Klinische Bedeutung - Dualer Wirkmechanismus von Galantamin zur Behandlung der Alzheimer-Demenz

Zusammenfassung

Mehrere Plazebo-kontrollierte klinische Studien haben gezeigt, dass eine Behandlung mit Galantamin (Reminyl®) die Symptome von Patienten mit Alzheimer-Demenz (AD) signifikant verbessern kann. Des Weiteren zeigten offene Langzeitstudien eine Verzögerung der Krankheitsprogression über mindestens vier Jahre. Galantamin unterscheidet sich von den anderen zugelassenen Acetylcholinesterase-Inhibitoren durch seine Eigenschaft, als sogenannter allosterischer Ligand die nikotinisch-cholinerge Neurotransmission, die bei der AD erheblich gestört ist, zu verbessern. Es ist möglich, dass dieser zusätzliche Wirkmechanismus zum positiven Langzeiteffekt von Galantamin auf den Krankheitsverlauf beiträgt. Neuere experimentelle und klinische Daten weisen darüber hinaus auf neuroprotektive Effekte von Galantamin hin.

Summary

A number of placebo-controlled clinical studies have shown that treatment with galantamine (Reminyl®) is capable of significantly improving the symptoms of patients with Alzheimer's dementia (AD). In addition, open long-term studies have revealed a delay in disease progression over a period of at least four years. Galantamine differs from the other commercially available acetylcholinesterase inhibitors in its ability, as a so-called allosteric ligand, to facilitate the nicotinic-cholinergic neurotransmission which is considerably disturbed in AD. It is possible that this additional effect contributes to the positive long-term effect of galantamine on the disease course. Furthermore, more recent experimental data indicate a neuroprotective effect for galantamine.

Key Words

Galantamine - Mechanism of action - Alzheimer's disease - Long-term treatment

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