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Cholinesterase inhibitors (ChEIs) by the US Food and Drug Administration Bureau ( the FDA ) approved Alzheimer's disease (AD) in symptomatic treatment drugs, including donepezil, galantamine and
.
However, their efficacy for mild cognitive impairment (MCI) is uncertain
Manage FDA
Quite a few studies have been conducted to evaluate the impact of CEI treatment on MCI patients
.
However, participants were included on the basis of the clinical diagnosis of MCI , and there was no pathological confirmation of AD
diagnosis
The lack of approved drug treatments for MCI patients and concerns about progression to dementia may lead to the use of ChEIs, although there is no strong evidence for their efficacy
.
Since ChEIs were developed based on the pathological changes of early AD, assessing the impact of ChEIs on MCI patients with AD biomarkers may provide useful clues about the timing of starting treatment or the indications for the use of ChEI
In this way, Jung-Min Pyun of Seoul University in South Korea explored the impact of ChEIs on the cognitive abilities of MCI patients and their interaction with amyloidosis
.
They enrolled 111 MCI patients with a clinical dementia score (CDR) of 0.
5, underwent a 1-year follow-up cognitive assessment, and underwent amyloid positron emission tomography within 6 months before and after the baseline cognitive assessment ( PET) (73 CEI users and 38 CEI non-users), from the Neurocognitive Behavior Center of Bundang Hospital, Seoul National University
In addition, patients who had a positive amyloid PET scan more than 6 months before the baseline cognitive evaluation and patients who had a negative amyloid PET scan more than 6 months after the 1-year follow-up cognitive evaluation were also included.
In a total of 111 patients, 25 CEI users and 25 CEI non-users were matched with propensity scores through baseline Mini Mental State Examination (MMSE) scores, age, education level, CDR and amyloid PET positive rates
.
A multiple linear regression analysis was performed to evaluate the effect of using CEI and amyloid PET positive on cognitive changes within 1 year
They found that the use or non-use of CEI was not related to cognitive changes within 1 year
.
Positive or negative amyloid PET did not change this non-correlation
In addition, the progression of CDR 1 was associated with a low baseline MMSE score (OR 0.
606, CI 0.
381-0.
873), but not with the use or absence of CEI, nor with the results of amyloid PET
.
The important significance of this study is that it found that in patients with or without amyloid burden, the use or non-use of CEI has nothing to do with the cognitive changes during the 1-year follow-up
.
In addition, the use or absence of CEI cannot predict disease progression to CDR 1 at 1 year follow-up
In patients with or without amyloid burden, the use or absence of CEI was not associated with cognitive changes during the 1-year follow-up
Original source:
Pyun JM, Ryoo N, Park YH, Kim S.
Change in cognitive function according to cholinesterase inhibitor use and amyloid PET positivity in patients with mild cognitive impairment.
Alz Res Therapy.
2021;13(1):10.
doi: 10.
1186/s13195-020-00749-5
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