Ugur Sener, MD, of the Department of Neurology, University of Oklahoma Medical Center in Oklahoma City, and colleagues conducted a retrospective chart review that compared patients with early-onset Alzheimer’s disease with those who had late-onset Alzheimer’s disease, regarding vascular risk factors, depression, excessive use of alcohol, TBI, education, and family history of dementia. Neuroimaging tests and laboratory screening tests were performed according to guidelines from the American Academy of Neurology.
The investigators found that 35 patients had early-onset Alzheimer’s disease and 103 patients had late-onset Alzheimer’s disease during the study period of September 1, 2010, through September 1, 2013. Seven of the 35 patients with early-onset Alzheimer’s disease had had a concussion two years or more before their initial visit, compared with five of the 103 patients with late-onset Alzheimer’s disease.
“There were no significant differences in any of the other risk factors,” stated Dr. Sener.
Sodium Channel–Blocking AEDs Linked to Better Adherence
Patients with epilepsy who use a sodium channel–blocking antiepileptic drug (AED) have a higher likelihood of treatment adherence for 12 months, compared with patients who use AEDs with other mechanisms, researchers reported.
Jennifer S. Korsnes, Senior Health Outcomes Scientist, RTI Health Solutions in Research Triangle Park, North Carolina, and colleagues based their findings on a review of a US commercial claims database of adult patients with epilepsy, ages 18 to 65. Patients were required to have six or more months of continuous health plan enrollment before their index date and 12 or more months of continuous enrollment after their index date, as well as a monotherapy index AED. Patients were considered to be adherent if they had a proportion of days covered greater than or equal to 80% with an AED during the 12-month follow-up. The investigators performed logistic regression analysis to assess the relationship between AED mechanism and adherence.
A total of 53,338 patients were included in the study—40.2% had been taking a sodium channel blocker, 15.8% were using a gamma-aminobutyric acid (GABA) enhancer, 23.3% were using a synaptic vesicle protein 2A (SV2A) binding agent, 10.1% had been taking a glutamate blocker, and 10.6% had been using a multiple-mechanism index AED.
Compared with patients who were using a sodium-channel blocker, the one-year odds of being adherent were 57.2% lower for patients taking a GABA enhancer, 8.3% lower for patients taking an SV2A-binding agent, 6.8% lower for patients taking a glutamate blocker, and 12% lower for patients using a multiple-mechanism AED.
—Colby Stong