PATIENTS suffering early stages of dementia in the North East were given new hope today after a health watchdog performed a drugs U-turn.
The National Institute for Health and Clinical Excellence (Nice) caused outrage in 2006 and 2007 when it controversially ruled that the key medicines would only be available to people in moderate stages of the disease.
Now rule changes announced today mean the medicines should now be made available to people with mild dementia – potentially benefiting hundreds of thousands of sufferers.
Campaigners argued it was “cruel and unethical” to force patients with early-stage Alzheimer’s to wait until they were worse before they could get drugs.
Last night, Alzheimer’s sufferers in the region welcomed the news that Nice had re-assessed its guidance.
Grandmother-of-four Anna Dutton, 64, a former teacher, was diagnosed with the condition four years ago when both her own and her family’s lives were turned upside down.
Speaking from their home in South Shields, her husband and carer Peter said: “Nice’s initial decision was wrong and I’m pleased they have now made a U-turn.
“It’s important those who have Alzheimer’s are put on the medication as soon as possible to help slow-down the progression of the disease.”
“There is evidence that Alzheimer’s is affecting younger people and it’s an injustice that Nice made a ruling years ago to deny access to these drugs as many more people could have been helped.”
The new guidance, which is subject to appeal, says Aricept (donepezil), Reminyl (galantamine) and Exelon (rivastigmine) will be made available to people with mild as well as moderate dementia.
It also recommends the use of Ebixa (memantine) for severe dementia and for some patients with moderate forms. Previously, it was only on offer to patients as part of a clinical trial.
The drugs, which cost around £2.80 a day, do not offer a cure for Alzheimer’s disease, but they have been shown to improve everyday functioning.
For some, they can stabilise everyday function for at least six months, and have been shown to increase alertness, improve mood and restore confidence. Evidence is increasing that the drugs can also alleviate anxiety, depression and apathy.
John O’ Brien, professor of old age psychiatry at Newcastle’s Institute for Ageing and Health, said: “We welcome the decision by Nice and it is good news for all the people who have dementia, their families and carers.
“Most clinicians did not agree with the previous Nice decision as it was not based on the effectiveness of the drugs but rather on the cost of the drugs.”
Nice’s chief executive, Sir Andrew Dillon said: “Since we published our guidance in September 2007 clinical trials have continued to show the positive effects of these drugs and, in the case of memantine, have reduced the uncertainty about its clinical effectiveness.
“In addition, we now have more information about the costs of living with and treating this very distressing disease, as it progresses through its mild, moderate and severe stages. Our increased confidence in the benefits and costs associated with the use of the three drugs for treating mild and moderate stages of the disease has enabled us to make a positive recommendation for their use in mild disease.”
Rebecca Wood, chief executive of the Alzheimer’s Research Trust, said: “This welcome proposal gives all people living with Alzheimer’s the best possible chance of benefiting from the treatments.
“These drugs hold the promise of relief from the symptoms for thousands of people.
“And, while not the cure we desperately need, they can still help.
“The Government’s national dementia strategy stresses the need for early diagnosis, so Nice’s proposal could provide swift treatment for people with Alzheimer’s in its early stages”.
There are 465,000 people with Alzheimer’s in the UK and 62,000 people develop the disease every year.
Q. What is Alzheimer's?
A. Alzheimer’s disease is the most common form of dementia, accounting for 465,000 out of 750,000 cases in the UK. Every year, 62,000 people develop Alzheimer’s but this number is expected to rise dramatically as people live longer. As the disease progresses, so-called ’plaques’ and ’tangles’ develop in the brain, and brain cells begin to die. People with Alzheimer’s also have a shortage of key chemicals in the brain which are essential for correctly transmitting messages.
Q. What do the drugs do?
A. Aricept (donepezil), Reminyl (galantamine), Exelon (rivastigmine) and Ebixa (memantine) are the only drugs licensed for the treatment of Alzheimer’s disease.
Aricept, Exelon and Reminyl work by maintaining the brain’s existing supplies of the chemical acetylcholine, which is a neurotransmitter essential for carrying messages. Ebixa blocks a messenger chemical known as glutamate – released in excessive amounts when brain cells are damaged by Alzheimer’s disease.
Q. Why has there been so much controversy?
A. In 2001, the National Institute for Health and Clinical Excellence (Nice) said Aricept, Exelon and Reminyl should be made available to people with mild to moderate Alzheimer’s disease. But, in 2005, it published draft guidance saying the drugs were not cost-effective for people in the mild stages.