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Margaret J. Knapp, PharmD; Stephen I. Gracon, DVM
Parke-Davis Pharmaceutical Research Ann Arbor, Mich

David S. Knopman, MD
University of Minnesota Minneapolis

Paul R. Solomon, PhD
Williams College Williamstown, Mass

William W. Pendlebury, MD
University of Vermont Burlington

Charles S. Davis, PhD
University of Iowa College of Medicine Iowa City

JAMA. 1994;272(24):1897.

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In Reply.

—We would like to address several points raised by Dr Luqman. First, in our report of the 30-week high-dose study of tacrine, we acknowledged both differential dropout rates between treatment groups and difficulties in interpreting study results. The large number of withdrawals included placebo-treated patients (32%) and tacrine-treated patients (68%). Nonetheless, the most conservative intent-to-treat analysis showed significant treatment differences in favor of tacrine vs placebo on the primary outcome measures.

Second, the conclusion that patients with a shorter duration of Alzheimer's disease tolerated the higher tacrine dose for a longer period of time is incorrect. In the week 30 intent-to-treat group, only seven patients had disease durations exceeding the maximum duration of 5.2 years reported for the week 30 evaluable patients, and only four had disease durations exceeding 6 years (6.4,6.8,7.4, and 12.7 years). The median disease duration in the evaluable patient population of 64 (treated with . . . [Full Text PDF of this Article]

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