論文の公開元へPersonalized Prediction of Alzheimer's Disease and Its Treatment Effects by Donepezil: An Individual Participant Data Meta-Analysis of Eight Randomized Controlled Trials
概要
Alzheimer’s disease (AD) is a progressive neurodegenerative disorder characterized by increasing
aggravation of memory and other cognitive functions [1]. AD is the most common cause of dementia
accounting for 60 to 80% of the cases worldwide,
while it affects 10% of the population aged 65 or older
[2]. There are limited therapeutics approved for the
treatment of AD and specific patient factors contributing to treatment efficacy are not well understood.
Donepezil, an acetylcholinesterase inhibitor
(AChEI), is the first approved drug currently available to treat AD, thus has accumulated the most
abundant evidence. Donepezil is a widely standard
treatment for the entire spectrum of AD. A recent
systematic review of donepezil shows small efficacy
of donepezil for AD in cognitive function, global
clinical states rated by a clinician, and activities of
daily living, compared to placebo [3]. Other AChEIs,
such as rivastigmine and galantamine, were approved
for mild and moderate stages, while the N-methylD-aspartate receptor antagonist, memantine, was for
moderate to severe stages. In June 2021, a new drug,
aducanumab, was granted by the US Food and Drug
Administration expedited approval. However, none
of these therapeutic drugs are expected to cure AD
[2], and there has been no breakthrough medication
for AD for the past two decades.
The efficacy of donepezil may be different for different types of patients. Personalized medicine (also
known as “stratified” or “precision medicine”) aims
to find the best treatment for each patient, given the
patient’s individual characteristics [4]. This approach
may lead to better patient outcomes. For example,
personalized medicine can target providing beneficial interventions to treatment-sensitive patients and
avoid specific treatments to treatment-resistant or
harm-sensitive patients. ...
この論文で使われている画像
