UK scientists have found that the drug donepezil, which is approved for use only in the mild to moderate stages of Alzheimer’s disease, could benefit patients in the later stages of the disease. The study is published in the New England Journal of Medicine.
The study, led by researchers at King’s College London, set out to assess the effects of two Alzheimer’s drugs – donepezil (often known as Aricept) and memantine (known as Ebixa or Axura). Donepezil is currently licensed in the UK for use in people with mild to moderate Alzheimer’s, while memantine is used in people in the moderate and severe stages of the disease. Both drugs can help with some of the symptoms of Alzheimer’s.
The study followed 295 people with moderate or severe Alzheimer’s disease over the course of a year. All the participants were living at home and had been prescribed donepezil, but not memantine, for at least three months before the study began, and were being assessed by their doctors for a possible change in their medication. They were randomly assigned to one of four treatment options: continuing donepezil, replacing donepezil with a placebo, stopping donepezil and switching to memantine, or taking both donepezil and memantine.
The researchers tested the participants’ cognition and their functional ability (the ability to carry out everyday tasks) several times over the course of the trial, and at the end of the study. They found those who continued taking donepezil showed less decline than those who stopped taking the drug. Meanwhile, those who took memantine also showed some benefit compared to those on a placebo, although the effect was smaller than those on donepezil.
Dr Simon Ridley, Head of Research at Alzheimer’s Research UK, said:
“We know that people can have different responses to donepezil, but these findings suggest that some people with Alzheimer’s may benefit for longer than previously thought. Trials such as this are extremely important for informing decisions about the way medication is prescribed, potentially helping even more people. It would be helpful to see longer-term trials to determine exactly how long the benefits seen in this study might last.
“While donepezil and memantine can help with the symptoms of Alzheimer’s, and are an enormous boost for many people, sadly we still lack a treatment that can stop the disease in its tracks. With 500,000 people affected by Alzheimer’s in the UK, we desperately need effective new treatments that can halt the disease if we are to offer them hope – that means we must invest in research.”