title: Cilostazol as an add-on therapy for patients with Alzheimer's disease in Taiwan: a case control study.
abstract: BACKGROUND
  Combination therapy using acetylcholinesterase inhibitors (AChEIs) and cilostazol is of unknown efficacy for patients with Alzheimer's disease (AD).
  
  
  METHODS
  We explored the therapeutic responses by using a case-control study, which was conducted in Taiwan. We enrolled 30 participants with stable AD who were receiving cilostazol (50 mg) twice per day as an add-on therapy combined with AChEIs, and 30 participants as controls who were not receiving cilostazol as an add-on therapy. The therapeutic responses were measured using neuropsychological assessments and analyzed in relation to cilostazol use, apolipoprotein E genotype, and demographic characteristics. Mini-mental state examination (MMSE) and clinical dementia rating sum of boxes (CDR-SB) were administered at the outset of the study and 12 months later. Multiple logistic regression analysis was used to estimate the association between the therapeutic response and cilostazol use.
  
  
  RESULTS
  For the therapeutic indicator of cognition, Cilostazol use (adjusted odds ratio (aOR) = 0.17, 95% confidence interval (CI) = 0.03-0.80), initial CDR-SB score (aOR = 2.06, 95% CI = 1.31-3.72), and initial MMSE score (aOR = 1.41, 95% CI = 1.11-1.90), but not age, sex, education, or ApoE ε4 status, were significantly associated with poor therapeutic outcomes. For the therapeutic indicator of global status, no significant association was observed between the covariates and poor therapeutic outcomes.
  
  
  CONCLUSIONS
  Cilostazol may reduce the decline of cognitive function in stable AD patients when applied as an add-on therapy.
authors.affiliation: Department of Family Medicine, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung City, Taiwan.|Department of Family Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung City, Taiwan.|Department of Family Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung City, Taiwan.|Research Center for Environmental Medicine, Kaohsiung Medical University, Kaohsiung City, Taiwan.
authors.forename: Shu-Yu
authors.initials: SY
authors.lastname: Tai
authors.affiliation: Department of Neurology, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung Medical University, Kaohsiung City, Taiwan.|Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung City, Taiwan.
authors.forename: Chun-Hung
authors.initials: CH
authors.lastname: Chen
authors.affiliation: Department of Otorhinolaryngology, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung City, Taiwan.|Department of Otorhinolaryngology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung City, Taiwan.
authors.forename: Chen-Yu
authors.initials: CY
authors.lastname: Chien
authors.affiliation: Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung City, Taiwan. endless@kmu.edu.tw.|Department of Neurology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung City, Taiwan. endless@kmu.edu.tw.|Department of and Master's Program in Neurology, Faculty of Medicine, Kaohsiung Medical University, HospitalNo.100, Tzyou 1st Road, Kaohsiung 807, Taiwan. endless@kmu.edu.tw.
authors.forename: Yuan-Han
authors.initials: YH
authors.lastname: Yang
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000188:drug therapy* / Q000235:genetics; D001057:Apolipoproteins E / Q000235:genetics; D016022:Case-Control Studies; D002800:Cholinesterase Inhibitors / Q000627:therapeutic use*; D000077407:Cilostazol; D003071:Cognition / Q000187:drug effects; D004359:Drug Therapy, Combination; D005260:Female; D005838:Genotype; D006801:Humans; D008297:Male; D018696:Neuroprotective Agents / Q000627:therapeutic use; D009483:Neuropsychological Tests; D016017:Odds Ratio; D013624:Taiwan; D013777:Tetrazoles / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D001057:Apolipoproteins E; D002800:Cholinesterase Inhibitors; D018696:Neuroprotective Agents; D013777:Tetrazoles; D000077407:Cilostazol
keywords: Alzheimer’s disease; CDR-SB; Cilostazol; MMSE