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Efecto de la vitamina E y la memantina en el deterioro funcional en la enfermedad de Alzheimer: el ensayo
Maurice W Dysken1, Mary Sano2, Sanjay Asthana3
1Minneapolis VA Health Care System, Minneapolis, Minnesota.
JAMA
|January 2, 2014
Resumen
La vitamina E (alfa tocoferol) ralentizó el deterioro funcional en la enfermedad de Alzheimer (EA) de leve a moderada. Memantina no mostró ningún beneficio significativo, y la combinación no mejoró los resultados en comparación con el placebo.
Área de la Ciencia:
- Neurología Neurología.
- Geriatría La geriatría es la medicina de los ancianos.
- Farmacología Farmacología.
Sus antecedentes:
- Existen pruebas limitadas para la vitamina E y la memantina en la enfermedad de Alzheimer (EA) de leve a moderada.
- Los inhibidores de la acetilcolinesterasa son un tratamiento estándar para la EA.
Objetivo del estudio:
- Para evaluar la eficacia de la vitamina E (alfa tocoferol), la memantina o su combinación en la ralentización de la progresión de la enfermedad de Alzheimer de leve a moderada.
- Para evaluar el impacto en el deterioro funcional y la carga del cuidador.
Principales métodos:
- Se realizó un ensayo clínico aleatorizado, doble ciego, controlado con placebo, con 613 pacientes con EA de leve a moderada.
- Los participantes recibieron dosis diarias de alfa tocoferol (2000 UI), memantina (20 mg), la combinación o placebo, junto con su inhibidor de la acetilcolinesterasa.
- La medida de resultado primaria fue el Estudio Cooperativo de la Enfermedad de Alzheimer / Actividades de la Vida Diaria (ADCS-ADL) puntaje de inventario.
Principales resultados:
- El alfa tocoferol ralentizó significativamente el deterioro funcional en comparación con el placebo, retrasando la progresión clínica en aproximadamente un 19% anual.
- La memantina sola o en combinación con alfa tocoferol no mostró diferencias significativas en el deterioro funcional en comparación con el placebo.
- El grupo de alfa tocoferol experimentó el menor aumento en el tiempo del cuidador, lo que sugiere una menor carga del cuidador.
Conclusiones:
- La vitamina E (alfa tocoferol) demuestra un beneficio en la ralentización del deterioro funcional en pacientes con enfermedad de Alzheimer de leve a moderada.
- La memantina no proporcionó beneficios significativos en esta población de pacientes.
- El alfa tocoferol puede ser una valiosa opción terapéutica para controlar el deterioro funcional y la carga del cuidador en la enfermedad de Alzheimer en etapa temprana.
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