Multi-year study shows galantamine slows progression of Alzheimer’s dementia

You'll have to ask your competent? doctor if they did ANYTHING AT ALL with this earlier research.

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The latest here:

Multi-year study shows galantamine slows progression of Alzheimer’s dementia

Cholinesterase inhibitors provided moderate but persistent benefits in patients with Alzheimer’s dementia, including a lower risk for death, according to data published in Neurology.

However, galantamine was the only the cholinesterase inhibitor (ChEI) that demonstrated a significant reduction in the risk for severe dementia.

Researchers found that cholinesterase inhibitors had a modest but persistent benefit for patients with Alzheimer’s dementia, particularly galantamine. Source: Adobe Stock

“ChEIs are a group of drugs recommended for the treatment of AD, but their effects on cognition have been debated and few studies have investigated their long-term effects,” Maria Eriksdotter, MD, head of the department of neurobiology, care sciences and society at the Karolinska Institutet in Sweden, told Healio Neurology. “We wanted to follow patients who are on treatment with ChEI for longer times since patients with AD live for many years with the disease.”

Eriksdotter and colleagues examined data from patients diagnosed with mild to advanced stage Alzheimer’s dementia who were enrolled the Swedish Dementia Registry between 2007 to 2017.

The study compared 11,652 AD patients who were started on ChEIs within 3 months of their dementia diagnosis — either donepezil, rivastigmine or galantamine — and 5,836 AD patients who did not take ChEIs.

During a mean follow up of 5 years, the researchers found ChEI use correlated with a 27% reduced risk for death (0.73; 95% CI, 0.69-0.77) compared with patients who did not take ChEIs. Among the three ChEIs, galantamine was linked with the highest reduction in the risk for death (HR = 0.71; 95% CI, 0.65-0.76) compared with donepezil (HR = 0.78; 95% CI, 0.74-0.83) and rivastigmine (HR = 0.86; 95% CI, 0.8-0.93). Galantamine also reduced the risk for severe dementia (HR = 0.69; 95% CI 0.47-1) and demonstrated the greatest impact on cognitive decline, measured on the Mini-Mental State Examination (0.18 MMSE points/year; 95% CI 0.07-0.28). It had a modulatory effect on nicotine receptors as well, according to Eriksdotter, but she said that finding requires further study.

During the study period, 255 patients developed severe dementia and 35% died. The researchers noted that patients who did not take ChEIs tended to be older and had more comorbidities and medications. ChEI use overall was associated with higher MMSE scores at each visit, they said (0.13 MMSE points/year; 95% CI, 0.06-0.2). Among those on treatment, 62% of patients took donepezil, 21% galantamine and 17% rivastigmine. The overall mortality rate for ChEI users was lower compared with nonusers (105.78/1,000 person-years vs. 136.93/1,000 person-years).

“What did surprise me is not that the cognitive benefits were modest (that has been shown for up to 1 year before) but that these cognitive benefits persisted for such a long time, up to 5 years.” Eriksdotter said. “That is very encouraging from a clinical perspective for a chronic and progressive disease as AD. Our results provide strong support to treat people with AD with ChEIs, but we also show that the therapeutic effect lasts for a long time (ie, the ChEIs should be used long term).”