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Exelon may benefit Alzheimer's patients who failed previous treatment

EAST HANOVER, N.J. -- If people with Alzheimer's disease (AD) don't respond to treatment, physicians and families shouldn't give up hope; another medication may work for them.

According to a new multi-center study of 382 people with AD published in Current Medical Research and Opinion, more than half of Alzheimer's disease patients who previously failed to respond to, or could not tolerate treatment with donepezil (Aricept) showed significant benefits when treated with Exelon (rivastigmine).

The new study found that 56% of patients who had stopped taking the acetylcholinesterase inhibitor donepezil because their symptoms continued to progress, or because they could not tolerate the drug's side effects, responded when therapy was initiated with the cholinesterase inhibitor Exelon. In this study, 26% of patients demonstrated significant improvements in global functioning with Exelon and 30% of subjects showed no further decline.

In Alzheimer's disease, both improvement from baseline and prevention of further decline are considered positive responses to treatment. The new findings may have important implications for future research strategies and the way physicians manage Alzheimer's disease. Taken together with other evidence, the study's findings provide strong support for physicians to consider initiating a different Alzheimer's disease therapy when patients have failed on one agent.

"Currently, physicians tend to stop treatment altogether rather than begin therapy with a new medication once a treatment has failed," said Sophie Auriacombe, MD, lead author of the study and neurologist at the Clinique St. Augustin in Bordeaux, France. "These findings suggest that starting patients on another Alzheimer's disease treatment after the first is discontinued - in this case, Exelon after discontinuation of donepezil - can be a valuable therapeutic strategy."

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Posted: May 2002