순수 알츠하이머병 치매 환자군과 혼합성 치매 환자군에서 12개월간의 도네페질(Donepezil) 투여에 따른 치료 성적의 비교 평가

Comparative Assessment of Clinical Efficacy after 12-Month Clinical Trial of Donepezil between the Patients with Pure Alzheimer’s Disease and Mixed Dementia

Objectives：The purpose of this study was to compare the efficacy of donepezil treatment between patients with pure Alzheimer’s disease (AD) and Mixed dementia (MD) during a 12-month trial. Methods：A total of 139 patients were recruited for this 52-week study. The effect of donepezil on cognitive function was measured using Alzheimer’s Disease Assessment Scale-cognitive subscale-preliminary Korean version (ADAS-cog-K). Patients’ activities of daily living using the Seoul-Instrumental Activities of Daily Living (S-IADL) and Seoul-Activities of Daily Living (S-ADL)；behavioral symptoms using the Korean version Neuropsychiatric Inventory (K-NPI) were measured at baseline, 13-weeks, 26-weeks, 39-weeks and 52-weeks. We defined the responsive patients to donepezil at those who showed a cognitive improvement or no change during the first six-month clinical trial. Results：84 pure AD patients and 34 MD patients were available for intent-to-treat (ITT) last observation carried forward (LOCF) analysis. There was no significant difference between two groups in mean change from baseline in the total ADAS-cog-k, S-ADL, SIADL and K-NPI scores at 52-week. Based on the operational criteria, 60.7% of pure AD patients and 58.8% of MD patients were responders to donepezil. Conclusion：MD patients had similar levels of efficacy with pure AD patients and donepezil was well tolerated in both groups. These results suggest that donepezil is an effective and well-tolerated treatment for MD patients as well as for pure AD patients.