维生素E和美曼丁对阿尔茨海默病功能衰退的影响:TEAM-AD VA合作随机试验
Maurice W Dysken1, Mary Sano2, Sanjay Asthana3
1Minneapolis VA Health Care System, Minneapolis, Minnesota.
JAMA
|January 2, 2014
概括
维生素E (alpha tocopherol) 减缓了轻度至中度阿尔茨海默病 (AD) 的功能衰退. 孟坦丁没有显著的益处,并且与安慰剂相比,该组合并没有改善结果.
科学领域:
- 神经学 神经学
- 老年病的医生 老年病的医生
- 药理学 药理学是指药理学的学科.
背景情况:
- 对于温和到中度阿尔茨海默病 (AD) 中的维生素E和美曼丁的证据有限.
- 乙胆化酶抑制剂是AD的标准治疗方法.
研究的目的:
- 评估维生素E (阿尔法托科菲罗尔),美曼丁或其组合在减缓轻度至中度AD进展方面的疗效.
- 评估对功能衰退和护理人员负担的影响.
主要方法:
- 进行了一项双盲,安慰剂控制,随机的临床试验,其中613名患者患有轻度至中度的AD.
- 参与者每天服用阿尔法托科菲罗尔 (2000 IU),孟坦丁 (20 mg),组合剂或安慰剂,并服用他们的乙胆酶抑制剂.
- 主要结局指标是阿尔茨海默病合作研究/日常生活活动 (ADCS-ADL) 库存得分.
主要成果:
- 与安慰剂相比,阿尔法托科菲罗尔显著减缓了功能衰退,每年约延迟了19%的临床进展.
- 与安慰剂相比,单独使用孟坦丁或与阿尔法托科菲罗尔联合使用并没有显示功能衰退的显著差异.
- 阿尔法托科菲罗尔组的护理人员时间增加最少,这表明护理人员负担减少.
结论:
- 维生素E (alpha tocopherol) 在减缓轻度至中度AD患者的功能衰退方面具有有益作用.
- 孟坦丁在这个患者群体中没有提供显著的益处.
- 在阿尔茨海默氏症早期阶段,阿尔法托科菲罗尔可能是管理功能衰退和护理人员负担的有价值的治疗选择.
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