Does treating dementia help?

25 Jun
2004

British Study Sees Scant Value in Alzheimer’s Drug Aricept

Experts in the United States are already divided over the usefulness of Aricept and related drugs, and the study is unlikely to end the debate.

Most studies have shown that the drugs can produce small improvements in scores on mental tests, but it is not clear whether the gains translate into anything helpful in real life. Even the drugs’ staunchest advocates say that they offer modest benefits at best, affording perhaps a short delay in a patient’s decline. But when small changes in functioning occur, it may be hard to tell whether they are owing to the drug or to the ups and downs of the disease itself.

The new report, being published in today’s issue of The Lancet, the British medical journal, is based on a study of 565 patients with mild to moderate Alzheimer’s disease who were assigned at random to receive either Aricept or a placebo and were then followed for up to three years.

Although the patients taking the drug did have slightly higher scores on mental tests, after three years they did not differ from the placebo group in their rates of being put in a nursing home or becoming disabled.

There were also no significant differences between the groups in behavioral or psychological symptoms or in the emotional well-being of the people taking care of the patients.

Richard Gray, the director of the study and a professor of medical statistics at the University of Birmingham, in England, said in a telephone interview that Aricept offered “poor value for the money,” with such small benefits that patients and families would probably not notice a difference if they discontinued the drug.

But the Alzheimer’s Association issued a statement saying that the study should “not dictate individual treatment decisions.”

It went on: “Working together, doctors, people with Alzheimer’s and their families can evaluate whether they believe the effects of currently approved drugs are worthwhile.”

This study does a nice job of focusing on the appropriate outcomes. I do understand the frustration of caring for these patients. We would like the short term benefits of Aricept to translate into long term benefits. The data argue that long term benefit does not occur. The data speak louder to me than the Alzheimer’s Association.

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2 Responses to Does treating dementia help?

Avatar

RGL

June 26th, 2004 at 1:01 pm

During my years of practice, I found out the benefits of Aricept, and other drugs, have been overhyped.

These drugs are not only expensive, but confer no material benefits that I or relatives of my patients could see. The claim had been made that their use at least arrested the progression of the disease, but I find that dubious and probably can make the same claim for placebos.

I would not recommend the use of these drugs. Drug reps ought to stop selling false hopes.

Avatar

drugreps aredrugpushers

June 29th, 2004 at 6:41 pm

Your first mistake was meeting with drug reps.

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