Clinical predictors of response to acetyl cholinesterase inhibitors: experience from routine clinical use in Newcastle
Background Acetyl Cholinesterase Inhibitors (AChEIs) have been in clinical use for the past five years in the UK for the symptomatic treatment of Alzheimer's disease (AD). There are few data on the patterns and predictors of response to AChEI therapy in routine clinical practice. We therefore i...
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| Veröffentlicht in: | International journal of geriatric psychiatry 2003-10, Vol.18 (10), p.879-886 |
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| container_title | International journal of geriatric psychiatry |
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| creator | Pakrasi, S. Mukaetova-Ladinska, E. B. McKeith, I. G. O'Brien, J. T. |
| description | Background
Acetyl Cholinesterase Inhibitors (AChEIs) have been in clinical use for the past five years in the UK for the symptomatic treatment of Alzheimer's disease (AD). There are few data on the patterns and predictors of response to AChEI therapy in routine clinical practice. We therefore investigated clinical variables that may distinguish between AChEI responders and non‐responders.
Methods
A retrospective sample of 160 consecutive patients with dementia who were treated on clinical grounds with an AChEI was studied. Treatment response was defined in two ways: (a) A clinical response was achieved when there was no deterioration or there was an improvement on a global clinical assessment (CGI) and (b) a Mini‐Mental‐State‐Examination (MMSE) response when there was an improvement of 2 or more MMSE points.
Results
A total of 62 (45%) patients achieved an MMSE response. A diagnosis of dementia with Lewy Bodies (DLB) and Parkinson's disease+Dementia (PDD) was associated with a MMSE response, as were hallucinations, and lower MMSE scores at baseline. 125 (78%) patients achieved a CGI response for which there were no clinical predictors.
Conclusions
Severity of illness, a diagnosis of DLB and PDD, and presence of hallucinations at baseline were predictive of a MMSE response. Non‐AD dementia and severe dementia responded equally well to AChEI treatment and results of further randomised, placebo‐controlled studies are needed to clarify the role of AChEI in the treatment of these disorders. Copyright © 2003 John Wiley & Sons, Ltd. |
| doi_str_mv | 10.1002/gps.928 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_75763811</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>75763811</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4788-5d54e62050ccd0bb9c4ff0ae1d001d1e4eb4820f3ff93a37a7cdf37b61944a1f3</originalsourceid><addsrcrecordid>eNqF0U1v1DAQBmALUdFlQfwD5AtwQCnj2Emc3tCKLv1gQQKE1IvlOGNqyMbBTmj33-OShZ4QJx_m8cxoXkKeMDhiAPmrr0M8qnN5jywY1HXGWFneJwuQssjKnMMheRjjN4BUY_IBOWSi4JzlsCA_V53rndEdHQK2zow-ROotDRgH30eko6fa4LjrqLnyyWIcMehUcP2Va9ytP6Z4M2Bw2BukNvgtDX4aE6XmT_Pp9we6wWuj49jhI3JgdRfx8f5dks8nbz6t3mYX79enq9cXmRGVlFnRFgLLHAowpoWmqY2wFjSyFoC1DAU2QuZgubU117zSlWktr5qS1UJoZvmSPJ_7DsH_mNLuauuiwa7TPfopqqqoSi4Z-y_M0105pKstyYsZmuBjDGjVENxWh51ioG6zUCkLlbJI8um-5dRssb1z--Mn8GwPdExHskH3xsU7VzAp6rTfkryc3bXrcPeveWr94eM8Npu1S0nd_NU6fFdlxatCfdms1dm780sOJxt1yX8BgkuxFw</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>21093053</pqid></control><display><type>article</type><title>Clinical predictors of response to acetyl cholinesterase inhibitors: experience from routine clinical use in Newcastle</title><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><creator>Pakrasi, S. ; Mukaetova-Ladinska, E. B. ; McKeith, I. G. ; O'Brien, J. T.</creator><creatorcontrib>Pakrasi, S. ; Mukaetova-Ladinska, E. B. ; McKeith, I. G. ; O'Brien, J. T.</creatorcontrib><description>Background
Acetyl Cholinesterase Inhibitors (AChEIs) have been in clinical use for the past five years in the UK for the symptomatic treatment of Alzheimer's disease (AD). There are few data on the patterns and predictors of response to AChEI therapy in routine clinical practice. We therefore investigated clinical variables that may distinguish between AChEI responders and non‐responders.
