| Disease | A RANDOMISED, DOUBLE BLIND, PLACEBO CONTROLLED TRIAL IN 43 CENTRES IN THE UNITED STATES, CANADA, GREAT BRITAIN, SOUTH AFRICA, AUSTRALIS AND NEW ZEALAND. PATIENTS WITH PROBABLE ALZHEIMER'S DISEASE (N-386; 171 WOMEN) WITH A SCORE OF 11-24 ON THE
MINI MENTAL STATE EXAMINATION, AND A SCORE >12 ON THE COGNITIVE SUBSCALE OF THE ALZHEIMER'S DISEASE ASSESSMENT SCALE (ADAS-COG) WERE RANDOMISED TO PLACEBO, OR GALANTAMINE ESCALATED OVER 4 WEEKS TO A MAINTENANCE DOSE OF 24 OR 32 MG/DAY. THE
PRIMARY OUTCOME MEASURES WERE THE CHANGE IN ADAS-COG SCORE AND THE CLINICAN'S INTERVIEW BASED IMPRESSION OF CHANGE PLUS CAREGIVER INPUT (CIBIC-PLUS) SCORE. ACTIVITIES OF DAILY LIVING (ADL) AND BEHAVIOURAL SYMPTOMS WERE SECONDARY OUTCOMES. TO
COMPARE THE EFFECTS OF HIGHEST LEVELS OF DOSING, AN OBSERVED CASES (OC) ANALYSIS WAS UNDER-TAKEN, WITH CLASSIC INTENTION TO TREAT (ITT) AND ITT WITH LAST OBSERVATION CARRIED FORWARD (LOCF) AS CONFIRMATORY ANALYSES. AT 3 MONTHS, GALANTAMINE
(24-32 MG/DAY) PRODUCED A SIGNIFICANTLY BETTER OUTCOME ON COGNITIVE FUNCTION THAN PLACEBO (TREATMENT DIFFERENCE=1.9 POINTS ON ADAS-COG, P=0.002) AND SIGNIFICANTLY BETTER GLOBAL RESPONSE THAN PLACEBO, AS MEASURED BY CIBIC-PLUS (DETERIORATION
IN 21% OF PATIENTS ON GALANTAMINE PRODUCED SIGNIFICANT BENEFITS ON BASIC AND INSTRUMENTAL ADL. BEHAVIOURAL SYMPTOMS DID NOT CHANGE SIGNIFICANTLY FROM BASELINE LEVELS IN EITHER GROUP. ADVERSE EVENTS (PRIMARILY GASTROIENTESTINAL) WERE OF MILD TO
MODERATE INTENSITY. THERE WERE NO IMPORTANT DIFFERENCES BETWEEN THE OC, ITT, AND ITT/LOCF ANALYSES. MOST PATIENTS (82%) WHO WERE MAINTAINED ON THE HIGHER DOSE OF GALANTAMINE COMPLETED THE STUDY. PATIENTS ON GALANTAMINE, COMPARED WITH THOSE ON
PLACEBO, EXPERIENCED BENEFITS IN COGNITIVE FUNCTION AND INSTRUMENTAL AND BASIC ACTIVITIES OF DAILY LIVING. FLEXIBLE DOSE ESCALATION OF GALANTAMINE WAS WELL TOLERATED. |