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April 08, 2003; 60 (7) Articles

DHEA treatment of Alzheimer’s disease

A randomized, double-blind, placebo-controlled study

O.M. Wolkowitz, J.H. Kramer, V.I. Reus, M.M. Costa, K. Yaffe, P. Walton, M. Raskind, E. Peskind, P. Newhouse, D. Sack, E. De Souza, C. Sadowsky, E. Roberts, the DHEA-Alzheimer’s Disease Collaborative Research Group
First published April 8, 2003, DOI: https://doi.org/10.1212/01.WNL.0000052994.54660.58
O.M. Wolkowitz
MD
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J.H. Kramer
PsyD
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V.I. Reus
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M.M. Costa
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E. De Souza
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C. Sadowsky
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Citation
DHEA treatment of Alzheimer’s disease
A randomized, double-blind, placebo-controlled study
O.M. Wolkowitz, J.H. Kramer, V.I. Reus, M.M. Costa, K. Yaffe, P. Walton, M. Raskind, E. Peskind, P. Newhouse, D. Sack, E. De Souza, C. Sadowsky, E. Roberts, the DHEA-Alzheimer’s Disease Collaborative Research Group
Neurology Apr 2003, 60 (7) 1071-1076; DOI: 10.1212/01.WNL.0000052994.54660.58

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Abstract

Objective: To compare the efficacy and tolerability of dehydroepiandrosterone (DHEA) vs placebo in AD.

Method: Fifty-eight subjects with AD were randomized to 6 month’s treatment with DHEA (50 mg per os twice a day; n = 28) or placebo (n = 30) in a multi-site, double-blind pilot trial. Primary efficacy measures assessed cognitive functioning (the AD Assessment Scale–Cognitive [ADAS-Cog]) and observer-based ratings of overall changes in severity (the Clinician’s Interview-Based Impression of Change with Caregiver Input [CIBIC-Plus]). At baseline, 3 months, and 6 months, the ADAS-Cog was administered, and at 3 and 6 months, the CIBIC-Plus was administered. The 6-month time point was the primary endpoint.

Results: Nineteen DHEA-treated subjects and 14 placebo-treated subjects completed the trial. DHEA was relatively well-tolerated. DHEA treatment, relative to placebo, was not associated with improvement in ADAS-Cog scores at month 6 (last observation carried forward; p = 0.10); transient improvement was noted at month 3 (p = 0.014; cutoff for Bonferroni significance = 0.0125). No difference between treatments was seen on the CIBIC-Plus at either the 6-month or the 3-month time points.

Conclusions: DHEA did not significantly improve cognitive performance or overall ratings of change in severity in this small-scale pilot study. A transient effect on cognitive performance may have been seen at month 3, but narrowly missed significance.

  • Received July 20, 2002.
  • Accepted November 29, 2002.
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Letters: Rapid online correspondence

  • DHEA treatment of Alzheimer’s disease: A randomized, double-blind, placebo-controlled study
    • Friedrich Leblhuber, MD, Wagner Jaureggweg 15, 4020 Linz, Austriafriedrich.leblhuber@gespag.at
    • Herbert Haller, Kostja Steiner, Dietmar Fuchs
    Submitted August 20, 2003
  • Reply to Leblhuber
    • Owen M. Wolkowitz, Dept. Psychiatry UCSF School Med, 401 Parnassus Ave., Box F-0984, San Francisco, CA 94143owenw@itsa.ucsf.edu
    • Joel H. Kramer, Psy.D.,Victor I. Reus, MD,Kristine Yaffe, MD
    Submitted August 20, 2003
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