Methods
A retrospective sample of 160 consecutive patients with dementia who were treated on clinical grounds with an AChEI was studied. Treatment response was defined in two ways: (a) A clinical response was achieved when there was no deterioration or there was an improvement on a global clinical assessment (CGI) and (b) a Mini‐Mental‐State‐Examination (MMSE) response when there was an improvement of 2 or more MMSE points.
Results
A total of 62 (45%) patients achieved an MMSE response. A diagnosis of dementia with Lewy Bodies (DLB) and Parkinson's disease+Dementia (PDD) was associated with a MMSE response, as were hallucinations, and lower MMSE scores at baseline. 125 (78%) patients achieved a CGI response for which there were no clinical predictors.
Conclusions
Severity of illness, a diagnosis of DLB and PDD, and presence of hallucinations at baseline were predictive of a MMSE response. Non‐AD dementia and severe dementia responded equally well to AChEI treatment and results of further randomised, placebo‐controlled studies are needed to clarify the role of AChEI in the treatment of these disorders. Copyright © 2003 John Wiley & Sons, Ltd.</description><identifier>ISSN: 0885-6230</identifier><identifier>EISSN: 1099-1166</identifier><identifier>DOI: 10.1002/gps.928</identifier><identifier>PMID: 14533120</identifier><language>eng</language><publisher>Chichester, UK: John Wiley & Sons, Ltd</publisher><subject>Acetyl cholinesterase inhibitors ; Aged ; Aged, 80 and over ; Biological and medical sciences ; Cholinesterase Inhibitors - adverse effects ; Cholinesterase Inhibitors - therapeutic use ; Cognition Disorders - drug therapy ; Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases ; Dementia ; Dementia - drug therapy ; Dementia - psychology ; donepezil ; Female ; galantamine ; Hallucinations - drug therapy ; Hallucinations - psychology ; Humans ; Lewy Body Disease - drug therapy ; Lewy Body Disease - psychology ; Male ; Medical sciences ; Mental Recall - drug effects ; Middle Aged ; Neurology ; Neuropharmacology ; Parkinson Disease - drug therapy ; Parkinson Disease - psychology ; Pharmacology. Drug treatments ; predictors ; Psychiatric Status Rating Scales ; Psychoanaleptics: cns stimulant, antidepressant agent, nootropic agent, mood stabilizer..., (alzheimer disease) ; Psychology. Psychoanalysis. Psychiatry ; Psychopharmacology ; response ; Retrospective Studies ; rivastigmine ; Treatment Outcome</subject><ispartof>International journal of geriatric psychiatry, 2003-10, Vol.18 (10), p.879-886</ispartof><rights>Copyright © 2003 John Wiley & Sons, Ltd.</rights><rights>2004 INIST-CNRS</rights><rights>Copyright 2003 John Wiley & Sons, Ltd.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4788-5d54e62050ccd0bb9c4ff0ae1d001d1e4eb4820f3ff93a37a7cdf37b61944a1f3</citedby><cites>FETCH-LOGICAL-c4788-5d54e62050ccd0bb9c4ff0ae1d001d1e4eb4820f3ff93a37a7cdf37b61944a1f3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fgps.928$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fgps.928$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27903,27904,45553,45554</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=15184976$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/14533120$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Pakrasi, S.</creatorcontrib><creatorcontrib>Mukaetova-Ladinska, E. B.</creatorcontrib><creatorcontrib>McKeith, I. G.</creatorcontrib><creatorcontrib>O'Brien, J. T.</creatorcontrib><title>Clinical predictors of response to acetyl cholinesterase inhibitors: experience from routine clinical use in Newcastle</title><title>International journal of geriatric psychiatry</title><addtitle>Int. J. Geriat. Psychiatry</addtitle><description>Background
Acetyl Cholinesterase Inhibitors (AChEIs) have been in clinical use for the past five years in the UK for the symptomatic treatment of Alzheimer's disease (AD). There are few data on the patterns and predictors of response to AChEI therapy in routine clinical practice. We therefore investigated clinical variables that may distinguish between AChEI responders and non‐responders.
Methods
A retrospective sample of 160 consecutive patients with dementia who were treated on clinical grounds with an AChEI was studied. Treatment response was defined in two ways: (a) A clinical response was achieved when there was no deterioration or there was an improvement on a global clinical assessment (CGI) and (b) a Mini‐Mental‐State‐Examination (MMSE) response when there was an improvement of 2 or more MMSE points.
Results
A total of 62 (45%) patients achieved an MMSE response. A diagnosis of dementia with Lewy Bodies (DLB) and Parkinson's disease+Dementia (PDD) was associated with a MMSE response, as were hallucinations, and lower MMSE scores at baseline. 125 (78%) patients achieved a CGI response for which there were no clinical predictors.
