Advanced

Can CSF biomarkers or pre-treatment progression rate predict response to cholinesterase inhibitor treatment in Alzheimer's disease?

Wallin, A K; Hansson, Oskar LU ; Blennow, K; Londos, Elisabet LU and Minthon, Lennart LU (2009) In International Journal of Geriatric Psychiatry 24. p.638-647
Abstract
OBJECTIVE: The main objective of this study was to investigate possible predictors of response to cholinesterase inhibitor (ChEI) treatment, including pre-treatment progression rates and levels of the cerebrospinal fluid (CSF) biomarkers. A secondary objective was to evaluate whether treatment with ChEI changed progression. METHODS: Out-patient individuals (n = 191) with the clinical diagnosis of Alzheimer's disease received ChEI treatment and were part of the Swedish Alzheimer Treatment Study (SATS), a prospective, longitudinal, non-randomised study in a routine clinical setting. Patients were assessed with MMSE, ADAS-cog and a global rating (CIBIC) at baseline, 2 months and every 6 months for a total period of 3 years. The following... (More)
OBJECTIVE: The main objective of this study was to investigate possible predictors of response to cholinesterase inhibitor (ChEI) treatment, including pre-treatment progression rates and levels of the cerebrospinal fluid (CSF) biomarkers. A secondary objective was to evaluate whether treatment with ChEI changed progression. METHODS: Out-patient individuals (n = 191) with the clinical diagnosis of Alzheimer's disease received ChEI treatment and were part of the Swedish Alzheimer Treatment Study (SATS), a prospective, longitudinal, non-randomised study in a routine clinical setting. Patients were assessed with MMSE, ADAS-cog and a global rating (CIBIC) at baseline, 2 months and every 6 months for a total period of 3 years. The following potential predictors of treatment response were investigated: age, gender, APOE epsilon4 carrier, education, duration of disease, cognitive level, pre-treatment progression rate (in MMSE) and the levels of the CSF biomarkers Abeta42, T-tau and P-tau. RESULTS: Fast pre-treatment progression rate was a predictor of treatment response even after adjusting for baseline severity, another positive predictor of response. Patients in the fastest quartile of pre-treatment progression rates were significantly more prone to be responders at 2 months (adjusted OR 6.6, p = 0.001) and 6 months (adjusted OR 10.4, p < 0.001) than those in the slowest progressing quartile. Moreover, the linearity of progression was significantly changed by ChEI treatment at 6 months compared to the pre-treatment period. CONCLUSION: The rate of pre-treatment progression was the most consistent positive predictor of ChEI treatment response in the routine clinical setting. The progression rate was significantly changed by ChEI treatment. Copyright (c) 2009 John Wiley & Sons, Ltd. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
International Journal of Geriatric Psychiatry
volume
24
pages
638 - 647
publisher
John Wiley and Sons Ltd
external identifiers
  • wos:000266674900012
  • pmid:19123199
  • scopus:67649386714
ISSN
1099-1166
DOI
10.1002/gps.2195
language
English
LU publication?
yes
id
54dd3359-5ca6-44cc-a9ed-02a2f1316ffd (old id 1290004)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/19123199?dopt=Abstract
date added to LUP
2009-02-03 09:55:09
date last changed
2017-11-12 04:07:49
@article{54dd3359-5ca6-44cc-a9ed-02a2f1316ffd,
  abstract     = {OBJECTIVE: The main objective of this study was to investigate possible predictors of response to cholinesterase inhibitor (ChEI) treatment, including pre-treatment progression rates and levels of the cerebrospinal fluid (CSF) biomarkers. A secondary objective was to evaluate whether treatment with ChEI changed progression. METHODS: Out-patient individuals (n = 191) with the clinical diagnosis of Alzheimer's disease received ChEI treatment and were part of the Swedish Alzheimer Treatment Study (SATS), a prospective, longitudinal, non-randomised study in a routine clinical setting. Patients were assessed with MMSE, ADAS-cog and a global rating (CIBIC) at baseline, 2 months and every 6 months for a total period of 3 years. The following potential predictors of treatment response were investigated: age, gender, APOE epsilon4 carrier, education, duration of disease, cognitive level, pre-treatment progression rate (in MMSE) and the levels of the CSF biomarkers Abeta42, T-tau and P-tau. RESULTS: Fast pre-treatment progression rate was a predictor of treatment response even after adjusting for baseline severity, another positive predictor of response. Patients in the fastest quartile of pre-treatment progression rates were significantly more prone to be responders at 2 months (adjusted OR 6.6, p = 0.001) and 6 months (adjusted OR 10.4, p &lt; 0.001) than those in the slowest progressing quartile. Moreover, the linearity of progression was significantly changed by ChEI treatment at 6 months compared to the pre-treatment period. CONCLUSION: The rate of pre-treatment progression was the most consistent positive predictor of ChEI treatment response in the routine clinical setting. The progression rate was significantly changed by ChEI treatment. Copyright (c) 2009 John Wiley &amp; Sons, Ltd.},
  author       = {Wallin, A K and Hansson, Oskar and Blennow, K and Londos, Elisabet and Minthon, Lennart},
  issn         = {1099-1166},
  language     = {eng},
  pages        = {638--647},
  publisher    = {John Wiley and Sons Ltd},
  series       = {International Journal of Geriatric Psychiatry},
  title        = {Can CSF biomarkers or pre-treatment progression rate predict response to cholinesterase inhibitor treatment in Alzheimer's disease?},
  url          = {http://dx.doi.org/10.1002/gps.2195},
  volume       = {24},
  year         = {2009},
}