Donepezil, sold under the brand name Aricept, is a commonly used drug for mild to moderate forms of the disease.

 

A common Alzheimer’s drug that is often withdrawn in later stages of the disease can halve the likelihood of severely ill patients needing to be moved into nursing homes, research has shown.

Donepezil, sold under the brand name Aricept, is frequently used to reduce or manage symptoms in cases of mild to moderate Alzheimer’s. However, it is typically not given to those in the advanced stages of the disease because of a perceived lack of benefit.

A study may now force a rethink of this policy. The Domino trial showed that withdrawing donepezil doubled the chances of an Alzheimer’s patient being moved into a nursing home after a year.

On average, the annual cost of residential care for people with dementia ranges between £30,732 and £34,424. In comparison, a year’s supply of donepezil can cost as little as £21.59, less than 6p a day.

Lead researcher Prof Robert Howard, from University College London, said: “Our previous work showed that, even when patients had progressed to the moderate or severe stages of their dementia, continuing with donepezil treatment provided modest benefits in cognitive function and in how well people could perform their daily activities.

“Our new results show that these benefits translate into a delay in becoming dependent on residential care, an event that many people dread.

“We are all impatient for the advent of true disease-modifying drugs that can slow or halt the Alzheimer process, but donepezil is available right now and at modest cost.”

The scientists, whose findings are reported in the Lancet Neurology journal, followed the progress of 295 people with moderate to severe Alzheimer’s disease. Participants were randomly selected either to continue taking Aricept, or to have the drug replaced by an inactive placebo. Another drug, memantine, had no effect on the risk of moving into a nursing home.

Dr Doug Brown, director of research and development at the Alzheimer’s Society, which co-funded the trial together with the Medical Research Council (MRC), said: “With no new treatments for Alzheimer’s disease in over a decade, it is absolutely crucial that we make the most of the drugs we have available.

“These robust findings are of real significance to people with dementia and their families who want to continue living at home for as long as possible. We urge clinicians to consider the implications of this research and adjust their prescribing patterns accordingly.""

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