Phenserine Efficacy in Alzheimer's Disease

Abstract

To gather preliminary evidence in Alzheimer's disease (AD) for the efficacy of phenserine, a non-competitive acetylcholinesterase inhibitor that has independent modulatory effects on amyloid-β generation, a 12-week comparison of patients receiving phenserine (10 and 15 mg BID) or placebo was conducted under double-blind conditions. Patients who completed 12 weeks of the double-blind before others were continued in the double-blind to determine longer-term treatment effects. At 12 weeks, mean ADAS-cog (AD assessment scale-cognitive) changes from baseline were −2.5 and −1.9 for high-dose phenserine (n = 83) and placebo (n = 81) groups, respectively, a non-statistically significant improvement for the high-dose phenserine group relative to placebo. CIBIC+ (clinician's interview based impression of change + caregiver's input) values for the high-dose and placebo groups were similar at 12 weeks. For patients who received more than 12 weeks of therapy, the ADAS-cog changes were −3.18 and −0.66 for the high-dose phenserine (n = 52) and placebo (n = 63) groups, respectively, a difference achieving statistical significance (p = 0.0286). After 12 weeks, CIBIC+ values were 3.59 and 3.95 for the high-dose (n = 54) and placebo (n = 66) groups respectively (p = 0.0568). These results from this short-term study are consistent with phenserine potentially benefiting mild to moderate Alzheimer's disease symptomatically but do not address possible amyloid metabolic mediated effects on disease processes in AD.