US review finds no good drugs for dementia
- From: rpautrey2 <rpautrey2@xxxxxxxxx>
- Date: Sun, 8 Jun 2008 05:42:07 -0700 (PDT)
US review finds no good drugs for dementia
Mon Mar 3, 2008 4:00pm EST
By Maggie Fox
Health and Science Editor
WASHINGTON, March 3 (Reuters) - There are no good drugs to treat
dementia and doctors just need to try them in a hit-or-miss fashion to
try to help patients, according to new guidelines released on Monday.
Experts who tried to set up treatment guidelines were disappointed to
find no good options for patients with dementia, and no way to
determine which drug might be best for certain cases.
"There is no cure for dementia and many of the drugs ... are being
prescribed without evidence," Dr. Amir Qaseem of the American College
of Physicians, who led the study, said in a telephone interview.
"The benefits of therapy may be very modest."
Qaseem and colleagues at the American Academy of Family Physicians
reviewed the results of 96 different studies of five different drugs
approved for treating dementia.
Four are in a class of drugs called cholinesterase inhibitors --
Pfizer and Eisai Co Inc's Aricept; galantamine, sold generically and
under the brand names Razadyne, Reminyl and Nivalin; rivastigmine,
sold by Novartis AG under the brand name Exelone; and tacrine,
marketed to combat Alzheimer's disease under the brand name Cognex.
The fifth drug, memantine, is known as a neuropeptide -modifying agent
and is sold by Forest Laboratories under the brand name Namenda.
The drugs can sometimes delay progression of the symptoms of dementia,
which can take many different forms.
None works very well for people in general, although individual
patients may see benefits, Qaseem said.
"There is so much variation between individual patients," he said. And
if doctors keep trying one drug after another, weeks and months can
pass. In the end, he said, "there might not be any effect at all."
Writing in the Annals of Internal Medicine, Qaseem and colleagues said
they looked for evidence that the drugs helped cognition, global
function, behavior, mood and quality of life.
Rather than trying to find the most effective drug, doctors should
focus on tolerability, adverse effects, ease of use and cost, they
recommended.
"Doctors, patients and family care-givers desperately want information
on how to treat this disease," Qaseem said.
"It is disheartening to find out that all we have to work with is
these five drugs, and the evidence on these is scant. Consider that in
50 years, one in 45 Americans will suffer from Alzheimer's disease.
This is huge problem."
Drugs need to be tested head to head, the committee said, and
combinations also should be tested.
"More research is warranted because the available evidence concerning
these pharmaceuticals' effects on quality of life is mixed and the
clinical significance of many of the findings is questionable," said
Dr. Kenneth Schellhase of the family physicians group.
The U.S. National Institutes of Health estimates that 2.4 million
people have Alzheimer's disease and another 1 million have some other
form of dementia in the United States, although advocacy groups put
the figure at 5 million.
(Editing by Will Dunham and Alan Elsner)
© Thomson Reuters 2008. All rights reserved
Article Link:
http://www.reuters.com/article/latestCrisis/idUSN03355538
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