Donepezil and memantine in moderate to severe Alzheimers disease - The DOMINO-AD Trial

多奈哌齐和美金刚治疗中度至重度阿尔茨海默病 - DOMINO-AD 试验

• 批准号: G0600989/1
• 负责人: Robert Howard
• 金额: $ 368.53万
• 依托单位: King's College London
• 依托单位国家: 英国
• 项目类别: Research Grant
• 财政年份: 2006
• 资助国家: 英国
• 起止时间: 2006 至 无数据
• 项目状态: 已结题
• 来源: https://gtr.ukri.org/projects?ref=G0600989%2F1
• 关键词: Donepezil; memantine; moderate; severe; Alzheimers

Alzheimer s disease is a devastating and progressive degenerative disorder for which there is no cure or treatment that can halt decline into a state of total dependence upon nursing care. A number of drug treatments have been shown to make small but significant and short-term improvements in some symptoms such as memory function or agitated or withdrawn behaviour in sufferers. Even when clear improvements are not seen with treatment, many studies have shown that those patients who are given these drugs do not decline as rapidly as those who were allocated placebo over a period of 6 months. Donepezil is a cholinesterase inhibitor - a drug which has been licensed for the treatment of patients with mild to moderate Alzheimer s disease. Memantine is a member of a different class of drugs and has a license for the treatment of patients with moderate to severe Alzheimer s disease. The two drugs work in different ways in the brain and there is some evidence that patients who are treated with both drugs together will decline less rapidly than those treated with just one drug. We want to see if this is correct and to see whether the benefits of drug treatments translate into real advantages in terms of preservation of activities of daily life and quality of life in patients. Because these drugs are relatively expensive, there is debate as to whether they are really cost-effective and therefore whether or not they should be available on the NHS. The DOMINO-AD Trial will provide information about the cost-effectiveness of these treatments to inform such a decision.

阿尔茨海默病是一种毁灭性的、进行性的退行性疾病，目前还没有治愈或治疗方法，无法阻止患者陷入完全依赖护理的状态。许多药物治疗已被证明对患者的某些症状，如记忆功能或激动或孤僻行为，有微小但显著的短期改善。即使在治疗没有明显改善的情况下，许多研究表明，在6个月的时间里，服用这些药物的患者的下降速度不如那些服用安慰剂的患者快。多奈哌齐是一种胆碱酯酶抑制剂，已被批准用于治疗轻度至中度阿尔茨海默病。美金刚是另一种药物，被许可用于治疗中重度阿尔茨海默病。这两种药物在大脑中以不同的方式起作用，有证据表明，同时服用两种药物的患者比只服用一种药物的患者衰退的速度要慢。我们想看看这是否正确，看看药物治疗的好处是否转化为真正的优势，在保持日常生活活动和患者的生活质量方面。由于这些药物相对昂贵，因此关于它们是否真正具有成本效益以及是否应该在NHS中提供这些药物存在争议。DOMINO-AD试验将提供有关这些治疗的成本效益的信息，为此类决策提供依据。