Patients who improved significantly were denoted “responders”. For the MMSE, the RCI was -2.99 selleck chem Imatinib Mesylate to +2.41 points (that is, those with at least a +3-point improvement were responders). After 8 weeks of treatment, AQT detected 26 treatment responders (34%), whereas the MMSE detected 13 (17%) treatment responders (Figure ?(Figure3).3). As expected according to the RCI, both test cut-offs falsely classified ??5% responders during the pretreatment period (Figure ?(Figure3).3). A “false responder” in this case is a patient who improved more than the RCI during the period when no treatment was given. After treatment, ??5% of all the patients deteriorated more than the RCI of AQT and the MMSE, which also is just as expected. Figure 3 Responders.
Percentage responders after 8 weeks without treatment and after 8 weeks with treatment according to cut-offs derived from RCI. Details on the RCI analysis can be found in Additional file 1. Calculated with the McNemar test. Unsurprisingly, the AQT-treatment responders showed greater improvement after 8 weeks of treatment compared with the nonresponders in mean AQT score (P < 0.0001). However, a major significant difference in mean AQT change between the groups was still found after 6 months of treatment. The AD patients who were classified as treatment responders by AQT after 8 weeks of treatment showed a mean improvement of -19.3 ?? 22.3 seconds on AQT after 6 months of treatment. The nonresponders, conversely, deteriorated 3.3 ?? 13.5 seconds over the 6-month treatment period.
Thus, the AQT responders at the 8-week visit continued clearly to show a better treatment response at the 6-month visit compared with the nonresponders (P < 0.0001). Discussion In this study, we evaluated AQT as a test for detecting early ChEI treatment response in AD and compared it with the MMSE. After 8 weeks of treatment, AQT had improved significantly more than the MMSE when accounting for disease progression (Figure ?(Figure2).2). Further, AQT identified twice as many treatment responders as did the MMSE (34% compared with 17%; p = 0.02; Figure ?Figure3).3). The increased number of responders cannot be explained by low reliability or random changes of AQT scores, because AQT classified only 5% (false) responders during the 8-week period before treatment (Figure ?(Figure3).3).
Finally, when comparing the AQT responders and nonresponders from GSK-3 the 8-week visit, the responders still showed a significantly better treatment response after 6 months of treatment. This indicates that AQT detects early treatment responders who seem to continue to benefit from ChEI treatment. Evaluation of treatment Good clinical practice and cost-benefit considerations require that all AD patients be evaluated before and after the initiation of treatment to determine whether the treatment shall continue namely .