A study result concluded that the cognitive benefits of Reminyl (galantamine), approved in more than 30 countries for the treatment of mild to moderate Alzheimer's disease, can be sustained for at least three years. Researchers reported that in this latest study, the decline in cognitive function - including memory, learning and problem solving -- that is typically expected with Alzheimer's disease was slowed by at least 12 months in patients who took Reminyl consistently over a three-year period.

The combination of the need for treatment early in the course of the disease and the long natural history of Alzheimer's mean that treatment may need to continue for many years. This is the second, and largest, study to show that benefit can be sustained long term with Reminyl. A separate study presented earlier found that Alzheimer's symptoms were slowed by an average of 18 months in patients who took Reminyl for three years.

Patients included in the analysis had originally enrolled in one of two double-blind trials in which Reminyl was compared to placebo. At the completion of the two studies, all patients were allowed to continue the research by taking 24 mg of Reminyl daily. A total of 491 patients enrolled at the beginning of the research; 64 percent completed the extended phases of the trials, bringing their participation to 36 months.

Using a standard scale to assess cognition, investigators compared patients treated continuously with Reminyl to the expected progression of untreated patients at 12, 24 and 36 months.

The analysis showed that, while the participating patients all showed a progressive decline in cognitive function, their decline was less at all time points than what would be expected in untreated persons with Alzheimer's disease. In patients who had taken Reminyl for the full three years, the average decline in their cognitive scores was 12 points, compared to an expected drop of 21 to 27 points among untreated individuals -- an approximate 50 percent delay in disease progression.

Over the course of the three years, the most frequent side effects believed to be related to Reminyl were primarily gastrointestinal in nature (nausea, vomiting and diarrhea). Side effects -- if they occur -- tend to develop when starting Reminyl or when increasing the dosage, and are usually mild and temporary.

Reminyl inhibits an enzyme that breaks down acetylcholine -- a 'neurotransmitter' in the brain that plays a key role in memory and learning. In addition, Reminyl modulates the brain's nicotinic receptors, to which acetylcholine binds. Laboratory research suggests that this causes more acetylcholine to be released, as well as increases the receptors' sensitivity to the neurotransmitter.