Effect of ApoE genotype on response to donepezil in patients with Alzheimer's disease.
OBJECTIVE
The possible influence of apolipoprotein E (ApoE) genotype on the response to acetylcholinesterase inhibitor therapy in patients with Alzheimer's disease (AD) remains a matter of controversy. In order to address this issue, we investigated the effects of ApoE genotype on the clinical response to donepezil in patients with mild to moderate AD.


METHODS
An open study was carried out in 51 patients with probable AD who were treated with 5-10 mg of donepezil per day for 48 weeks.


RESULTS
Eighteen (35.3%) of the 51 patients had 1 or 2 ApoE epsilon4 alleles. ApoE epsilon4 carriers with AD showed a mean 1.1-point increase from the baseline score of 23.9 on the 70-point Alzheimer's Disease Assessment Scale-Cognitive Component at 48 weeks, while the ApoE epsilon4 noncarrier group showed a 3.1-point increase from the baseline score of 22.5 (p = 0.03). The ApoE epsilon4 carrier group exhibited a mean 0.13-point worsening from the baseline score of 0.97 on the Korean Instrumental Activities of Daily Living at 48 weeks, while the ApoE epsilon4 noncarrier group exhibited a 0.17-point worsening from the baseline score of 0.64 (p = 0.05).


CONCLUSIONS
AD patients who carry the ApoE epsilon4 allele may respond more favorably to donepezil than epsilon4 noncarriers.
Choi
Seong Hye
SH
Department of Neurology, Inha University College of Medicine, Incheon, South Korea.
Kim
Sang Yun
SY
Na
Hae Ri
HR
Kim
Byung-Kun
BK
Yang
Dong Won
DW
Kwon
Jay C
JC
Park
Mee Young
MY
D000368:Aged; D000544:Alzheimer Disease / Q000188:drug therapy* / Q000235:genetics*; D053327:Apolipoprotein E4 / Q000235:genetics*; D000077265:Donepezil; D004351:Drug Resistance / Q000235:genetics; D005260:Female; D005500:Follow-Up Studies; D005838:Genotype; D006801:Humans; D007189:Indans / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D018697:Nootropic Agents / Q000627:therapeutic use*; D010880:Piperidines / Q000627:therapeutic use*; D016896:Treatment Outcome
D053327:Apolipoprotein E4; D007189:Indans; D018697:Nootropic Agents; D010880:Piperidines; D000077265:Donepezil