New drug approved to fight Alzheimer’s

Tuesday, Nov. 26, 1996 | 11:59 a.m.

Eisai Co. Ltd. of Japan received the FDA approval late Monday night and plans to have the drug Aricept on pharmacy shelves within several weeks.

Aricept works essentially the same as Cognex, until now the nation's sole medicine for Alzheimer's. Neither drug slows Alzheimer's progression but eases symptoms by inhibiting the breakdown of a brain chemical attacked by the disease.

Some 4 million Americans suffer from Alzheimer's disease, which has no known cause or cure. It afflicts mainly the elderly, robbing them of their memories and ability to care for themselves and eventually kills them.

Like Cognex, Aricept also inhibits the breakdown of the neurotransmitter acetylcholine. The difference is that Aricept targets only acetylcholine in the brain, while Cognex affects related chemicals throughout the body, explained Sharon Rogers, Eisai's vice president for research.

Eisai gave 473 patients Aricept, known chemically as donepezil hydrochloride, or a dummy pill for 30 weeks. Doctors measured the patients' cognitive ability and ability to function, using tests that usually highlight Alzheimer's patients' steady decline.

Some 80 percent of patients taking Aricept either improved or exhibited no further deterioration, and doctors rated about twice as many Aricept patients as improved in ability to function.

Aricept was not tested against Cognex, but Rogers said in a recent interview that patient improvement is about the same with the two drugs.

The difference is that Aricept caused no serious side effects, including the liver abnormalities that plague many Cognex patients. The main Aricept complaints were diarrhea and nausea, although the FDA does warn that it has the potential to cause irregular heartbeat, particularly in patients with certain heart conditions.

And the FDA cautioned that the drug just works on mild to moderate symptoms but doesn't halt or reverse Alzheimer's itself. While both Alzheimer's drugs protect acetylcholine from breaking down, they don't prevent Alzheimer's from killing the nerve cells that produce acetylcholine in the first place.

Studies are under way to see if other compounds could help those vital cells survive longer.