Double-Blind, Placebo-Controlled Study of Metrifonate, an... : Alzheimer Disease & Associated Disorders (original) (raw)
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Double-Blind, Placebo-Controlled Study of Metrifonate, an Acetylcholinesterase Inhibitor, for Alzheimer Disease
Becker, Robert E.; Colliver, Jerry A.; Markwell, Stephen J.; Moriearty, Pamela L.; Unni, Latha K.; Vicari, Sandra
Department of Psychiatry, Southern Illinois University School of Medicine, Springfield, Illnois, U.S.A.
Abstract
Summary:
Fifty patients with probable Alzheimer disease (AD) completed a 3-month double-blind study to compare metrifonate to placebo. We dosed metrifonate to achieve a 40–60% inhibition of red blood cell acetylcholinesterase activity. The Alzheimer Disease Assessment Scale cognitive subscale score (ADAS-C) served as the primary outcome measure. At the completion of 3 months of treatment, the metrifonate group ADAS-C score differed significantly from the placebo group score by 2.6 points (p<0.01). A 0.75-point trend toward improvement occurred during treatment in the ADAS cognitive performance of the metrifonate group (p=0.15), and a 1.10-point deterioration in cognitive performance was found in the placebo group (p<0.02). On the Global Improvement Scale (GIS), the two groups differed significantly on their changes from baseline to treatment phase (p<0.02). Significant deterioration occurred in GIS scores (p<0.01) and in Mini Mental State Examination (MMSE) scores (p<0.03) in the placebo-treated group. Adverse effects were uncommon and did not require adjustment of the dose of metrifonate or discontinuation of treatment. We achieved a mean of 52.3% decrease in red blood cell acetylcholinesterase activity. During up to 18 months of subsequent open metrifonate treatment of patients, we found a deterioration of 1.68 points per year in MMSE performance. These findings support further study of the effects of metrifonate on deterioration rate in AD.
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