Leczenie choroby Alzheimera: czy istnieją możliwości przewidywania klinicznej odpowiedzi na inhibitory cholinesterazy?

• Authors: Marcin Flirski , Iwona Kłoszewska , Tomasz Sobów

Title variants

EN

Predictors of clinical response to cholinesterase inhibitors in dementia of Alzheimer’s type

• Languages of publication: EN PL

Abstracts

EN

Acetylcholinesterase inhibitors are the mainstay of treatment of Alzheimer’s disease. However, in the majority of studies the proportion of patients demonstrating a significant clinical improvement under treatment does not exceed 40%. A routine method of identifying responders in clinical practice is the assessment of change in their cognitive functions during treatment. This review presents the available data on predictors of response to acetylcholinesterase inhibitor therapy in Alzheimer’s disease – factors allowing the prognosis of a patient’s reaction to treatment (in terms of target symptoms and tolerance) at its very beginning or even before therapy has been initiated. A variety of predictors will be discussed: genetic factors (apolipoprotein E, butyrylcholinesterase, choline acetyltransferase), demographic factors (age, gender), clinical factors (severity and rate of progression of dementia, comorbid neuropsychiatric symptoms, vascular risk factors, response to the test dose of the drug, results of neuropsychological testing, orthostatic hypotension), and work-up results (SPECT, MRI, EEG). The ability to predict patient’s response to treatment would allow a precise choice of szczególdrug for a given patient, taking into account its clinical efficacy in different subpopulations and potency for the generation of side effects, could also help cut down the global costs of prescribing those medications, and stimulate research on the biological mechanisms of Alzheimer’s disease. Altogether, the current level of knowledge on predictors of response to acetylcholinesterase inhibitors, with good tolerance and benign side-effect profile of this class of drugs, and lack of alternative, more effective methods of treatment of Alzheimer’s disease cannot entitle the physician to give up on the introduction of treatment in any single patient.

Keywords

EN

Alzheimer’s disease; cholinesterase inhibitors; choroba Alzheimera; inhibitory cholinesterazy; odpowiedź; predictors; response; skuteczność

Discipline

• MEDICINE: MEDICINE

• Publisher: Medical Communications
• Journal: Aktualności Neurologiczne
• Year: 2006
• Volume: 6
• Issue: 2
• Pages: 95-107

Contributors

author

Marcin Flirski

• Klinika Psychiatrii Wieku Podeszłego i Zaburzeń Psychotycznych, Uniwersytet Medyczny w Łodzi. Kierownik Kliniki: dr hab. n. med. Iwona Kłoszewska

author

Iwona Kłoszewska

• Klinika Psychiatrii Wieku Podeszłego i Zaburzeń Psychotycznych, Uniwersytet Medyczny w Łodzi. Kierownik Kliniki: dr hab. n. med. Iwona Kłoszewska

author

Tomasz Sobów

• Klinika Psychiatrii Wieku Podeszłego i Zaburzeń Psychotycznych, Uniwersytet Medyczny w Łodzi, ul. Czechosłowacka 8/10, 92-216 Łódź, tel./faks 042 678 36 99

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• Document Type: article