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Nervenheilkunde 2005; 24(06): 476-482
DOI: 10.1055/s-0038-1629983
Original article
Schattauer GmbH

Antidementive Kombinationstherapie

Combination therapy in dementia
O. Peters
1   Klinik und Hochschulambulanz für Psychiatrie und Psychotherapie Charité – Universitätsmedizin Berlin CBF (Leiterin: Prof. Dr. med. Dipl. Psych. I. Heuser)
,
L. Frölich
2   Zentralinstitut für seelische Gesundheit Mannheim, Abteilung für Gerontopsychiatrie Universität Heidelberg (Leiter: Prof. Dr. med. L. Frölich)
,
I. Heuser
1   Klinik und Hochschulambulanz für Psychiatrie und Psychotherapie Charité – Universitätsmedizin Berlin CBF (Leiterin: Prof. Dr. med. Dipl. Psych. I. Heuser)
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Publikationsdatum:
25. Januar 2018 (online)

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Zusammenfassung

Gegenwärtig stehen zur Behandlung der Alzheimer Krankheit (AD) mehrere, in ihrer Wirksamkeit geprüfte Substanzen aus verschiedenen Klassen als Monotherapie zur Verfügung. Ihr therapeutischer Nutzen besteht primär in einer symptomatischen Besserung der Krankheitssymptome. Neue krankheitsmodifizierende Wirkstoffe werden in klinischen Studien geprüft. In Ermangelung einer bislang nicht verfügbaren, kausalen Therapie und in Anbetracht der Komplexität der Erkrankung, liegt es nahe anzunehmen, dass ein gezielter, multifokaler Ansatz zum einen die Symptome, aber auch den Verlauf neurodegenerativer Erkrankungen, günstiger beeinflussen kann, als dieses eine Monotherapie zu leisten vermag. Zur Zeit gibt es nur 6 größere (>100 Patienten) veröffentlichte Studien, die eine Kombinationstherapie hinsichtlich kognitiver Effekte bei AD untersuchten. Nur 4 Studien hatten ein randomisiertes kontrolliertes Design. In 4 der 6 Studien waren die Effekte einer Kombinationstherapie denen einer Monotherapie überlegen. Obwohl die Anzahl der abgeschlossenen Studien noch gering ist, zeichnen sich damit erste Hinweise auf eine mögliche Überlegenheit des Therapieerfolgs einer Kombinationstherapie ab.

Summary

Several approved drugs for the mono therapy of Alzheimers disease (AD) are available. Their therapeutic benefit is primarily a symptomatic improvement of the disease symptoms. Current clinical studies are testing the efficacy of new drugs with the aim to modify disease progression. While causal treatment is still not available, it has been assumed that a combination of antidementia drugs with distinct molecular targets may enhance the efficacy or even have a synergistic effect. Presently, there are only 6 large (>100 patients) clinical studies published which have investigated effects of a combination regimen on cognitive performance or AD. Only four of the treatment studies followed a randomized controlled design. Four out of six controlled studies showed a superior efficacy of a combination therapy over mono therapy. Although only few studies testing this hypothesis have been conducted so far, first promising results give hope that improved cognitive function and delayed disease progression can be expected from combination therapy in dementia.

Schlüsselwörter

Neurodegeneration - Alzheimer - Antidementiva - klinische Studien

Key words

Neurodegeneration - Alzheimer - antidementia drugs - clinical trials
 

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