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Title: Clinical Recommendations for the Use of Donepezil 23 mg in Moderate-to-Severe Alzheimer's Disease in the Asia-Pacific Region
Authors: Marwan Sabbagh
Seolheui Han
Sangyun Kim
Hae Ri Na
Jae Hong Lee
Nagaendran Kandiah
Kammant Phanthumchinda
Chuthamanee Suthisisang
Vorapun Senanarong
Ming Chyi Pai
Diatri Narilastri
Ajit M. Sowani
Encarnita Ampil
Amitabh Dash
Barrow Neurological Institute
Konkuk University
Seoul National University Bundang Hospital
Seoul National University College of Medicine
Bobath Memorial Hospital
University of Ulsan, College of Medicine
Duke-NUS Medical School Singapore
Chulalongkorn University
Mahidol University
National Cheng Kung University
University of Indonesia, RSUPN Dr. Cipto Mangunkusumo
SAL Hospital and Medical Institute
University of Santo Tomas Hospital
Eisai Pharmaceuticals India Pvt. Ltd.
Keywords: Medicine
Issue Date: 9-Sep-2016
Citation: Dementia and Geriatric Cognitive Disorders Extra. Vol.6, No.3 (2016), 382-395
Abstract: © 2016 The Author(s) Published by S. Karger AG, Basel. Background: The 'Asia-Pacific Expert Panel (APEX) for donepezil 23 mg' met in November 2015 to review evidence for the recently approved high dose of donepezil and to provide recommendations to help physicians in Asia make informed clinical decisions about using donepezil 23 mg in patients with moderate-to-severe Alzheimer's disease (AD). Summary: In a global phase III study (study 326) in patients with moderate-to-severe AD, donepezil 23 mg/day demonstrated significantly greater cognitive benefits versus donepezil 10 mg/day, with a between-treatment difference in mean change in the Severe Impairment Battery score of 2.2 points (p < 0.001) in the overall population and 3.1 points (p < 0.001) in patients with advanced AD. A subanalysis of study 326 demonstrated that the benefits and risks associated with donepezil 23 mg/day versus donepezil 10 mg/day in Asian patients with moderate-to-severe AD were comparable to those in the global study population. Key Message: Donepezil 23 mg is a valuable treatment for patients with AD, particularly those with advanced disease. The APEX emphasized the importance of patient selection (AD severity, tolerability of lower doses of donepezil, and absence of contraindications), a stepwise titration strategy for dose escalation, and appropriate monitoring and counseling of patients and caregivers in the management of patients with AD.
ISSN: 16645464
Appears in Collections:Scopus 2016-2017

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