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Effectiveness of Donepezil in Reducing Clinical Worsening in Patients with Mild-to-Moderate Alzheimer's Disease
Dementia and Geriatric Cognitive Disorders, 09/25/09

Wilkinson D et al. – In this population, donepezil treatment was associated with reduced odds of clinical worsening of AD symptoms. Moreover, patients worsening on donepezil were likely to experience less cognitive decline than expected if left untreated. This suggests that AD patients showing clinical worsening on donepezil may still derive benefits compared with placebo/untreated patients.

Methods

Data from 906 patients (388 receiving placebo; 518 receiving donepezil) with mild–to–moderate AD [Mini–Mental State Examination (MMSE) score 10–27] were pooled from 3 randomized, double–blind placebo–controlled studies.
Clinical worsening was defined as decline in (1) cognition (MMSE), (2) cognition and global ratings (Clinician's Interview–Based Impression of Change plus Caregiver Input/Gottfries–Brane–Steen scale) or (3) cognition, global ratings and function (various functional measures).

Results

At week 24, lower percentages of donepezil–treated patients than placebo patients met the criteria for clinical worsening, regardless of the definition.
The odds of declining were significantly reduced for donepezil–treated versus placebo patients.
Among patients meeting criteria for clinical worsening, mean declines in MMSE scores were greater for placebo than donepezil–treated patients.

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