Clinical Recommendations for the Use of Donepezil 23 mg in Moderate-to-Severe Alzheimer's Disease in the Asia-Pacific Region

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

Research output: Contribution to journalReview article

5 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)382-395
Number of pages14
JournalDementia and Geriatric Cognitive Disorders Extra
Volume6
Issue number3
DOIs
Publication statusPublished - 2016 Sep 9

Fingerprint

Alzheimer Disease
donepezil
Physiologic Monitoring
Patient Selection
Caregivers
Population
Counseling
Physicians
Therapeutics

All Science Journal Classification (ASJC) codes

  • Cognitive Neuroscience
  • Psychiatry and Mental health

Cite this

Sabbagh, Marwan ; Han, Seolheui ; Kim, Sangyun ; Na, Hae Ri ; Lee, Jae Hong ; Kandiah, Nagaendran ; Phanthumchinda, Kammant ; Suthisisang, Chuthamanee ; Senanarong, Vorapun ; Pai, Ming-Chyi ; Narilastri, Diatri ; Sowani, Ajit M. ; Ampil, Encarnita ; Dash, Amitabh. / Clinical Recommendations for the Use of Donepezil 23 mg in Moderate-to-Severe Alzheimer's Disease in the Asia-Pacific Region. In: Dementia and Geriatric Cognitive Disorders Extra. 2016 ; Vol. 6, No. 3. pp. 382-395.
@article{9754a5c2817c470daae197c77a4d52bd,
title = "Clinical Recommendations for the Use of Donepezil 23 mg in Moderate-to-Severe Alzheimer's Disease in the Asia-Pacific Region",
abstract = "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.",
author = "Marwan Sabbagh and Seolheui Han and Sangyun Kim and Na, {Hae Ri} and Lee, {Jae Hong} and Nagaendran Kandiah and Kammant Phanthumchinda and Chuthamanee Suthisisang and Vorapun Senanarong and Ming-Chyi Pai and Diatri Narilastri and Sowani, {Ajit M.} and Encarnita Ampil and Amitabh Dash",
year = "2016",
month = "9",
day = "9",
doi = "10.1159/000448214",
language = "English",
volume = "6",
pages = "382--395",
journal = "Dementia and Geriatric Cognitive Disorders Extra",
issn = "1664-5464",
publisher = "S. Karger AG",
number = "3",

}

Sabbagh, M, Han, S, Kim, S, Na, HR, Lee, JH, Kandiah, N, Phanthumchinda, K, Suthisisang, C, Senanarong, V, Pai, M-C, Narilastri, D, Sowani, AM, Ampil, E & Dash, A 2016, 'Clinical Recommendations for the Use of Donepezil 23 mg in Moderate-to-Severe Alzheimer's Disease in the Asia-Pacific Region', Dementia and Geriatric Cognitive Disorders Extra, vol. 6, no. 3, pp. 382-395. https://doi.org/10.1159/000448214

Clinical Recommendations for the Use of Donepezil 23 mg in Moderate-to-Severe Alzheimer's Disease in the Asia-Pacific Region. / Sabbagh, Marwan; Han, Seolheui; Kim, Sangyun; Na, Hae Ri; Lee, Jae Hong; Kandiah, Nagaendran; Phanthumchinda, Kammant; Suthisisang, Chuthamanee; Senanarong, Vorapun; Pai, Ming-Chyi; Narilastri, Diatri; Sowani, Ajit M.; Ampil, Encarnita; Dash, Amitabh.

In: Dementia and Geriatric Cognitive Disorders Extra, Vol. 6, No. 3, 09.09.2016, p. 382-395.

Research output: Contribution to journalReview article

TY - JOUR

T1 - Clinical Recommendations for the Use of Donepezil 23 mg in Moderate-to-Severe Alzheimer's Disease in the Asia-Pacific Region

AU - Sabbagh, Marwan

AU - Han, Seolheui

AU - Kim, Sangyun

AU - Na, Hae Ri

AU - Lee, Jae Hong

AU - Kandiah, Nagaendran

AU - Phanthumchinda, Kammant

AU - Suthisisang, Chuthamanee

AU - Senanarong, Vorapun

AU - Pai, Ming-Chyi

AU - Narilastri, Diatri

AU - Sowani, Ajit M.

AU - Ampil, Encarnita

AU - Dash, Amitabh

PY - 2016/9/9

Y1 - 2016/9/9

N2 - 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.

AB - 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.

UR - http://www.scopus.com/inward/record.url?scp=84988350405&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84988350405&partnerID=8YFLogxK

U2 - 10.1159/000448214

DO - 10.1159/000448214

M3 - Review article

AN - SCOPUS:84988350405

VL - 6

SP - 382

EP - 395

JO - Dementia and Geriatric Cognitive Disorders Extra

JF - Dementia and Geriatric Cognitive Disorders Extra

SN - 1664-5464

IS - 3

ER -