No Cognitive Improvement With Idalopirdine in Mild Alzheimer Disease

older woman with her hand on her head
older woman with her hand on her head
For patients with mild-to-moderate Alzheimer disease, the use of idalopirdine does not improve cognition.

HealthDay News — The use of idalopirdine does not improve cognition vs placebo over 24 weeks of treatment for patients with mild-to-moderate Alzheimer disease (AD), according to research published the Journal of the American Medical Association.

Alireza Atri, MD, PhD, from the California Pacific Medical Center in San Francisco, and colleagues conducted 3 randomized 24 week clinical trials that included 2525 patients aged 50 years or older with mild-to-moderate AD to examine whether idalopirdine is effective for symptomatic treatment of mild-to-moderate AD.

The researchers found that the mean change in the 11-item cognitive subscale of the Alzheimer Disease Assessment Scale (ADAS-Cog) was 0.37, 0.61, and 0.41 for the 60- and 30-mg idalopirdine groups and the placebo group, respectively (adjusted mean difference vs placebo: 0.05 [95% CI, −0.88-0.98] and 0.33 [95% CI, −0.59-1.26], respectively), in study 1. In study 2, the mean change in ADAS-Cog total score was 1.01, 0.53, and 0.56 for the 30- and 10-mg groups, and placebo, respectively (adjusted mean difference vs placebo, 0.63 [95% CI, −0.38-1.65] for the 30-mg group). The mean change in ADAS-Cog total score in study 3 was 0.38 and 0.82 for the 60-mg and placebo groups, respectively (adjusted mean difference, −0.55 [95% CI, −1.45-0.36]).

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“These findings do not support the use of idalopirdine for the treatment of AD,” the authors write.

Several authors disclosed financial ties to medical device and pharmaceutical companies, including H. Lundbeck A/S, which funded the study.


Atri A, Frölich L, Ballard C, et al. Effect of idalopirdine as adjunct to cholinesterase inhibitors on change in cognition in patients with Alzheimer disease: three randomized clinical trials. JAMA. 2018;319(2):130-142.