Keep Alzheimer’s patients on Aricept for longer, study says
pharmafile | March 8, 2012 | News story | Research and Development, Sales and Marketing | Aricept, Pfizer, Teva, donepezil
Patients with severe forms of Alzheimer’s disease should stay on Pfizer’s Aricept for longer, according to new research.
A new study from the New England Journal of Medicine found that patients who stayed on Pfizer’s drug for a year had a slower decline in their memory.
Current clinical practice sees patients taken off the drug when their condition moves from being moderate to severe, but this new research challenges this.
The study’s authors add that this new evidence could lead to twice as many Alzheimer’s sufferers worldwide being given medication.
This could also be a very cheap solution as Aricept (donepezil) has started to lose its patent protection in a number of big markets.
Last month Teva rolled out its copy of the drug in the UK at a price 80% lower than the branded equivalent, meaning patients could be on the drug for longer, but at a much cheaper price.
The NEJM studied 295 patients who had been treated with Alzheimer’s for at least three months and who had moderate or severe forms of the disease.
One set were given placebo pills while another set stayed on Aricept. A third set received Lundbeck’s dementia drug Ebixa (memantine), and the fourth were given a combination of both medicines.
The research concluded that in patients with moderate or severe Alzheimer’s disease, continued treatment with Aricept showed improved cognitive benefits for the 12 months.
The study’s lead author, Professor Robert Howard from King’s College London Institute of Psychiatry, told the BBC: “For the first time, we have robust and compelling evidence that treatment with these drugs can continue to help patients at the more severe stages.
“Patients who continued taking donepezil were about four months ahead in how they were able to remember, communicate and perform daily tasks than those who stopped taking the drugs.
“It means a lot to doctors and carers to see differences like that. These improvements were sustained throughout the year.
“It’s fair to say that both drugs have independent, positive effects at this stage of dementia. I’m advising hospital colleagues to continue patients on donepezil, when it’s tolerated, and to add in memantine.”
NICE and Alzheimer’s drugs
In the UK, current NICE guidelines advise that Alzheimer’s patients on Aricept should stop taking the drug when their disease becomes severe, which is usually between six to 12 weeks.
But NICE also advises that Alzheimer’s patients can keep taking anti-dementia drugs if their disease progresses, if a benefit from the medicines can be shown.
The watchdog initially recommended against using Aricept and other dementia drugs when they were given regulatory approval in 2006.
After a series of legal battles and mounting political pressure, NICE eventually overturned its own decision and allowed the drugs to be funded by the NHS in certain circumstances.
Professor Clive Ballard from the Alzheimer’s Society, which part-funded the trial, said: “Usual practice has been to discontinue the treatment once patients have declined to a certain stage.
“This trial suggests the default position should be the other way round, because most people are benefiting.
“It’s not so much the NICE guidance that needs to change – but how clinicians interpret it.”
Ben Adams
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