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Alzheimer's Drug Has Staying Power

Galantamine improved memory for two years, says study

THURSDAY, May 10 (HealthScout) -- A drug that staves off memory loss in people with Alzheimer's disease seems to have staying power, new research shows.

The effects of galantamine usually have been monitored for only six months, but a new study found patients who took the drug for two years scored higher on memory and learning tests than those who took a placebo. The drug was approved by the U.S. Food and Drug Administration (FDA) in February and will be available in pharmacies this month as Reminyl.

"People who were maintained on galantamine without interruption did better than those with no treatment," says lead study author Dr. Rachelle Doody, an associate professor of neurology at Baylor College of Medicine in Houston. "And there's no evidence that the effect was stopping at two years. I guess the news isn't in the study. The news is in the results."

Doody presented her findings today at the annual meeting of the American Academy of Neurology in Philadelphia. Janssen Research Foundation funded the study, and its parent company, Janssen Pharmaceutica Products LP, will market Reminyl in this country.

Doody's study randomly picked 636 Alzheimer's patients to receive either galantamine or a placebo for six months. After that, all participants were eligible to take galantamine for another 18 months. The mean age of the patients was 75, and 62 percent were women.

All patients took a cognitive skills test, and those who had been taking galantamine steadily fared better than those who took placebos for six months. Then, the entire group was compared with a control group that had taken a placebo in an earlier, year-long study. The galantamine group retained more memory than the control group, and the cognitive benefits of the drug increased in the second year, compared with the decline usually experienced by untreated patients.

One expert in aging and dementia says every year counts with Alzheimer's disease.

"It's certainly promising that the drug lasts up to two years. Even a year or two, in terms of delaying the disease, is important," says Neil Buckholtz, chief of dementias at the National Institute on Aging. That window of mental clarity can help patients take care of their affairs and spend more time with their loved ones, he says.

Galantamine is one of several Alzheimer's drugs that increase the brain's levels of acetylcholine, a chemical that helps nerve cells talk to each other. Scientists think the drug also acts on certain brain receptors, leading to the release of even more acetylcholine.

Doody says he isn't sure how galantamine works: "I personally feel it's difficult to tell a drug that actually modifies a disease and one that suppresses symptoms. But at this point, there are no other drugs available."

Compounds that would block the buildup of amyloids, sticky proteins that collect in the brain and signal the start of Alzheimer's, still are undergoing safety studies, Doody says. Other future treatments could include anti-inflammatories and a class of drugs that may block neural degeneration.

Galantamine is derived from the bulbs of daffodils, and its use dates back to Grecian times. Scientists have found the drug works well for mild to moderate Alzheimer's, but doesn't work in severe cases. Its side effects are minimal, but include nausea and vomiting.

About 4 million Americans have Alzheimer's disease. About one in 10 Americans over 65 has the condition; nearly half of those over 85 have it. Statistics show the disorder is the third most-expensive illness in the United States, costing roughly $100 billion a year. It ranks behind only heart disease and cancer.

Although Doody says she hopes galantamine will work for even longer periods, she doesn't see a cure for the disease on the horizon.

"I personally don't think we're going to have something that's going to cure or wipe out Alzheimer's. We'll have a group of agents that suppress symptoms and control progression of the disease," she says.

What To Do

For more information on Reminyl, visit Janssen Pharmaceutica Products LP, a subsidiary of Johnson & Johnson.

The Mayo Clinic offers an online quiz to test your knowledge about Alzheimer's disease. If you are a caregiver, check the Alzheimer's Association.

Read these previous HealthScout stories on Alzheimer's.

SOURCES: Interviews with Rachelle Doody, M.D., associate professor, neurology, Baylor College of Medicine, Houston; Neil Buckholtz, chief of dementias, National Institute of Aging, Bethesda, Md.; May 10, 2001, presentation, annual meeting of the American Academy of Neurology, Philadelphia
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