Long-term combination drug therapy slows Alzheimer's progression

Long-term drug treatment significantly slows the progression of Alzheimer's disease, say researchers from Massachusetts General Hospital.

Alireza Atri and colleagues studied data collected from Alzheimer's patients treated at the hospital's Memory Disorders Unit since 1990.  The study included 144 patients who did not receive any treatment, 122 treated with a cholinesterase inhibitor, and 116 patients treated with a cholinesterase inhibitor and memantine, a drug that modulates the actions of the amino acid glutamate.

Results revealed that symptom progression was significantly slower in patients receiving combination therapy than it was in patients treated with cholinesterase inhibitors alone and those that received no treatment.

The researchers had, on average, 2½ years data for each patient, however they used a computer model that predicted probable outcomes for up to four years to analyze the data. The model predicted that the longer the patient received the combination therapy, the slower the rate of decline would become, thus suggesting that the treatment may actually offer brain cells some level of protection against the disease.

"Finding something that could actually modify the course of the disease is the Holy Grail of Alzheimer's treatment, but we really don't know if that is happening or what the mechanism behind these effects might be,” said study leader Alireza Atri in a news release issued by Massachusetts General Hospital. “What we can say now is that providers should help patients understand that the benefits of these drugs are long term and may not be apparent in the first months of treatment. Even if a patient's symptoms get worse, that doesn't mean the drug isn't working, since the decline probably would have been much greater without therapy."

Atri A, Shaughnessy LW, Locascio JJ, Growdon JH. Long-term Course and Effectiveness of Combination Therapy in Alzheimer Disease. Alzheimer Disease & Associated Disorders. 2008;22:209-221.

Study confirms benefit of combination therapy for Alzheimer's disease. Massachusetts General Hospital website. September 22nd 2008.