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FDA
Approves Alzheimer's Drug By
Shankar The new medicine, Memantine, works in a different way
than the several drugs used to treat early Alzheimer's disease. New
research that has not yet been published -- but was evaluated by the Food
and Drug Administration in making yesterday's approval -- suggests that a
combination of old and new medicines may be especially potent. Perhaps of greatest interest to patients and caregivers
is the glimmer of possibility that Memantine may help not only with
symptoms, but also in slowing the march of a neurodegenerative illness
that has long been considered unstoppable. The unpublished study showed that patients getting both
Memantine and an older medicine showed moderate improvement in their
cognitive ability. Most doctors have hoped only to stabilize or slow the
decline of Alzheimer's patients. For families struggling with the disease, the loss of a
patient's thinking abilities, including the powers of recognition and
concentration that make patients feel connected with loved ones, can be
especially cruel. "We're optimistic that this is going to have an
impact," said Anton Porsteinsson, an assistant professor of
psychiatry at the Porsteinsson cited the anecdotal example of an elderly
patient who slowly lost the ability to participate in conversations and
joke back and forth as her Alzheimer's disease progressed, even though she
was taking the popular medicine Aricept. "Now she was getting more and more passive, not
joking around, dozing off -- you didn't feel connected with her," he
said in an interview. The patient's family arranged to add Memantine to her
treatment -- they brought the medicine from "She regained the ability to participate, to have
interaction with people around her," Porsteinsson said. "She was
much more verbal, attentive and not falling asleep all the time -- she
regained some of her ability to participate in the conversation and joke
around." The advent of Memantine has generated excitement among
physicians and patients, but Porsteinsson and other physicians warned that
it is not a magic bullet. His research has been presented at professional meetings
but has not yet been published in a peer-reviewed journal. He said the
study evaluated the benefits of adding Memantine to existing treatments
for patients with moderate and severe Alzheimer's -- people who need
assistance with daily living. Patients taking Memantine and the older medicine still
declined in daily functioning -- such as in the ability to dress and bathe
on their own -- but those in the group taking only the older medicine had
even steeper declines. Another scale used to measure behavior problems in
Alzheimer's patients showed that patients who got Memantine were stable at
the end of the six-month trial, whereas there was a decline in the other
group of patients. As with an earlier study that had evaluated Memantine
against dummy pills, the drug appeared to be well tolerated. "There are very few side effects with Memantine,"
said Steven Ferris of the Alzheimer's Disease Center at Ferris said Memantine focuses on a brain receptor system
called NMDA, which regulates the entry of calcium into brain cells. The
entry of calcium is involved in cell death in several neurodegenerative
conditions -- and blocking its action may explain Memantine's benefits,
Ferris said. The previous class of medicines, including drugs such as
Aricept, work on a different receptor system in the brain. While cautioning that Memantine is not a cure, Ferris
said, "Lots of small steps add up to a big benefit to patients."
Copyright
© 2002 Global Action on Aging |
