A new randomised, double-blind, placebo-controlled study in the lancet has shown that a Russian antihistamine drug called Dimebon has shown a positive effect in Alzheimer’s Disease (Doody et al, 2008). 183 patients with mild-to-moderate Alzheimers disease were assigned to either Dimebon (20mg tds) or placebo. The Alzheimers disease assessment scale was used to assess performance at baseline and 26 weeks. If patients dropped out before completion, the last results were carried forwards (intention-to-treat, last observation carried forward). 88% of patients in the Dimebon arm and 82% in the placebo arm completed the study. The results showed a significant 4-point mean difference between Dimebon and placebo (p<0.0001). This study is interesting because it shows an improvement in scores, rather than a stabilisation of decline. The results of phase 3 trials are awaited. In the same issue, another study reported the results of a post-mortem analysis of a phase I trial for an Amyloid-Beta peptide immunisation in people with Alzheimer’s disease (Holmes et al, 2008). The immunisation resulted in a significant decrease in plaques although this didn’t prevent a decline in functioning. This adds to the ongoing debate about the role of plaques in Alzheimer’s disease.
Doody R S et al. Effect of dimebon on cognition, activities of daily living, behaviour and global function in patients with mild-to-moderate Alzheimer’s disease: a randomised, double-blind, placebo-controlled study. The Lancet. 372. 207-215. 2008.
Holmes, C et al. Long term effects of Alpha-Beta 42 immunisation in Alzheimer’s Disease: follow-up of a randomised placebo-controlled phase 1 trial. The Lancet. 372. 216-223. 2008.
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