Effect of gender and apolipoprotein E genotype on response to anticholinesterase therapy in Alzheimer's disease.
BACKGROUND
Anticholinesterase therapies offer modest benefit to subgroups of AD sufferers. However, there has previously been no way of predicting which patients will respond to any of the drugs.


OBJECTIVE
To discover if gender and/or apolipoprotein E genotype can be used as predictors of response in the clinical setting.


METHODS
107 patients from the Bristol Memory Disorders Clinic took part in a double-blinded or open label trial of tacrine therapy for between 3 and 12 months or an open label trial of galanthamine therapy for 3 months.


RESULTS
After 3 months of therapy, gender was found to be the only significant influence on the number of responders to anticholinesterase therapy. Men had a 73% greater chance of responding than women (p = 0.012). While ApoE genotype did not modify response to therapy in the short term, there are indications that it may affect response over the longer term (up to 12 months), and also that the initial advantage of male gender may not be maintained after 3 months.


CONCLUSIONS
Gender is likely to be a more powerful determinant of outcome of anticholinesterase treatment than apolipoprotein E status in the short term.
Frenchay Hospital, Bristol, UK.
S H
SH
MacGowan
G K
GK
Wilcock
M
M
Scott
D000544:Alzheimer Disease / Q000188:drug therapy* / Q000235:genetics; D001057:Apolipoproteins E / Q000235:genetics*; D002800:Cholinesterase Inhibitors / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D005702:Galantamine / Q000627:therapeutic use; D005838:Genotype; D006801:Humans; D008297:Male; D012727:Sex Characteristics; D013619:Tacrine / Q000627:therapeutic use; D013997:Time Factors
D001057:Apolipoproteins E; D002800:Cholinesterase Inhibitors; D005702:Galantamine; D013619:Tacrine