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Dergiler / Meandros Medical And Dental Journal / 2025 / Volume: 26 Issue: 4

Alzheimer Hastalığında Farmakolojik Tedavi Yöntemlerinin Karşılaştırmalı Prospektif Analizi

Comparative Prospective Analysis of Pharmacological Modalities in Alzheimer’s Disease

Esra Demir Unal(Ankara Yıldırım Beyazıt Üniversitesi Tıp Fakültesi Nöroloji Anabilim Dalı)0000-0002-1752-9619
Sayfa
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Yayın Tarihi
2025-12-25
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⚡ TL;DR(1 Cümlede Hızlı Çıkarım)

Bulgular: Standardize Ginkgo biloba ekstraktı (EGB-761) grubunda hafif bilişsel bozukluk (MCI) evresi, CDR analizlerine göre diğer tedavi modalitelerine kıyasla daha düşüktü (medyan [Çeyrekler Arası Aralık, IQR] = 1 [4.0], χ² = 15.610), buna karşılık donepezil-memantin grubunda daha yüksekti (9 [36.0], χ² = 11.469).

📌 3 Maddede Bu Makale

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Amaç & Hipotez:Amaç: Bu çalışma, Alzheimer hastalığı (AH) tedavilerinin farmako-biyolojik optimizasyonunun psiko-bilişsel ve metabo-enflamatuvar açılardan çok değişkenli korelasyon analizleriyle prospektif olarak araştırılmasını amaçlamıştır.
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Temel Bulgular & Veri:Yöntemler: AH hastalarında 24 haftalık tedavi öncesi-sonrası takip çalışması yürütüldü.
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Sonuç & Katkı:Bulgular: Standardize Ginkgo biloba ekstraktı (EGB-761) grubunda hafif bilişsel bozukluk (MCI) evresi, CDR analizlerine göre diğer tedavi modalitelerine kıyasla daha düşüktü (medyan [Çeyrekler Arası Aralık, IQR] = 1 [4.0], χ² = 15.610), buna karşılık donepezil-memantin grubunda daha yüksekti (9 [36.0], χ² = 11.469).
🔬Tür:Laboratuvar & Saha Deneyi
📍Kapsam:Genişletilmiş Akademik Örneklem
⚙️Değişkenler:Alzheimer’s disease · cognitive decline · neuropharmacology

Özet

Amaç: Bu çalışma, Alzheimer hastalığı (AH) tedavilerinin farmako-biyolojik optimizasyonunun psiko-bilişsel ve metabo-enflamatuvar açılardan çok değişkenli korelasyon analizleriyle prospektif olarak araştırılmasını amaçlamıştır. Yöntemler: AH hastalarında 24 haftalık tedavi öncesi-sonrası takip çalışması yürütüldü. Farmakolojik modalitelerin psiko-bilişsel (kategorik/sayısal) [Mini-Mental Durum Muayenesi (MMDM), Klinik Demans Derecelendirme Ölçeği (KDDÖ)], metabo-enflamatuvar ve hematolojik indeksler üzerindeki etkileri incelendi. Bulgular: Standardize Ginkgo biloba ekstraktı (EGB-761) grubunda hafif bilişsel bozukluk (MCI) evresi, CDR analizlerine göre diğer tedavi modalitelerine kıyasla daha düşüktü (medyan [Çeyrekler Arası Aralık, IQR] = 1 [4.0], χ² = 15.610), buna karşılık donepezil-memantin grubunda daha yüksekti (9 [36.0], χ² = 11.469). MMSE analizlerinde (kategorik veri olarak), MCI hastaları (MMSE skoru: 21–26) donepezil grubunda baskındı (medyan [IQR] = 17 [68.0], χ² = 7.946), buna karşın orta evre kognitif bozukluk (MMSE skoru: 11–20), memantin (18 [69.2], χ² = 9.489) ve donepezil-memantin (16 [64.0], χ² = 10.545) gruplarında daha yaygındı. Memantin grubu, hematolojik ve inflamatuvar indekslerde belirgin anti-inflamatuar etkiler gösterdi. EGB-761 grubunda ise tiroid fonksiyon bozukluğu ile ilişkili metabolik düzensizlikler gözlendi. Psiko-bilişsel test skorları ile trombosit sayısı arasında pozitif korelasyon saptandı: CDR için %20.9, MMSE için %22.3. Sonuç: Donepezil bilişsel iyileşmede üstün performans sergilerken, donepezil-memantin kombinasyonu özellikle bilişsel-işlevsel gelişiminde avantaj sağlamaktadır. Memantin anti-enflamatuvar etkilerde belirgin üstünlük göstermiş; EGB-761'ın ise metabolik dengenin dikkatle izlenmesi koşuluyla HBB tedavisinde monoterapi seçeneği olabileceği ortaya konmuştur. Trombosit indeksleri, ileri psiko-bilişsel laboratuvar belirteçleri olarak gelecek araştırmalarda ve klinik uygulamalarda önemli yer edinebilir.

Abstract

Objective: This study aimed to prospectively investigate the pharmaco-biological optimization of Alzheimer’s disease (AD) treatments in terms of psychocognitive and metabo-inflammatory aspects via multivariate correlation analyses. Methods: A 24-week pre-and-post-treatment follow-up study was conducted prospectively on AD patients. The effects of each pharmacological modality on psycho-cognitive (categorical and numeric)(Mini-Mental Status Examination (MMSE), Clinical Dementia Rating Scale (CDR)), Metabo-inflammatory, and hematologic indexes were analyzed. Results: The mild cognitive impairment (MCI) stage was lower in the standardized Ginkgo biloba extract (EGB-761) (median[Interquartile Range(IQR)]=1[4.0](χ2=15.610)) group compared to the other modalities in CDR analyses, whereas it was higher in the donepezil-memantine (9[36.0](χ2=11.469)). In MMSE analyses (categorical data), MCI patients were dominant (MMSE:21-26) in the donepezil group (median(IQR(17[68.0](χ2=7.946)), while moderate stage (MMSE score:11-20) was in memantine (18[69.2](χ2=9.489)) and donepezil-memantine (16[64.0](χ2=10.545)). The memantine group showed apparent anti-inflammatory effects in hematological and inflammatory indices. Metabolic disturbance regarding thyroid dysfunction was observed in the EGB 761 group. A positive correlation was detected between psycho-cognitive tests and platelet count (20.9% for CDR and 22.3% for MMSE). Conclusion: Donepezil showed superior performance in terms of cognitive improvement, and the combination of donepezil-memantine offers significant advantages, especially in cognitive-functional enhancement. Memantine showed significantly superior results in terms of anti-inflammatory effects; despite the need for careful monitoring of metabolic imbalances, it was demonstrated that EGB-761 can be considered as a monotherapy option in the treatment of MCI. The platelet indices can have an important place in both future research and clinical applications as advanced psychocognitive laboratory markers.

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Bu Makaleye Atıf Yap

Unal, E. D. (2025). Alzheimer Hastalığında Farmakolojik Tedavi Yöntemlerinin Karşılaştırmalı Prospektif Analizi. Meandros Medical And Dental Journal, Volume: 26 Issue: 4. https://doi.org/10.69601/meandrosmdj.1722593

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