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Drug may delay advance of Alzheimer's disease

A study finds Aricept can help people suffering from memory loss hold off Alzheimer's up to three years.

By LISA GREENE
Published April 14, 2005

The nation's most widely prescribed Alzheimer's drug can help prevent the onset of the disease, but only for a little while, says a major study released Wednesday.

The drug Aricept is the first treatment found to delay diagnosis of Alzheimer's for people who already suffer memory loss.

For the moment, it offers little more than hope: Aricept slowed the diagnosis in most patients for one year, but after three years it didn't help.

The most important result is not for Aricept, but for future research. Doctors now know it is possible to stave off the cognitive decline that leads to Alzheimer's, said Neil Buckholtz, chief of the Dementias of Aging Branch of the federal National Institute on Aging.

"This is the first indication that you can do this," Buckholtz said.

Researchers have been anticipating the study's results, which will be published in the New England Journal of Medicine . The study was conducted by a network of 69 Alzheimer's research centers that included the University of South Florida.

"It's very exciting," said Dr. Eric Pfeiffer, director of USF's Suncoast Alzheimer's and Gerontology Center and one of the study's authors. "This was an opportunity to prevent Alzheimer's from happening. We're able to stop progression for a limited period of time ... not forever, but a measurable and important period of time."

The study also found that vitamin E, which is used by many people to try to reduce Alzheimer's symptoms, had no effect at all in preventing people from getting the disease.

The excitement about such a limited result shows how few effective treatments exist for Alzheimer's, said Dr. Deborah Blacker, associate professor of psychiatry at Harvard Medical School and author of a Journal editorial about the study.

"The current treatments, while they're better than nothing, are not that great," Blacker said. "We really don't have great treatments right now. But we didn't use to have any treatments."

Neither Aricept nor other drugs cure or reverse the disease, said Doug Berger, assistant director of education for the Florida Gulf Coast Chapter of the Alzheimer's Association.

"The best they do is create more moments of memory for some people," he said.

It's a problem Valrico resident Eloise Williams knows all too well. Her husband, James W., now 78, was diagnosed in 1996 after he started getting lost while driving to places he once knew.

This week, they went to a concert at their church Sunday evening, and she thought her husband enjoyed the music. Monday morning, he didn't remember it. She spent 54 years as a church organist and choir director, but gave it up so she could stay with him.

"We're hoping there will be a breakthrough someday, like for other diseases," she said. "So far, all we have is something to keep it at bay."

In this study, researchers followed 769 patients who had "mild cognitive impairment," or memory loss and thinking problems, for three years. One-third received Aricept, one-third vitamin E, and one-third a sugar pill. After three years, 212 patients had developed Alzheimer's.

The Aricept patients had a 58 percent lower risk of developing Alzheimer's after the first year of the study, a 36 percent lower risk after the second, and an equal risk after three years. After three years, Aricept still helped one group of patients - carriers of a gene that puts them at higher risk for Alzheimer's.

"It's not overwhelming. It's not going to last and last," said Dr. Ronald C. Petersen, director of the Alzheimer's Disease Research Center at the Mayo Clinic and the study's lead author. "It at least gives people some hope that we can intervene earlier."

The modest results are comparable to results in patients who already have Alzheimer's. Studies have found a six-month delay in progress of the disease.

The failure of vitamin E comes on the heels of studies showing that the popular vitamin doesn't reduce risks of cancer or heart problems and may increase the risk of heart failure.

Petersen presented the study, to be published in the June 9 edition of the Journal, at the American Academy of Neurology's annual meeting Wednesday. The study was funded by the National Institute on Aging and by Eisai Inc. and Pfizer Inc., the drug's maker and marketers. The companies had no role in the study's design or analysis.

The study's authors didn't recommend that people with memory loss take Aricept, but it "should open the door" for patients to discuss it with their doctors, Petersen said. It's likely that many patients will want the drug, said Dr. Sam Gandy, director of the Farber Institute for Neurosciences at Thomas Jefferson University and vice chairman of the medical advisory board of the Alzheimer's Association.

"Memory loss is distressing, and the concern of progressing to Alzheimer's is very real and very serious," he said. "Once you're counting the days where you know what your surroundings are and recognize your loved ones, every day counts."

If such a drug were available when her husband first had problems, Eloise Williams said, she would want him to take it - even if it worked for only a year.

"I guess you cling to whatever you can get," she said. "If I could get another year, I would take it. That would give you a year to build some more memories."

[Last modified April 14, 2005, 01:17:13]