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Back To Vidyya NICE Recommends Treatment For Mild To Moderate Alzheimer's Disease

Group Recommends Treatment To Be Made Available On The NHS

On Friday, the UK National Institute of Clinical Excellence (NICE) announced that treatments for Alzheimer's disease should be made available as part of the management of people with mild to moderate Alzheimer's disease within the UK.

European Approval of Novel Dual Action Treatment

Two pharmaceutical companies, Shire and Janssen, have jointly developed Reminyl(tm) (galantamine), a new dual action treatment for Alzheimer's disease, approved under the EU Mutual Recognition Procedure and recently launched in the UK and Ireland.

  • Reminyl has a novel dual mechanism of action. Like other Alzheimer's treatments currently on the market, Reminyl inhibits the enzyme acetylcholinesterase.
  • However, in addition, Reminyl also modulates the brain's nicotinic receptors.2 Compounds which modulate nicotinic receptors may increase the release of acetylcholine and other neurotransmitters which are believed to play a role in AD pathophysiology.2,3,4

Reminyl's Clinical Trial Results

  • Over 3,200 patients worldwide have taken part in a rigorous programme of 6 randomised controlled clinical trials evaluating the use of Reminyl in Alzheimer's disease.5
  • The trials assessed the benefits of Reminyl across the four domains of Alzheimer's disease: cognitive impairment; activities of daily living; behavioural disturbances; and the impact of all these on the caregiver. Reminyl is the only Alzheimer's treatment shown in clinical trials to have a positive impact on all four domains.6,7,8 
  • Recently, two Phase III studies published in Neurology6,7 have demonstrated that Reminyl significantly improves cognitive, functional and behavioural symptoms compared to placebo over 6 months. Benefits on cognition and the ability to perform activities of daily living (ADL) were maintained over 12 months.
  • A third study was recently published in the British Medical Journal9 and again demonstrated that Reminyl significantly improves cognitive function and, relative to placebo, slowed the progression of functional decline.

NICE has endorsed the role of Reminyl and other treatments in the management of Alzheimer's disease. The focus now should be to ensure that NICE guidance is implemented throughout the UK, in order to resolve the issue of so-called 'postcode prescribing' and ensure fair and equal access to treatment.

  1. Under review with the US Food and Drug Administration (FDA)
  2. Maelicke : Allosteric modulation of nicotinic receptors as a treatment strategy for Alzheimer's disease, Dementia Geriatric Cogn. Disorders 2000, 11(suppl 1): 11-18
  3. Schrattenholz A et al. Agonist Responses of Neuronal Nicotinic Acetylcholine Receptors Are Potentiated by a Novel Class of Allosterically Acting Ligands. Molecular Pharmacology. 1996; 49:1-6
  4. Vidal, C. Nicotinic Receptors in the Brain: Molecular Biology, Function, and Therapeutics. Molecular and Chemical Neuropathology. 1996;28:3-11
  5. Lillenfeld S. and Parys W. Galantamine: additional benefits to patients with Alzheimer's disease, Dementia and Geriatric Cognitive Disorders: 11 (suppl 1): 19-27
  6. Tariot P N et al. A five month, randomized, placebo-controlled trial of galantamine in AD. Neurology (2000); 54: 2269-2278
  7. Raskind M A et al. Galantamine in AD. Neurology (2000); 54: 2261-2268
  8. Wilcock G & Lillenfeld H. Poster presented at World Alzheimer's Congress, Washington DC, USA July 9-13 2000
  9. Wilcock et al. Efficacy and safety of galantamine in patients with mild to moderate Alzheimer's disease: multicentre randomised controlled trial. British Medical Journal (2000), 321: 1445-1449

Please refer to the Reminyl Summary of Product Characteristics for full prescribing information. This may be obtained from:
Niamh Matthews (Medical Information, Shire) +44 (0)1264 348541

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Editor: Susan K. Boyer, RN
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