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DOMINO trial results show donepezil is associated with cognitive benefits for Alzheimer’s patients
DOMINO trial results show donepezil is
associated with cognitive benefits for Alzheimer’s
patients
16 March 2012
The DOMINO
trial has demonstrated that continued treatment with donepezil is
beneficial for patients with moderate to severe Alzheimer’s
disease. In these patients, donepezil slows the decline of
cognitive function and activities of daily living. The trial also
showed that there were no important benefits of combination therapy
with memantine and donepezil compared to donepezil alone.
Alzheimer’s disease is the commonest cause of dementia. There
are 750,000 living with dementia today in the UK and this number is
expected to rise to over 1 million by 2021. There is no cure for
Alzheimer’s disease although there are drugs that have been shown
to be effective for disease in the mild to moderate range of
severity. However, there is inadequate evidence to guide treatment
decisions for patients who have reached the moderate to severe
point.
DOMINO was a blinded 2x2 factorial randomised
controlled trial where patients were randomly allocated to
either continue donepezil only, continue donepezil and start
memantine, discontinue donepezil and start memantine or discontinue
donepezil and do not start memantine. The trial was conducted to
evaluate whether treatment with donepezil or memantine or both
combined were effective at slowing the decline of cognitive
function and activities of daily living. A total of 295 patients
were randomised into the trial and were followed up for a total of
12 months. The results of the trial have now been published in
the New England Journal of Medicine.
The trial report was accompanied in the journal by an
editorial
noting the importance of the results in patients that are severely
impaired, a group that is not often studied in clinical trials.
Further information about the trial can be found in the
protocol that
was previously published. The study was sponsored by King’s College
London and funded by the MRC and the Alzheimer’s Society. The MRC
CTU was responsible for statistical analysis and oversight and some
aspects of data management.
Further information
