Drug-cholinesterase-inhibitors persistence patterns in treated patients with dementia of Alzheimer type retrospective comparative analysis of donepezil, wastigmineand galantamine

Introduction and aim. Long term duration of treatment of the dementia of Alzheimer type, the most frequent type of dementia in our environment, is associated with delay in patient functional and cognitive impairment. The aim of the study was to determine retrospectively the persistence of treatment with donepezil, rivastigmine and galantamine in patients with dementia of the Alzheimer type in a population setting. Patients and methods. Retrospective study performed in Primary Care Health Centres. The study included patients who were treated between January, 2000 and September 2003. Kaplan-Meier survival analysis was applied to assess Pattern of treatment persistence. Results. A total of 95 patients (78.8% female), with a mean age of 77.6 years (SD: 6.2) were included; 39 donepezil, 35 rivastigmine, and 21 galantamine, with a mean MMSE score of 10.3 +/- 7.8, 9.7 +/- 8.4 and 13.6 +/- 7.1, respectively (p = 0.256). Mean treatment duration was donepezil: 80.3 (SD: 7,7) weeks, rivastigmine: 52.4(SD: 5.3) weeks and galantamine: 49.8(SE: 4,0) weeks, p:less than or equal to0.01. Median persistence of treatment was 129.3 weeks for donepezil, 59.1 for rivastigmine and 45.0 for galantamine, p less than or equal to0.001 in both cases. At week 52, 62% of donepezil-treated patients maintained the initial therapy, compared with 40% rivastigmine-treated and 33% galantamine-treated, p < 0.05. Conclusion. This retrospective study found that patients with dementia of the Alzheimer type treated with donepezil showed more persistence of treatment compared which those who received rivastigmine or galantamine.