Conclusions
Severity of illness, a diagnosis of DLB and PDD, and presence of hallucinations at baseline were predictive of a MMSE response. Non‐AD dementia and severe dementia responded equally well to AChEI treatment and results of further randomised, placebo‐controlled studies are needed to clarify the role of AChEI in the treatment of these disorders. Copyright © 2003 John Wiley & Sons, Ltd.</description><subject>Acetyl cholinesterase inhibitors</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Biological and medical sciences</subject><subject>Cholinesterase Inhibitors - adverse effects</subject><subject>Cholinesterase Inhibitors - therapeutic use</subject><subject>Cognition Disorders - drug therapy</subject><subject>Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases</subject><subject>Dementia</subject><subject>Dementia - drug therapy</subject><subject>Dementia - psychology</subject><subject>donepezil</subject><subject>Female</subject><subject>galantamine</subject><subject>Hallucinations - drug therapy</subject><subject>Hallucinations - psychology</subject><subject>Humans</subject><subject>Lewy Body Disease - drug therapy</subject><subject>Lewy Body Disease - psychology</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Mental Recall - drug effects</subject><subject>Middle Aged</subject><subject>Neurology</subject><subject>Neuropharmacology</subject><subject>Parkinson Disease - drug therapy</subject><subject>Parkinson Disease - psychology</subject><subject>Pharmacology. Drug treatments</subject><subject>predictors</subject><subject>Psychiatric Status Rating Scales</subject><subject>Psychoanaleptics: cns stimulant, antidepressant agent, nootropic agent, mood stabilizer..., (alzheimer disease)</subject><subject>Psychology. Psychoanalysis. Psychiatry</subject><subject>Psychopharmacology</subject><subject>response</subject><subject>Retrospective Studies</subject><subject>rivastigmine</subject><subject>Treatment Outcome</subject><issn>0885-6230</issn><issn>1099-1166</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2003</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqF0U1v1DAQBmALUdFlQfwD5AtwQCnj2Emc3tCKLv1gQQKE1IvlOGNqyMbBTmj33-OShZ4QJx_m8cxoXkKeMDhiAPmrr0M8qnN5jywY1HXGWFneJwuQssjKnMMheRjjN4BUY_IBOWSi4JzlsCA_V53rndEdHQK2zow-ROotDRgH30eko6fa4LjrqLnyyWIcMehUcP2Va9ytP6Z4M2Bw2BukNvgtDX4aE6XmT_Pp9we6wWuj49jhI3JgdRfx8f5dks8nbz6t3mYX79enq9cXmRGVlFnRFgLLHAowpoWmqY2wFjSyFoC1DAU2QuZgubU117zSlWktr5qS1UJoZvmSPJ_7DsH_mNLuauuiwa7TPfopqqqoSi4Z-y_M0105pKstyYsZmuBjDGjVENxWh51ioG6zUCkLlbJI8um-5dRssb1z--Mn8GwPdExHskH3xsU7VzAp6rTfkryc3bXrcPeveWr94eM8Npu1S0nd_NU6fFdlxatCfdms1dm780sOJxt1yX8BgkuxFw</recordid><startdate>200310</startdate><enddate>200310</enddate><creator>Pakrasi, S.</creator><creator>Mukaetova-Ladinska, E. B.</creator><creator>McKeith, I. G.</creator><creator>O'Brien, J. T.</creator><general>John Wiley & Sons, Ltd</general><general>Wiley</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TK</scope><scope>7X8</scope></search><sort><creationdate>200310</creationdate><title>Clinical predictors of response to acetyl cholinesterase inhibitors: experience from routine clinical use in Newcastle</title><author>Pakrasi, S. ; Mukaetova-Ladinska, E. B. ; McKeith, I. G. ; O'Brien, J. T.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4788-5d54e62050ccd0bb9c4ff0ae1d001d1e4eb4820f3ff93a37a7cdf37b61944a1f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2003</creationdate><topic>Acetyl cholinesterase inhibitors</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Biological and medical sciences</topic><topic>Cholinesterase Inhibitors - adverse effects</topic><topic>Cholinesterase Inhibitors - therapeutic use</topic><topic>Cognition Disorders - drug therapy</topic><topic>Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases</topic><topic>Dementia</topic><topic>Dementia - drug therapy</topic><topic>Dementia - psychology</topic><topic>donepezil</topic><topic>Female</topic><topic>galantamine</topic><topic>Hallucinations - drug therapy</topic><topic>Hallucinations - psychology</topic><topic>Humans</topic><topic>Lewy Body Disease - drug therapy</topic><topic>Lewy Body Disease - psychology</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Mental Recall - drug effects</topic><topic>Middle Aged</topic><topic>Neurology</topic><topic>Neuropharmacology</topic><topic>Parkinson Disease - drug therapy</topic><topic>Parkinson Disease - psychology</topic><topic>Pharmacology. Drug treatments</topic><topic>predictors</topic><topic>Psychiatric Status Rating Scales</topic><topic>Psychoanaleptics: cns stimulant, antidepressant agent, nootropic agent, mood stabilizer..., (alzheimer disease)</topic><topic>Psychology. Psychoanalysis. Psychiatry</topic><topic>Psychopharmacology</topic><topic>response</topic><topic>Retrospective Studies</topic><topic>rivastigmine</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Pakrasi, S.