Relationship between the response to donepezil and plasma amyloid beta oligomers in patients with Alzheimer's disease

Abstract

Aim: To date, there is no reported effective biomarker that can predict which Alzheimer's disease (AD) patients will respond to donepezil and which will not. This study aimed to investigate whether baseline values of Aβ oligomers (AβOs), measured by the Multimer Detection System-Oligomeric Aβ (MDS-OAβ), can be used to predict responders after 6 months of donepezil medication.

Methods: The study enrolled 104 patients diagnosed with probable AD. After 6 months of donepezil medication, the response to treatment was evaluated by re-assessing the Korean version of the Mini-Mental State Examination (K-MMSE) and Clinical Dementia Rating scale-Sum of Box (CDR-SB) scales conducted at baseline. The patients were categorized into two groups according to the baseline MDS-OAβ values known as the cut-off for AD diagnosis: a group with values below 0.78 and another group with values equal to or above 0.78.

Results: After 6 months of medication, the number of responders was 50 (49.5%). Responders exhibited significantly worse baseline CDR, CDR-SB, K-MMSE, and Barthel index compared with non-responders. There was a significantly higher number of responders among patients with MDS-OAβ values below the cut-off of 0.78 compared with those with values equal to or above this threshold. Furthermore, there was a significant improvement in the K-MMSE and CDR-SB after 6 months of donepezil medication in patients with MDS-OAβ values below 0.78 compared with those with values equal to or above 0.78.

Conclusions: Baseline MDS-OAβ values might constitute a novel biochemical marker for the efficacy of 6 months of donepezil treatment in AD.