Effects of statins on cognitive function in patients with Alzheimer's disease in galantamine clinical trials.
OBJECTIVE
A number of reports have been published on the possible involvement of changes in brain cholesterol metabolism in the origin of Alzheimer's disease (AD) and the potential for influencing these changes by administration of HMG-CoA reductase inhibitors ('statins'). The aim of this study was to evaluate a potential association between use of statins and maintenance of cognitive function in patients with AD in galantamine clinical trials.


METHODS
A post hoc analysis was conducted on data pooled from three double-blind, placebo-controlled, clinical trials of galantamine in patients with AD. Patients were divided into four treatment groups: statin plus galantamine (n = 42), statin alone (n = 50), galantamine alone (n = 614) or neither galantamine nor statin (n = 619).


RESULTS
Galantamine was associated with a significant beneficial effect on cognitive status (p < 0.001). The association of use of statins with changes in cognitive status was not significant (p = 0.083). There was no significant interaction between the effects on cognition of statins and galantamine (p = 0.183) and no statistically significant changes in adverse effect rates were observed.


CONCLUSIONS
These findings suggest the need for larger long-term trials to confirm or refute possible effects of statins on cognitive function and the potential interaction of statins with acetylcholinesterase inhibitors in the treatment of AD.
Winblad
Bengt
B
Alzheimer Disease Research Center and Department of Clinical Geriatrics, Karolinska Institute, Stockholm, Sweden.
Jelic
Vesna
V
Kershaw
Paul
P
Amatniek
Joan
J
D000368:Aged; D000544:Alzheimer Disease / Q000188:drug therapy*; D003072:Cognition Disorders / Q000188:drug therapy*; D004311:Double-Blind Method; D004347:Drug Interactions; D004359:Drug Therapy, Combination; D005260:Female; D005702:Galantamine / Q000627:therapeutic use*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D008297:Male; D018697:Nootropic Agents / Q000627:therapeutic use*
D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D018697:Nootropic Agents; D005702:Galantamine