TOLERANCE-EFFICACY OUTCOME OF ONE-YEAR OF TACRINE UTILIZATION IN 100 ALZHEIMERS-DISEASE CASES

We report our first 100 cases of Alzheimer's (AD) patients treated wit h tacrine (Cognex(R)) for a period of one year. At the beginning of tr eatment the mean Mini-Mental-Status (MMS) score was 15.1. To date 71 p atients are still under treatment (12 for more than 12 months). Forty- three instances of side-effects were observed, of which 31 involved he patic side-effects with an increase in ALAT>1N (normal value) (6 cases >3N), the mean date of appearance was 10.4+/-6.8 weeks, there were 16 cholinergic side-effects (nausea, vomiting, diarrhoea), plus 4 neurol ogic and 2 cutaneous side-effects. These side-effects led to the arres t of the treatment in 19 cases (16 for hepatic toxicity). Treatment wa s reattempted after interruption in 13 cases; successfully in 3 instan ces only. The measure of tacrine efficacy was based on 52 MMS score re evaluations in week 18: there was an increase of the MMS score in 22 c ases (3.3 points+/-2.5), a stabilisation in 11 cases and a decrease in 19 cases (3.3 points+/-2.2.). In week 30, the MMS scores (35 patients ) increased in 9 cases (3.6 points+/-2.4), stabilized in 5 cases and d ecreased in 21 cases (3.9 points+/-3.3). At week 52, only 28 per cent of the patients were considered as either improved or stabilized. We c onclude that there is a necessity for close follow-up of tacrine-treat ed patients, and that globally at 8 months there is an improvement or a stabilization in 40 per cent of patients and long term (at one year) a stabilizing effect on AD patients.