</creatorcontrib><creatorcontrib>Mukaetova-Ladinska, E. B.</creatorcontrib><creatorcontrib>McKeith, I. G.</creatorcontrib><creatorcontrib>O'Brien, J. T.</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Neurosciences Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>International journal of geriatric psychiatry</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Pakrasi, S.</au><au>Mukaetova-Ladinska, E. B.</au><au>McKeith, I. G.</au><au>O'Brien, J. T.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Clinical predictors of response to acetyl cholinesterase inhibitors: experience from routine clinical use in Newcastle</atitle><jtitle>International journal of geriatric psychiatry</jtitle><addtitle>Int. J. Geriat. Psychiatry</addtitle><date>2003-10</date><risdate>2003</risdate><volume>18</volume><issue>10</issue><spage>879</spage><epage>886</epage><pages>879-886</pages><issn>0885-6230</issn><eissn>1099-1166</eissn><abstract>Background
Acetyl Cholinesterase Inhibitors (AChEIs) have been in clinical use for the past five years in the UK for the symptomatic treatment of Alzheimer's disease (AD). There are few data on the patterns and predictors of response to AChEI therapy in routine clinical practice. We therefore investigated clinical variables that may distinguish between AChEI responders and non‐responders.
Methods
A retrospective sample of 160 consecutive patients with dementia who were treated on clinical grounds with an AChEI was studied. Treatment response was defined in two ways: (a) A clinical response was achieved when there was no deterioration or there was an improvement on a global clinical assessment (CGI) and (b) a Mini‐Mental‐State‐Examination (MMSE) response when there was an improvement of 2 or more MMSE points.
Results
A total of 62 (45%) patients achieved an MMSE response. A diagnosis of dementia with Lewy Bodies (DLB) and Parkinson's disease+Dementia (PDD) was associated with a MMSE response, as were hallucinations, and lower MMSE scores at baseline. 125 (78%) patients achieved a CGI response for which there were no clinical predictors.
Conclusions
Severity of illness, a diagnosis of DLB and PDD, and presence of hallucinations at baseline were predictive of a MMSE response. Non‐AD dementia and severe dementia responded equally well to AChEI treatment and results of further randomised, placebo‐controlled studies are needed to clarify the role of AChEI in the treatment of these disorders. Copyright © 2003 John Wiley & Sons, Ltd.</abstract><cop>Chichester, UK</cop><pub>John Wiley & Sons, Ltd</pub><pmid>14533120</pmid><doi>10.1002/gps.928</doi><tpages>8</tpages></addata></record> |
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| subjects | Acetyl cholinesterase inhibitors Aged Aged, 80 and over Biological and medical sciences Cholinesterase Inhibitors - adverse effects Cholinesterase Inhibitors - therapeutic use Cognition Disorders - drug therapy Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases Dementia Dementia - drug therapy Dementia - psychology donepezil Female galantamine Hallucinations - drug therapy Hallucinations - psychology Humans Lewy Body Disease - drug therapy Lewy Body Disease - psychology Male Medical sciences Mental Recall - drug effects Middle Aged Neurology Neuropharmacology Parkinson Disease - drug therapy Parkinson Disease - psychology Pharmacology. Drug treatments predictors Psychiatric Status Rating Scales Psychoanaleptics: cns stimulant, antidepressant agent, nootropic agent, mood stabilizer..., (alzheimer disease) Psychology. Psychoanalysis. Psychiatry Psychopharmacology response Retrospective Studies rivastigmine Treatment Outcome |
| title | Clinical predictors of response to acetyl cholinesterase inhibitors: experience from routine clinical use in Newcastle |
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