J Clin Neurol.  2021 Jul;17(3):376-384. 10.3988/jcn.2021.17.3.376.

Discontinuation Rate of Newly Prescribed Donepezil in Alzheimer’s Disease Patients in Asia

• Park KH
• Yang Y
• Chen C
• Shim YS
• Dominguez JC
• Lee CN
• Kang K
• Kim HJ
• Jeong SK
• Jeong JH
• Hong Z
• Yoon SJ
• Zhang ZX
• Kim EJ
• Jang JW
• Li Y
• Xu Y
• Lin YT
• Qu Q
• Hu CJ
• Chou CH
• Fan D
• Kandiah N
• Yang YH
• Lau Ci
• Chu LW
• Wang H
• Jung S
• Choi SH
• Kim S

• KMID: 2516733
• DOI: http://doi.org/10.3988/jcn.2021.17.3.376

Abstract

Background and Purpose
The rate of donepezil discontinuation and the underlying reasons for discontinuation in Asian patients with Alzheimer’s disease (AD) are currently unknown. We aimed to determine the treatment discontinuation rates in AD patients who had newly been prescribed donepezil in routine clinical practice in Asia.
Methods
This 1-year observational study involved 38 institutions in seven Asian countries, and it evaluated 398 participants aged 50–90 years with a diagnosis of probable AD and on newly prescribed donepezil monotherapy. The primary endpoint was the rate of donepezil discontinuation over 1 year. Secondary endpoints included the reason for discontinuation,treatment duration, changes in cognitive function over the 1-year study period, and compliance as assessed using a clinician rating scale (CRS) and visual analog scale (VAS).
Results
Donepezil was discontinued in 83 (20.9%) patients, most commonly due to an adverse event (43.4%). The mean treatment duration was 103.67 days in patients who discontinued. Among patients whose cognitive function was assessed at baseline and 1 year, there were no significant changes in scores on the Mini-Mental State Examination, Montreal Cognitive Assessment, and Trail-Making Test–Black and White scores, whereas the Clinical Dementia Rating score increased significantly (p<0.001). Treatment compliance at 1 year was 96.8% (306/316) on the CRS and 92.6±14.1% (mean±standard deviation) on the VAS.
Conclusions
In patients on newly prescribed donepezil, the primary reason for discontinuation was an adverse event. Cognitive assessments revealed no significant worsening at 1 year, indicating that continuous donepezil treatment contributes to the maintenance of cognitive function.

Keyword

Alzheimer’s disease; Asia; cognition; donepezil