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病人用藥教育

中重度阿茲海默症治療新契機(下)

 

 

◎文╱洪浩淵

 

六、結論


目前AD治療仍侷限於使用 ChEI 與 memantine來改善或延緩疾病惡化速率,並沒有專一有效的藥物可以用來治癒 AD,即便是使用 memantine 與 donepezil 合併製劑,因此,即早發現並治療,是決定是否能有效控制病情及緩解病程惡化的關鍵!而AD病人在做其他疾病治療時,應盡量避免使用到會影響AD 疾病的藥物,如此,才可使得病人獲得最好的治療效果與生活品質。


目前許多國外藥廠都積極進行新藥之研發,部分藥品已經進入了臨床實驗,如作用在beta-secretase (BACE) 之抑制劑與針對tau protein所設計之疫苗等;隨著基因解密、蛋白質體學技術與轉譯醫學的進展,相信在不遠的將來一定能夠帶給失智症者有更好的治療選擇,進而減輕家庭、社會與國家成本負擔。


(全文完)


參考資料


1. Folch, J., Petrov, D., Ettcheto, M., Abad, S., Sanchez-Lopez, E., Garcia, M. L., . . . Camins, A. (2016). Current Research Therapeutic Strategies for Alzheimer's Disease Treatment. Neural Plast, 2016, 8501693. doi:10.1155/2016/8501693.
2. Grossberg, G. T., Manes, F., Allegri, R. F., Gutierrez-Robledo, L. M., Gloger, S., Xie, L., . . . Graham, S. M. (2013). The safety, tolerability, and efficacy of once-daily memantine (28 mg): a multinational, randomized, double-blind, placebo-controlled trial in patients with moderate-to-severe Alzheimer's disease taking cholinesterase inhibitors. CNS Drugs, 27(6), 469-478. doi:10.1007/s40263-013-0077-7.
3. Howard, R., McShane, R., Lindesay, J., Ritchie, C., Baldwin, A., Barber, R., . . . Phillips, P. (2012). Donepezil and memantine for moderate-to-severe Alzheimer's disease. N Engl J Med, 366(10), 893-903. doi:10.1056/NEJMoa1106668.
4. Porsteinsson, A. P., Grossberg, G. T., Mintzer, J., Olin, J. T., & Memantine, M. E. M. M. D. S. G. (2008). Memantine treatment in patients with mild to moderate Alzheimer's disease already receiving a cholinesterase inhibitor: a randomized, double-blind, placebo-controlled trial. Curr Alzheimer Res, 5(1), 83-89.
5. Scheltens, P., Blennow, K., Breteler, M. M., de Strooper, B., Frisoni, G. B., Salloway, S., & Van der Flier, W. M. (2016). Alzheimer's disease. Lancet, 388(10043), 505-517. doi:10.1016/S0140-6736(15)01124-1.
6. Tariot, P. N., Farlow, M. R., Grossberg, G. T., Graham, S. M., McDonald, S., Gergel, I., & Memantine Study, G. (2004). Memantine treatment in patients with moderate to severe Alzheimer disease already receiving donepezil: a randomized controlled trial. JAMA, 291(3), 317-324. doi:10.1001/jama.291.3.317.
7. https://www.fda.gov/Safety/MedWatch/SafetyInformation/ucm514763.htm.
8. https://www.uptodate.com/contents/epidemiology-pathology-and-pathogenesis-of-alzheimer-disease?source=search_result&search=alzheimers&selectedTitle=2~150.
9. https://www.uptodate.com/contents/treatment-of-dementia?source=search_result&search=alzheimers&selectedTitle=3~150
10. http://www.alz.org/alzheimers_disease_1973.asp.
11. http://www.tada2002.org.tw/tada_know_02.html\.


(本文作者為三軍總醫院臨床藥學部藥師)

 

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