A UCLA researcher has found that one of the most commonly prescribed medications for Alzheimer’s disease may accelerate the cognitive decline of patients who carry a genetic variation.
Sophie Sokolow, an associate professor at the UCLA School of Nursing, published her study in February using data collected during a 2005 trial of donepezil, a medication used to treat patients with Alzheimer’s. The clinical trial examined the effects of the drug, commonly known as Aricept, on mild cognitive impairment patients who carry the BChE-K genetic variation.
MCI is a stage between the normal cognitive decline associated with aging and the more severe cognitive decline seen within dementia patients, Sokolow added.
“I had access to the data (from the clinical trial), so I reanalyzed the data collected during the trial because (the researchers) didn’t look at genetics,” Sokolow said. “They just looked at the disease, so we looked at how patients with this mutation respond differently than those who don’t have it.”
After examining the results of the three-year trial, Sokolow observed an association between individuals with the genetic variation who had been administered the medication and poorer scores on memory tests used to measure cognitive function.
Sokolow said donepezil is approved by the Food and Drug Administration to treat people with Alzheimer’s disease. However, some physicians prescribe the medication “off-label,” a practice that is not approved by the FDA.
“People (with MCI) have some mild memory problems, but these problems would not be interfering with their everyday lives,” said Edmond Teng, a clinical neurology physician at the David Geffen School of Medicine at UCLA. “Right now, there aren’t any FDA-approved treatments for mild cognitive impairment.”
Teng added that the data about donepezil has always been uncertain, so some physicians choose to prescribe the drug to patients experiencing memory problems, while others do not.
“What’s cool about this study is that it moves us closer to personalized medicine,” Teng said. “As we get more knowledge about how genetics work with pharmacology, we’ll be able to better tailor and better choose our medications to help minimize side effects and maximize benefits.”
Josselyn Perez, a third-year biology student who volunteers with TimeOut, a student group that volunteers to assist patients with dementia, said she was surprised about the results of Sokolow’s study.
“I have a grandma showing signs of Alzheimer’s, and I can understand the frustration and the wanting to try any medication,” Perez said. “This was really surprising, and sad in a way because (the patients) want to get better, but (the medication is) counterproductive.”
Sokolow added that she does not think that just one kind of medication will be able to treat Alzheimer’s.
“This disease is complicated,” Sokolow said. “It will probably require a combination of a number of (medications), but if you try to approve a combination, it becomes much more complicated.”