Quinacrine Does Not Delay Course of Prion Disease

Disease severity affects patient preference for treatment

MONDAY, March 16 (HealthDay News) -- Treating human prion disease with quinacrine does not reduce the mortality rate associated with the disease, according to a study published online March 10 in The Lancet Neurology.

John Collinge, M.D., of University College London Hospital, National Health Service Foundation Trust in London, U.K., and colleagues conducted a study of 107 patients with prion disease, of which 45 cases were sporadic, two were iatrogenic, 18 were variant and 42 were inherited. The patients were offered a choice between 300 mg a day of quinacrine, no treatment, or randomization to immediate or deferred treatment with quinacrine, an option that only two patients took. In all, 37 chose immediate treatment with quinacrine, while 68 chose no treatment.

While 26 of 38 of the quinacrine treatment patients died, versus 51 of 68 for the group that did not chose quinacrine, the difference was due to the confounding effects of disease severity, and after adjustment the mortality rate was the same for both groups, the researchers found.

"Because patients with prion disease form a heterogeneous population and survival is likely to be strongly influenced by other medical interventions, future treatments should be assessed primarily through randomized and adequately controlled clinical trials or at least in prospectively followed cohort studies," the authors write.

Collinge is a director and shareholder of D-Gen Ltd., London, U.K., which works in the field of prion disease. The author of an accompanying editorial is an investigator in another trial involving quinacrine.

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