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Dose and plasma concentration of galantamine in Alzheimer's disease - clinical application

Wattmo, Carina LU ; Jedenius, Erik ; Blennow, Kaj and Wallin, Åsa LU (2013) In Alzheimer's Research & Therapy 5(1).
Abstract
Introduction: Patients with Alzheimer's disease (AD) are currently treated with cholinesterase inhibitors, such as galantamine, without actual knowledge of its concentration in plasma. Our objective was to analyse potential relationships between galantamine concentration, galantamine dose, socio-demographic characteristics, body weight, body mass index (BMI), and treatment response. Methods: Eighty-four patients with AD recruited from the Memory Clinic, Malmo, Sweden, and treated with galantamine were included in the study. Efficacy measures, including cognition (Mini-Mental State Examination (MMSE), Alzheimer's Disease Assessment Scale - cognitive subscale (ADAS-cog)) and instrumental activities of daily living (IADL), were evaluated at... (More)
Introduction: Patients with Alzheimer's disease (AD) are currently treated with cholinesterase inhibitors, such as galantamine, without actual knowledge of its concentration in plasma. Our objective was to analyse potential relationships between galantamine concentration, galantamine dose, socio-demographic characteristics, body weight, body mass index (BMI), and treatment response. Methods: Eighty-four patients with AD recruited from the Memory Clinic, Malmo, Sweden, and treated with galantamine were included in the study. Efficacy measures, including cognition (Mini-Mental State Examination (MMSE), Alzheimer's Disease Assessment Scale - cognitive subscale (ADAS-cog)) and instrumental activities of daily living (IADL), were evaluated at baseline, 2 months after treatment initiation (MMSE only) and semi-annually over 3 years. At these assessments, blood samples were obtained for the analysis of the galantamine concentration, and body weight, BMI, drug dose and time from drug intake were recorded. Results: All patients had a measurable concentration of galantamine at all assessments. The mean plasma concentration of the drug exhibited a positive linear association with dose (r = 0.513, P < 0.001). The dose did not differ between sexes. Negative linear associations between the galantamine plasma concentration and BMI (r = -0.454, P = 0.001) or body weight (r = -0.310, P = 0.034) were found exclusively in the male group. When mixed-effects models were used, the dose of galantamine (P < 0.001), time from drug intake (P < 0.001), and BMI (P = 0.021) or weight (P = 0.002) were factors that predicted the concentration, whereas sex, age, and cognitive and functional changes were not. Conclusions: High compliance to galantamine treatment was found among all patients in this naturalistic AD study. The impact of BMI or body weight on the plasma concentration of galantamine was important only among males. No relationship was observed between concentration and short-term treatment response or progression rate in terms of cognitive and functional abilities. (Less)
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author
; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Alzheimer's Research & Therapy
volume
5
issue
1
article number
2
publisher
BioMed Central (BMC)
external identifiers
  • wos:000325285300002
  • scopus:84871721290
  • pmid:23286718
ISSN
1758-9193
DOI
10.1186/alzrt156
language
English
LU publication?
yes
id
1d702902-64d4-4fe9-8051-a86da983d82f (old id 4172446)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/23286718
date added to LUP
2016-04-01 12:56:59
date last changed
2025-04-04 14:39:05
@article{1d702902-64d4-4fe9-8051-a86da983d82f,
  abstract     = {{Introduction: Patients with Alzheimer's disease (AD) are currently treated with cholinesterase inhibitors, such as galantamine, without actual knowledge of its concentration in plasma. Our objective was to analyse potential relationships between galantamine concentration, galantamine dose, socio-demographic characteristics, body weight, body mass index (BMI), and treatment response. Methods: Eighty-four patients with AD recruited from the Memory Clinic, Malmo, Sweden, and treated with galantamine were included in the study. Efficacy measures, including cognition (Mini-Mental State Examination (MMSE), Alzheimer's Disease Assessment Scale - cognitive subscale (ADAS-cog)) and instrumental activities of daily living (IADL), were evaluated at baseline, 2 months after treatment initiation (MMSE only) and semi-annually over 3 years. At these assessments, blood samples were obtained for the analysis of the galantamine concentration, and body weight, BMI, drug dose and time from drug intake were recorded. Results: All patients had a measurable concentration of galantamine at all assessments. The mean plasma concentration of the drug exhibited a positive linear association with dose (r = 0.513, P &lt; 0.001). The dose did not differ between sexes. Negative linear associations between the galantamine plasma concentration and BMI (r = -0.454, P = 0.001) or body weight (r = -0.310, P = 0.034) were found exclusively in the male group. When mixed-effects models were used, the dose of galantamine (P &lt; 0.001), time from drug intake (P &lt; 0.001), and BMI (P = 0.021) or weight (P = 0.002) were factors that predicted the concentration, whereas sex, age, and cognitive and functional changes were not. Conclusions: High compliance to galantamine treatment was found among all patients in this naturalistic AD study. The impact of BMI or body weight on the plasma concentration of galantamine was important only among males. No relationship was observed between concentration and short-term treatment response or progression rate in terms of cognitive and functional abilities.}},
  author       = {{Wattmo, Carina and Jedenius, Erik and Blennow, Kaj and Wallin, Åsa}},
  issn         = {{1758-9193}},
  language     = {{eng}},
  number       = {{1}},
  publisher    = {{BioMed Central (BMC)}},
  series       = {{Alzheimer's Research & Therapy}},
  title        = {{Dose and plasma concentration of galantamine in Alzheimer's disease - clinical application}},
  url          = {{https://lup.lub.lu.se/search/files/3064467/4610156.pdf}},
  doi          = {{10.1186/alzrt156}},
  volume       = {{5}},
  year         = {{2013}},
}