摘要
前言:阿尔茨海默病(AD)是老年痴呆症最常见的病因,其特点是认知和功能逐渐下降。目前的治疗方案包括胆碱酯酶抑制剂(Cheis)多奈哌齐(Cheis)、加兰他明(Galantamine)和里维斯丁(Rivastigmin),以及N-甲基-天冬氨酸受体拮抗剂美丹汀(Memantine)。治疗指南建议使用胆碱酯酶(ChEIS)作为一线治疗的标准。一些随机的临床研究已经证明了ChEIS对认知、整体功能、行为和日常生活活动的有所改善。然而,由于缺乏疗效和/或安全性、耐受性问题和对治疗的依从性差,患者可能无法获得持续的临床上的疗效。 方法:对发表在“Pubmed”和“Medline”上的文章进行文献检索,使用预先指定的搜索术语,根据文章的标题、摘要和全文对文章进行批判性评价。 结果与结论:本综述的结果表明,剂量滴定和ChEIS之间的切换有助于改善CHI治疗的反应,也可以解决ADI患者缺乏/失去疗效或安全性/耐受性等问题,但需要精心设计的研究才能提供有力的证据。
关键词: 阿尔茨海默病,转换,AD治疗,胆碱酯酶抑制剂,痴呆,粘附。
Current Alzheimer Research
Title:Strategies for Continued Successful Treatment in Patients with Alzheimer’s Disease: An Overview of Switching Between Pharmacological Agents
Volume: 15 Issue: 10
关键词: 阿尔茨海默病,转换,AD治疗,胆碱酯酶抑制剂,痴呆,粘附。
摘要: Introduction: Alzheimer’s disease (AD) is the most common cause of dementia, characterized by a progressive decline in cognition and function. Current treatment options for AD include the cholinesterase inhibitors (ChEIs) donepezil, galantamine, and rivastigmine, as well as the N-methyl-Daspartate receptor antagonist memantine. Treatment guidelines recommend the use of ChEIs as the standard of care first-line therapy. Several randomized clinical studies have demonstrated the benefits of ChEIs on cognition, global function, behavior and activities of daily living. However, patients may fail to achieve sustained clinical benefits from ChEIs due to lack/loss of efficacy and/or safety, tolerability issues, and poor adherence to the treatment. The purpose of this review is to explore the strategies for continued successful treatment in patients with AD.
Methods: Literature search was performed for articles published in PubMed and MEDLINE, using prespecified search terms. Articles were critically evaluated for inclusion based on their titles, abstracts, and full text of the publication.
Results and Conclusion: The findings of this review indicate that dose up-titration and switching between ChEIs may help to improve response to ChEI treatment and also address issues such as lack/loss of efficacy or safety/tolerability in patients with AD. However, well-designed studies are needed to provide robust evidence.
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Cite this article as:
Strategies for Continued Successful Treatment in Patients with Alzheimer’s Disease: An Overview of Switching Between Pharmacological Agents, Current Alzheimer Research 2018; 15 (10) . https://dx.doi.org/10.2174/1567205015666180613112040
DOI https://dx.doi.org/10.2174/1567205015666180613112040 |
Print ISSN 1567-2050 |
Publisher Name Bentham Science Publisher |
Online ISSN 1875-5828 |
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