Drug helps memory loss, study says

November 11, 1992|By Thomas H. Maugh II | Thomas H. Maugh II,Los Angeles Times

LOS ANGELES -- A highly touted but still controversial drug called tacrine can partially reverse memory loss and reduce dementia in some patients with early stages of Alzheimer's disease, a new study has found.

The study results reported yesterday in the Journal of the American Medical Association are the strongest yet to suggest that drugs can ease the ill effects of Alzheimer's, which afflicts at least 2.5 million Americans and perhaps as many as 4 million, most over the age of 65.

More than half of patients who received the highest doses of tacrine in a trial at 23 medical centers showed improvement in their short-term memory, use of language and ability to carry out simple tasks, according to the study.

"We saw significant improvements in a large number of patients," said Dr. Martin Farlow, a neurologist at Indiana University who headed the trial. "The improvement was the equivalent of rolling back the clock by about six months, on average."

He added that the trend of the results suggests that "if tacrine can be given in higher doses, a larger percentage of patients will respond."

Perhaps more important, according to University of Southern California neurologist Dr. Lon Schneider, the results are exciting "because they show that the course of the disease can be modified by drugs."

"This has legitimately pumped up the enthusiasm and expectation of clinicians and Alzheimer's families," said Dr. Gene Cohen, acting director of the National Institute on Aging, "but it remains to be seen how useful this drug will be. . . . We're encouraged, but we want more data."

Tacrine has been highly controversial since 1986, when Dr. William H. Summers and his colleagues at the University of California, Los Angeles reported dramatic improvements in mental functioning in some patients who took the drug. The UCLA report has subsequently been largely dismissed, however, because of flaws in its experimental design.

Similar problems cast doubt on a large clinical trial of tacrine that was reported two weeks ago in the New England Journal of Medicine. One critic found the results of that trial "clinically trivial."

The beneficial effects of the drug, also known as THA or by the brand name Cognex, are mitigated by its potential to cause severe liver damage in one of four patients. The liver damage is reversible if patients stop taking the drug.

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