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| Doctors may prescribe some of the more popular Alzheimer’s-approved medications for vascular dementia. |
Though nothing has been specifically approved for the treatment of vascular dementia, doctors may prescribe some of the more popular Alzheimer’s-approved medications for this ailment. The jury is still out as to their effectiveness.
On the one hand, there have been some hopeful results from clinical trials in recent years. As far back as 2002, clinical trials showed Aricept (generic name: donepezil) to be effective in treating the cognitive decline of vascular dementia.
Further trials are being pursued at great cost because of the strength of the evidence that there is real potential here. One trial, Aricept to Improve Functional Tasks in Vascular Dementia, is currently recruiting participants. You can click on the link in the previous sentence to get details. A second trial is also currently underway. The trial, Efficacy and Safety of Donepezil Hydrochloride (Aricept) in Vascular Dementia, is ongoing, but not currently recruiting participants.
On the other hand, there have been a few bumps along the way. In 2006, there were an unusual number of deaths in one trial. Notwithstanding, an analysis of three Vascular Dementia trials, according to Eisai, "shows no statistically significant differences in observed mortality rates between the donepezil and placebo groups (1.7% vs. 1.1%)". The FDA seemed to agree that this was not a particularly worrisome outcome, as they allow the other aforementioned trials to continue.
In another negative development, Aricept failed a clinical trial in 2008 designed to test its use in treating a form of vascular dementia known as CADASIL. (This stands for cerebral autosomal dominant arteriopathy with subcortical infarcts and leucoencephalopathy.) In the trial, Aricept did not improve cognition in patients with this genetic form of dementia.
No matter how Aricept fairs in future clinical trial results, even the best of what we have seen so far mostly reflects a slower decline rather than positive improvement. Therefore, having modest expectations could bring about results that are meaningful.
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Source:
Click on links in article above for respective sources.
Week of February 28 - March 7, 2010
Reviewed by
Dr. Boaz Ancselovic, MD, Geriatrician, Alzheimer's Weekly.
Edited by Peter Berger, Alzheimer's Weekly.
COPYRIGHT © 2010 Alzheimer's Weekly LLC.
All Rights Reserved.
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