Safety and Efficacy of Idebenone versus Tacrine in Patients with Alzheimer's Disease.

Gutzmann H, Kuhl KP, Hadler D, Rapp MA.

 Wilhelm Griesinger Hospital, 
Department of Gerontopsychiatry,
 Berlin, Germany.
Pharmacopsychiatry 2002 Jan;35(1):12-8

ABSTRACT

This study evaluated the safety and efficacy of idebenone vs. tacrine in a prospective, randomized, double-blind, parallel-group multicenter study in patients suffering from dementia of the Alzheimer type (DAT) of mild to moderate degree. Diagnosis was based on DSM-III-R (primary degenerative dementia) and NINCDS-ADRDA criteria (probable Alzheimer's disease). A total of 203 patients of both sexes aged between 40 and 90 years were randomized to either idebenone 360 mg/day (n = 104) or tacrine up to 160 mg/day (n = 99) and treated for 60 weeks. The primary outcome measure was the Efficacy Index Score (EIS). The EIS combines dropout as well as the relevant improvements individually across the three levels of assessment (cognitive function, activities of daily living, global function). Secondary outcome measures were the ADAS-Cog score, the NOSGER-IADL score and the clinical global response (CGI-Improvement). After 60 weeks of treatment, 28.8 % of the patients randomized to idebenone, but only 9.1 % of the patients randomized to tacrine were still on the drug. In the LOCF analysis, 50 % of the patients randomized to idebenone but only 39.4 % of the patients randomized to tacrine showed an improvement in the Efficacy Index Score or at least one of the secondary outcome variables. The primary efficacy measurement was the change of the Efficacy Index Score from baseline to the assessment after 60 weeks treatment. The analysis was done on intention-to-treat (ITT) in a before-and-after test design. Patients randomized to idebenone showed a higher benefit from treatment than patients randomized to tacrine. We conclude that the benefit-risk ratio is favorable for idebenone compared to tacrine, and furthermore, that this ratio is likely to be similar when comparing idebenone to other cholinesterase inhibitors.

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Idebenone - the ultimate anti-aging drug.  (article)
  
Alzheimer's disease
Idebenone  in the treatment of Alzheimer's disease
Idebenone  efficacy of idebenone in the treatment of Alzheimer's disease
Idebenone  Nerve Growth Factor synthesis stimulators in Alzheimer's disease
Idebenone  in the treatment of dementia of the Alzheimer type
Idebenone  cognitive enhancement therapy for Alzheimer's disease

MELAS
Idebenone  improves cerebral mitochondrial oxidative metabolism in MELAS
Idebenone  in young patients with mitochondrial encephalomyopathy (MELAS)
Idebenone  therapy in Mitochondrial encephalomyopathy (MELAS)
Idebenone  and Mitochondrial encephalomyopathy (MELAS)
Idebenone  successful therapy in Mitochondrial encephalomyopathy (MELAS)
 .
Cardiomyopathy
Idebenone  improvement in mitochondrial cardiomyopathy
Idebenone   effect of idebenone on cardiomyopathy in Friedreich's ataxia
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Leber hereditary optic neuropathy (LHON)
Idebenone  does it shorten the time to recovery in Leber hereditary optic neuropathy?
Idebenone  improvement in a patient with Leber's hereditary optic neuropathy (LHON)

Misc.
Idebenone  use in age-related cognitive disorders

Idebenone  protects hippocampal neurons against beta amyloid neurotoxicity

Idebenone  functions as a potent protective hepatocyte antioxidant

Idebenone  neuroprotective effects of idebenone can be attributed to its antioxidant ability

Idebenone  inhibition of brain mitochondrial swelling

Idebenone  suppression of cold ischemia/reperfusion injury of liver endothelium

Idebenone  ability to eliminate a nitroxide radical in the rat

Idebenone  interaction with respiratory complexes of heart mitochondria

Idebenone  effect on serotonin release and seroton receptors in rats

Idebenone  protects hepatic microsomes against damage in organ preservation solutions

Idebenone  protects against toxicity induced by low density lipoprotein

Idebenone  protects against disorders due to cerebral hypoxia or ischemia

Idebenone  protects against toxicity induced by low density lipoprotein

Idebenone  attenuates neuronal degeneration induced by excitotoxins

Idebenone  augments long-term potentiation in hippocampal slices in the guinea pig

Idebenone  effects on electroencephalograms of patients with cerebrovascular disorders
   
Idebenone  effects on respiratory activities of brain mitochondria

Idebenone  effects on lipid peroxidation in erythrocytes of stroke-prone, hypertensive rats

Idebenone  brain distribution and its effect on local cerebral glucose utilization in rats

Idebenone  effects on acetylcholine levels in the brains of rats with cerebral ischemia

Idebenone  protective effect of idebenone against hypoxia in mice

Idebenone  improves learning and memory impairment induced in rats

Idebenone  effects of idebenone on neurological deficits in stroke-prone rats

Idebenone  effects on memory induced impairment in rats

Idebenone  effects of idebenone on cerebral blood flow in rats with cerebral ischemia

Idebenone  inhibition of brain mitochondrial swelling by idebenone

Idebenone  inhibition of platelet aggregation by idebenone

Idebenone  effects of idebenone on monoamine metabolites of patients with dementia

Idebenone  effects of idebenone on metabolism of monoamines and cyclic AMP formation

Idebenone  effects on impairment of radial maze learning in cerebral embolized rats

Idebenone  effect of idebenone on lipid peroxidation in rat brain homogenate

Idebenone  effects on muricidal behavior in rats with raphe lesions

Idebenone  inhibitory effect of idebenone on vascular lesions in hypertensive rats

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