. 3Nursing home placement in the donepezil and memantine in moderate to severe Alzheimer's disease (DOMINO) trial: secondary and post-hoc analyses of a randomised trial Structured abstractBackground: Observational studies have suggested delay in nursing home placement (NHP) with dementia drug treatment, but an earlier randomised trial in patients with mild to moderate Alzheimer's disease (AD) showed no effect. We investigated the effects of continuing or discontinuing donepezil and starting memantine on subsequent NHP in moderate to severe AD. Methods:In the DOMINO trial (ISRCTN49545034) 295 community living patients with moderate to severe AD recruited from 15 centres in England and Scotland from February 2008 to March 2010 were randomised with double-blind placebo-control to continue donepezil (73), discontinue donepezil (73), discontinue donepezil and start memantine (76), or continue donepezil and start memantine (73) for 52 weeks. After 52 weeks choice of treatment was left to participants and their physicians. Place of residence was recorded at outcomes assessment points during the first 52 weeks of the trial and subsequently every 26 weeks for a further 3 years. Nursing home placement was an irreversible move from independent accommodation to a residential caring facility and was a secondary trial endpoint. Analyses restricted to the risk of placement in the first year of follow-up were post-hoc.Findings: 162 patients (55%) underwent NHP within 4 years of randomisation. Numbers of NHPs were similar for all arms (36 in patients who continued donepezil, 42 who discontinued donepezil, 41 who discontinued donepezil and started memantine, and 43 who continued donepezil and started memantine). There was significant (p=0.010) heterogeneity of treatment effect over time with significantly more NHPs in the donepezil discontinuation group during the first year (HR 2.09 (95% CI, 1.29 to 3.39)) and no difference later (HR 0.89 (95% CI, 0.58 to 1.35)). Subsequent analyses focussed on the first year of the trial and on donepezil only were post-hoc. 1-year NHP risk was 17% higher (95% CI 6% to 28%) in patients...

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Long-term tacrine (Cognex) treatment

Cited by 276 publications

References 12 publications

Predictors of hospitalization and institutionalization in Medicaid patient populations with Alzheimer’s Disease

Predictors of hospitalization and institutionalization in Medicaid patient populations with Alzheimer’s Disease

The Public Health Impact of Alzheimer's Disease, 2000–2050: Potential Implication of Treatment Advances

Nursing home placement in the Donepezil and Memantine in Moderate to Severe Alzheimer's Disease (DOMINO-AD) trial: secondary and post-hoc analyses

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