LONDON, January 18, 2011 /PRNewswire/ — the National Institute for Health and Clinical Excellence (NICE) today published its final appraisal determination containing final recommendations on the use of specific treatments for Alzheimer´s disease. the new ruling means Alzheimer´s patients will now have access to treatment from the earliest stage of the disease.[1]*

A survey conducted among general practitioners across the UK has suggested that the new recommendations will give Doctors[2] a strong reason to diagnose and treat this devastating disease early. it highlighted that nearly two thirds (64.1%) of GPs believe that their detection and diagnosis of mild Alzheimer´s disease patients will improve as a result of the NICE guidance. Until now diagnosing the condition early has been difficult for GPs, as the guidelines previously recommended treatment only for patients with moderate or severe Alzheimer´s disease. 70.2% of GPs surveyed believe that their management of Alzheimer´s disease will change as a result of the new guidance with over half (57.9%) of GPs stating that they would be likely to recall patients with mild Alzheimer´s previously denied treatment for reassessment. This should help more people with early disease get access to specialist care by being referred to a memory service for assessment. A total of 40.7% of doctors also thought that their prescribing of AChEIs would change as a result of the NICE recommendations.

“This is great news for people with Alzheimer´s disease and their families because we will now be able to offer effective drug treatment in mild, moderate and severe Alzheimer´s disease. for example, patients with mild disease will at last be able to get access to early, cost-effective treatment at the point of diagnosis – treatment that can potentially help to relieve the symptoms in these patients”, says Professor Roy Jones from the Research Institute for the Care of Older People (RICE), Royal United Hospital, Bath, UK. “Previously it was difficult to see patients with mild disease and ask them to come back when their condition worsened before we were able to prescribe drugs that could improve their symptoms. This new ruling will help keep patients as independent as possible for as long as possible.”

the new survey data also revealed that, unfortunately 29.6 % of GPs surveyed were unaware of the preliminary recommendations published by NICE on the use of AChEIs in patients with Alzheimer´s disease and 55.5% believe that there are inadequate protocols / materials in place to effectively help them diagnose people showing early signs of disease. In addition, the survey revealed that 86.7% of GPs believe that families and carers of patients with Alzheimer´s disease do not have adequate support to recognise and manage the early signs of the disease. it is vital that Alzheimer´s disease is diagnosed as early as possible, as having an early diagnosis, starting treatment and putting lifestyle modifications in place in the early stages of the disease can help individuals prepare for the future.[3] Greater awareness is needed amongst patients, carers and GPs of the early treatment options now available to them which could lead to better outcomes for the patient and carers.

*Additional information on the NICE guidance1

1.1 the three acetylcholinesterase (AChE) inhibitors (donepezil, galantamine and rivastigmine) are recommended as options for managing mild to moderate Alzheimer´s disease under all of the conditions specified in 1.3 and 1.4.

1.2 Memantine is recommended as an option for managing Alzheimer´s disease for people with: moderate Alzheimer´s disease who are intolerant of or have a contraindication to AChE inhibitors or severe Alzheimer´s disease.

1.3 Treatment should be under the conditions specified in 1.3.

– Only specialists in the care of patients with dementia (that is, psychiatrists including those specialising in learning disability, neurologists, and physicians specialising in the care of older people) should initiate treatment. Carers´ views on the patient´s condition at baseline should be sought. – Treatment should be continued only when it is considered to be having a worthwhile effect on cognitive, global, functional or behavioural symptoms. – Patients who continue on treatment should be reviewed regularly using cognitive, global, functional and behavioural assessment. Treatment should be reviewed by an appropriate specialist team, unless there are locally agreed protocols for shared care. Carers´ views on the patient´s condition at follow-up should be sought.

1.4 if prescribing an AChE inhibitor (donepezil, galantamine or rivastigmine), treatment should normally be started with the drug with the lowest acquisition cost (taking into account required daily dose and the price per dose once shared care has started). however, an alternative AChE inhibitor could be prescribed if it is considered appropriate when taking into account adverse event profile, expectations about adherence, medical comorbidity, possibility of drug interactions and dosing profiles.

for the full guidance, please visit: guidance.nice.org.uk/

currently, there are around 820,000 people living with Alzheimer´s and other dementias in the UK, [4] including an estimated 575,000 sufferers in England and 37,000 in Wales.[5] Alzheimer´s disease is the most common form of dementia, affecting 62% of dementia patients in the UK.[5] This irreversible, progressive brain disorder gradually destroys memory, reasoning and thinking skills, and may eventually leave patients unable to carry out even the simplest tasks.[6] Alzheimer´s disease has impacts in many ways including physical, mental, nursing, medical and social impacts.[1] despite its burden, Alzheimer´s remains a relatively overlooked disease. Just 2.5% of the government´s medical research budget is devoted to dementia; in contrast a quarter is allocated to cancer research.[7]

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[1] National Institute for Health and Clinical Excellence, Final Appraisal Determination – Donepezil, galantamine, rivastigmine and memantine for the treatment of Alzheimer´s disease (review of NICE technology appraisal guidance 111)

[2] Opinion Health survey data. Total sample size was 200 GPs in the UK. Online internet-based survey fieldwork undertaken between 13th – 16th December 2010. Eisai Europe and Pfizer Ltd. Data on File

[3] Doraiswamy PM, Steffens DC, Pitchumoni S, Tabrizi S. Early Recognition of Alzheimer´s disease: what is consensual? what is controversial? what is practical? J Clin Psychiatry. 1998;59 (suppl. 13):6-18.

[4] Alzheimer´s Research Trust -Dementia 2010. Available at: dementia2010.org/reports/Dementia2010Full.pdf. Last accessed Jan 2011

[5] Alzheimer Society. Available at: alzheimers.org.uk Last accessed Jan 2011

[6] National Institute on Aging (NIA). Alzheimer´s Disease Factsheet. NIH Publication no 08-6423. Reprinted February 2010

[7] Alzheimer´s Research Trust. Available at: alzheimers-research.org.uk/info/statistics/ Last accessed Jan 2011

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