RT Journal Article SR Electronic T1 A 1-year multicenter placebo-controlled study of acetyl-L-carnitine in patients with Alzheimer's disease JF Neurology JO Neurology FD Lippincott Williams & Wilkins SP 705 OP 711 DO 10.1212/WNL.47.3.705 VO 47 IS 3 A1 Thal, L. J. A1 Carta, A. A1 Clarke, W. R. A1 Ferris, S. H. A1 Friedland, R. P. A1 Petersen, R. C. A1 Pettegrew, J. W. A1 Pfeiffer, E. A1 Raskind, M. A. A1 Sano, M. A1 Tuszynski, M. H. A1 Woolson, R. F. YR 1996 UL http://n.neurology.org/content/47/3/705.abstract AB A 1-year, double-blind, placebo-controlled, randomized, parallel-group study compared the efficacy and safety of acetyl-L-carnitine hydrochloride (ALCAR) with placebo in patients with probable Alzheimer's disease (AD). Subjects with mild to moderate probable AD, aged 50 or older, were treated with 3 g/day of ALCAR or placebo (1 g tid) for 12 months. Four hundred thirty-one patients entered the study, and 83% completed 1 year of treatment. The Alzheimer's Disease Assessment Scale cognitive component and the Clinical Dementia Rating Scale were the primary outcome measures.Overall, both ALCAR- and placebo-treated patients declined at the same rate on all primary and most secondary measures during the trial. In a subanalysis by age that compared early-onset patients (aged 65 years or younger at study entry) with late-onset patients (older than 66 at study entry), we found a trend for early-onset patients on ALCAR to decline more slowly than early-onset AD patients on placebo on both primary endpoints. In addition, early-onset patients tended to decline more rapidly than older patients in the placebo groups. Conversely, late-onset AD patients on ALCAR tended to progress more rapidly than similarly treated early-onset patients. The drug was very well tolerated during the trial. The study suggests that a subgroup of AD patients aged 65 or younger may benefit from treatment with ALCAR whereas older individuals might do more poorly.However, these preliminary findings are based on post hoc analyses. A prospective trial of ALCAR in younger patients is underway to test the hypothesis that young, rapidly progressing subjects will benefit from ALCAR treatment. NEUROLOGY 1996;47: 705-711