Safety and efficacy of galantamine in subjects with mild cognitive impairment

Winblad, B., Gauthier, S., Scinto, L., Feldman, H., Wilcock, G. K., Truyen, L., Mayorga, A. J., Wang, D., Brashear, H. R., Nye, J. S. (May 2008) Safety and efficacy of galantamine in subjects with mild cognitive impairment. Neurology, 70 (22). pp. 2024-35. ISSN 1526-632X (Electronic)0028-3878 (Linking)

DOI: 10.1212/01.wnl.0000303815.69777.26


OBJECTIVE: To assess the safety of galantamine in subjects with mild cognitive impairment (MCI), the ability of galantamine to benefit cognition and global functioning in subjects with MCI, and the ability of galantamine to delay conversion to dementia. METHODS: In two studies, 2,048 subjects, 990 in Study 1 and 1,058 in Study 2, with a Clinical Dementia Rating (CDR) = 0.5, CDR memory score > or =0.5, without dementia were randomized to double-blind galantamine (16-24 mg/day) or placebo for 24 months. Primary efficacy endpoint at month 24 was number (%) of subjects who converted from MCI to dementia (CDR > or = 1.0). RESULTS: There were no differences between galantamine and placebo in 24-month conversion rates (Study 1: 22.9% [galantamine] vs 22.6% [placebo], p = 0.146; Study 2: 25.4% [galantamine] vs 31.2% [placebo], p = 0.619). Mean CDR-sum of boxes declined less with galantamine than placebo at 12 and 24 months in Study 1 (p = 0.024 [12 months] and p = 0.028 [24 months]), but not in Study 2 (p = 0.662 [12 months] and p = 0.056 [24 months]). Digit Symbol Substitution Test scores improved with galantamine in Study 1 at 12 months and in Study 2 at 24 months (Study 1: p = 0.009 [month 12] and p = 0.079 [Month 24]; Study 2: p = 0.154 [month 12] and p = 0.020 [month 24]). The most frequently reported adverse event was nausea (galantamine, 29%; placebo, 10%). Serious AEs occurred in 19% of each group. Mortality of the cohort after retrospectively determining the status of subjects (98.3%) at 24 months was 1.4% (galantamine) and 0.3% (placebo); RR (95% CI), 1.70 (1.00, 2.90). CONCLUSIONS: Galantamine failed to significantly influence conversion to dementia. Galantamine was generally well tolerated. Whereas recorded mortality was greater in the galantamine group than in the placebo group in the original per-protocol assessment, a post hoc analysis of the cohort was consistent with no increased risk.

Item Type: Paper
Uncontrolled Keywords: Aged Aged, 80 and over Alzheimer Disease/mortality/prevention & control Cognition Disorders/ drug therapy/mortality/ psychology Cohort Studies Double-Blind Method Female Galantamine/ adverse effects/therapeutic use Humans Male Middle Aged Retrospective Studies
Subjects: diseases & disorders
diseases & disorders > mental disorders
CSHL Authors:
Communities: CSHL labs > Henn lab
Depositing User: Matt Covey
Date: 27 May 2008
Date Deposited: 25 Feb 2013 19:56
Last Modified: 25 Feb 2013 19:56
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