학술논문

Efficacy and safety of donepezil in patients with dementia with Lewy bodies: results from a 12‐week multicentre, randomised, double‐blind, and placebo‐controlled phase IV study.
Document Type
Article
Source
Psychogeriatrics. May2024, Vol. 24 Issue 3, p542-554. 13p.
Subject
*DONEPEZIL
*PATIENT safety
*PLACEBOS
*DATA analysis
*RESEARCH funding
*BLIND experiment
*STATISTICAL sampling
*QUESTIONNAIRES
*RANDOMIZED controlled trials
*DESCRIPTIVE statistics
*DRUG efficacy
*RESEARCH
*STATISTICS
*DEMENTIA
*CONFIDENCE intervals
Language
ISSN
1346-3500
Abstract
Background: Donepezil has been approved in Japan for the treatment of dementia with Lewy bodies (DLB) based on clinical trials showing its beneficial effects on cognitive impairment. This phase IV study evaluated the efficacy of donepezil by focusing on global clinical status during a 12‐week double‐blind phase. Methods: Patients with probable DLB were randomly assigned to the placebo (n = 79) or 10 mg donepezil (n = 81) groups. The primary endpoint was changes in global clinical status, assessed using the Clinician's Interview‐Based Impression of Change plus Caregiver Input (CIBIC‐plus). We also assessed four CIBIC‐plus domains (general condition, cognitive function, behaviour, and activities of daily living) and changes in cognitive impairment and behavioural and neuropsychiatric symptoms measured using the Mini‐Mental State Examination (MMSE) and the Neuropsychiatric Inventory (NPI), respectively. Results: Although donepezil's superiority was not shown in the global clinical status, a significant favourable effect was detected in the cognitive domain (P = 0.006). MMSE scores improved in the donepezil group after adjustments in post hoc analysis (MMSE mean difference, 1.4 (95% confidence interval (CI), 0.42–2.30), P = 0.004). Improvements in NPIs were similar between the groups (NPI‐2: −0.2 (95% CI, −1.48 to 1.01), P = 0.710; NPI‐10: 0.1 (95% CI, −3.28 to 3.55), P = 0.937). Conclusion: The results support the observation that the efficacy of 10 mg donepezil in improving cognitive function is clinically meaningful in DLB patients. The evaluation of global clinical status might be affected by mild to moderate DLB patients enrolled in this study. No new safety concerns were detected. [ABSTRACT FROM AUTHOR]