title: The prediction of response to galantamine treatment in patients with mild to moderate Alzheimer's disease.
abstract: The prediction of efficacy in long-term treatment of acetylcholinesterase inhibitors (AChEIs) is a major clinical issue, although no consistently strong predictive factors have emerged thus far. The present analyses aimed to identify factors for predicting long-term outcome of galantamine treatment. Analyses were conducted with data from a 24 weeks randomized, double-blind, placebo controlled trial to evaluate the efficacy and the safety of galantamine in the treatment of 303 patients with mild to moderate AD. Patients were divided into responders (4 or more point improvement of ADAScog scores at 24 weeks of treatment) and non-responders. We explored whether patients' background (e.g. sex, age, and duration of disease) and scores of cognitive scales at early stage, are relevant to the long-term response to AChEIs. Predictive values were estimated by the logistic regression model. The responder rate was 31.7%. We found that changes in scores of ADAS-J cog subscales between week 4 and baseline, especially word recognition, can be a good variable to predict subsequent response to galantamine, with approximately 75% of predictive performance. Characteristics of patients, including demographic characteristics, severity of disease and neuropsychological features before treatment were poorly predictive. The present study indicate that initial response to galantamine administration in patients with mild to moderate AD seems to be a reliable predictor of response of consequent galantamine treatment. Patients who show improvement of episodic memory function during the first 4 weeks of galantamine administration may be likely to particularly benefit from galantamine treatment.
authors.forename: Takashi
authors.initials: T
authors.lastname: Ohnishi
authors.forename: Yojiro
authors.initials: Y
authors.lastname: Sakiyama
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Okuri
authors.forename: Yuji
authors.initials: Y
authors.lastname: Kimura
authors.forename: Nami
authors.initials: N
authors.lastname: Sugiyama
authors.forename: Takayuki
authors.initials: T
authors.lastname: Saito
authors.forename: Masayoshi
authors.initials: M
authors.lastname: Takahashi
authors.affiliation: Scientific Affairs Division, CNS Science Department, Janssen Pharmaceutical K.K., 5-2, Nishi-kanda 3-chome, Chiyoda-ku, Tokyo 101-0065, Japan. tohnish8@its.jnj.com.
authors.forename: Takumi
authors.initials: T
authors.lastname: Kobayashi
mesh_terms: D000544:Alzheimer Disease / Q000175:diagnosis* / Q000188:drug therapy*; D002800:Cholinesterase Inhibitors / Q000627:therapeutic use*; D004311:Double-Blind Method; D005702:Galantamine / Q000627:therapeutic use*; D006801:Humans; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D002800:Cholinesterase Inhibitors; D005702:Galantamine