PubMed日本語 - アルツハイマー病のgalantamineの用量と血漿濃度-臨床適用。―QLifePro医療翻訳医療翻訳 QLifePro


Dose and plasma concentration of galantamine in Alzheimer's disease - clinical application.


Published date



Carina Wattmo, Erik Jedenius, Kaj Blennow, Asa K Wallin


Clinical Memory Research Unit, Department of Clinical Sciences, Malmö, Lund University, SE-205 02 Malmö, Sweden ; Memory Clinic, Skåne University Hospital, SE-205 02 Malmö, Sweden.


INTRODUCTION: Patients with Alzheimer's disease (AD) are currently treated with cholinesterase inhibitors, such as galantamine, without actual knowledge of its concentration in plasma. Our objective was to analyse potential relationships between galantamine concentration, galantamine dose, socio-demographic characteristics, body weight, body mass index (BMI), and treatment response.


METHODS: Eighty-four patients with AD recruited from the Memory Clinic, Malmö, Sweden, and treated with galantamine were included in the study. Efficacy measures, including cognition (Mini-Mental State Examination (MMSE), Alzheimer's Disease Assessment Scale - cognitive subscale (ADAS-cog)) and instrumental activities of daily living (IADL), were evaluated at baseline, 2 months after treatment initiation (MMSE only) and semi-annually over 3 years. At these assessments, blood samples were obtained for the analysis of the galantamine concentration, and body weight, BMI, drug dose and time from drug intake were recorded.


RESULTS: All patients had a measurable concentration of galantamine at all assessments. The mean plasma concentration of the drug exhibited a positive linear association with dose (r = 0.513, P < 0.001). The dose did not differ between sexes. Negative linear associations between the galantamine plasma concentration and BMI (r = -0.454, P = 0.001) or body weight (r = -0.310, P = 0.034) were found exclusively in the male group. When mixed-effects models were used, the dose of galantamine (P < 0.001), time from drug intake (P < 0.001), and BMI (P = 0.021) or weight (P = 0.002) were factors that predicted the concentration, whereas sex, age, and cognitive and functional changes were not.


CONCLUSIONS: High compliance to galantamine treatment was found among all patients in this naturalistic AD study. The impact of BMI or body weight on the plasma concentration of galantamine was important only among males. No relationship was observed between concentration and short-term treatment response or progression rate in terms of cognitive and functional abilities.



治療開始(MMSEだけ)と半年ごとに3年以上の2ヵ月後に、有効性手段(認識(ミニ精神状態検査(MMSE)、アルツハイマー病評価スケール ― 認識サブスケール(ADAS-歯車))と器械の日常生活の活動(IADL)を含む)は、試験開始時に評価された。

本剤の平均血漿濃度は、用量(r = 0.513、P < 0.001)との正の線形関連を示した。
galantamine血漿濃度とBMI(r =-0.454、P = 0.001)の間の負の線形関係または体重(r =-0.310、P = 0.034)は、男性の群だけで見つかった。
混合効果モデル(galantamine(P < 0.001)の用量)が使われたとき、薬から摂取量(P < 0.001)の時間を計る、そして、BMI(P = 0.021)または体重(P = 0.002)は濃度を予測した因子であったが、性、年齢と認識および機能的な変化はそうでなかった。


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