Two-year outcome of Galantamine treatment in Alzheimer’s disease in a routine clinical setting.

Objectives: To describe and evaluate the two-year outcome on cognition (MMSE, ADAS-cog) and global rating (CIBIC) of galantamine treatment in Alzheimer’s disease (AD) in a routine clinical setting. Methods: The Swedish Alzheimer Treatment Study (SATS) is an open, longitudinal, multicenter study evaluating cholinesterase inhibitor (ChEI) treatment in AD. Patients are investigated at baseline, at 2 months and every 6 months for a total period of three years. Here we present the two-year outcome for the first 123 patients receiving the ChEI galantamine in SATS. Results: At baseline the mean (±SD) age of the patients was 72.3 (±7.7) years, the MMSE score 23.3 (±4.2) and the ADAS-cog score 17.2 (±8.4). After two years of treatment the total mean decline from baseline in MMSE-score was 1.6 points (95% CI, 0.6 - 2.6). The ADAS-cog rise after two years was 3.8 points (95% CI, 1.9 - 5.6) i.e. significantly better than the score predicted by the Stern equation (8.3 points, 95% CI, 7.3 - 9.4). Half of the patients were considered unchanged or better in the CIBIC-rating after two years of treatment. At this time 70 % of the patients remained in the study. Conclusions: Long-term galantamine treatment in a routine clinical setting resulted in a positive effect in cognitive tests compared to historical controls and mathematical models. After 2 years of treatment a positive global outcome was observed in half of the patients. Dropout was less than expected.