19 September 2003. Two similar studies funded by Eisai and Pfizer companies, the developer and US-promoter of the acetylcholinesterase inhibitor drug donepezil, suggest that their drug, already widely used for the treatment of Alzheimer’s disease, may also relieve symptoms of patients with vascular dementia. This condition can develop after a person has suffered one or several strokes, and it is among the most common forms of dementia. No treatments are specifically approved for vascular dementia, though some are in clinical trials for cerebral amyloid angiopathy (CAA), a pathologically-defined complication of stroke that is similar to vascular dementia.
In the September issue of Stroke and the August issue of Neurology, research teams at the University of Toronto and Moorgreen Hospital in Southampton, England, report that donepezil improved cognitive function in the two separate, but almost identical trials. Each trial enrolled about 600 patients with probable or possible vascular dementia to test two doses of donepezil for 24 weeks in a placebo-controlled, multicenter, randomized design. In both trials, both donepezil doses appeared to improve cognition and help with the patients' ability to perform activities of daily living. Patients tolerated the drug relatively well; the lower dose (5mg/d) produced roughly as many withdrawals due to side effect as the placebo (around 10 percent), while the higher dose (10 mg/d) had about twice as many. These two studies are part of a larger effort by the makers of acetyocholinesterase inhibitor drugs to test their medications in neurodegenerative conditions related to Alzheimer’s, the original indication for which they were approved.-Gabrielle Strobel.
Wilkinson D, Doody R, Helme R, Taubman K, Mintzer J, Kertesz A, Pratt RD. Donepezil in vascular dementia: A randomized, placebo-controlled study. Neurology. 2003 Aug 26;61(4):479-86. Abstract
Black S, Roman GC, Geldmacher DS, Salloway S, Hecker J, Burns A, Perdomo C, Kumar D, Pratt R. Efficacy and Tolerability of Donepezil in Vascular Dementia. Positive Results of a 24-Week, Multicenter, International, Randomized, Placebo-Controlled Clinical Trial. Stroke. 2003 Sep 11. Abstract
For more on the relationship between vascular dementia and AD, see ARF live discussion.