ABSTRACT
Synaptic loss correlates closely with cognitive deficits in Alzheimer's disease and represents a new target for intervention. Souvenaid® is the first medical nutrition product to be designed to support synapse formation and function in early Alzheimer's disease, and has undergone an extensive, 12-year development programme. The relatively large amount of clinical data available for Souvenaid® is unusual for a medical nutrition product. Souvenaid® contains omega-3 polyunsaturated fatty acids (docosahexaenoic acid and eicosapentaenoic acid), uridine (as uridine monophosphate) and choline which are nutritional precursors required for synaptic membrane phospholipid synthesis, together with phospholipids and other cofactors. Souvenaid® has demonstrated cognitive benefits in patients with mild Alzheimer's disease but not in patients with mild-to-moderate Alzheimer's disease. Two randomised, double-blind, controlled trials (duration 12 and 24 weeks) in patients with mild Alzheimer's disease untreated with acetylcholinesterase inhibitors and/or memantine have demonstrated that Souvenaid® is well tolerated and improves episodic memory performance. The daily intake of Souvenaid® has not been associated with any harmful effects or interactions with medications and none are anticipated. The ongoing, 24-month, European Union-funded LipiDiDiet trial in subjects with prodromal Alzheimer's disease is evaluating the potential benefits of Souvenaid® on memory and in slowing progression to Alzheimer's dementia. If Souvenaid® induces synaptogenesis and improved synaptic function, it may provide benefits in other clinical conditions characterised by neurodegeneration. A number of trials are ongoing and planned to evaluate the potential wider benefits of Souvenaid®.
Subject(s)
Alzheimer Disease/diet therapy , Prodromal Symptoms , Uridine Monophosphate/therapeutic use , Alzheimer Disease/pathology , Alzheimer Disease/physiopathology , Choline/adverse effects , Choline/pharmacology , Choline/therapeutic use , Cholinesterase Inhibitors , Disease Progression , Docosahexaenoic Acids/adverse effects , Docosahexaenoic Acids/pharmacology , Docosahexaenoic Acids/therapeutic use , Double-Blind Method , Eicosapentaenoic Acid/adverse effects , Eicosapentaenoic Acid/pharmacology , Eicosapentaenoic Acid/therapeutic use , European Union , Female , Humans , Male , Memantine , Memory, Episodic , Randomized Controlled Trials as Topic , Synapses/drug effects , Uridine Monophosphate/adverse effects , Uridine Monophosphate/pharmacologyABSTRACT
BACKGROUND: Many anticancer drugs are only available to Australian patients at a significant cost in the time preceding approval for government subsidy. Studies indicate that many oncologists find it difficult to discuss high-cost drugs (HCDs) with patients whom they believe are unable to afford treatment, thereby limiting treatment choices. We sought to identify the information needs and communication preferences of women with breast cancer regarding HCDs. PATIENTS AND METHODS: An e-mail invitation was sent to 317 members of Breast Cancer Network Australia. Forty-seven subjects participated in telephone interviews on the basis of a structured questionnaire regarding personal experience with HCD discussions and information preferences. RESULTS: Participants considered an out-of-pocket cost of $50/week to be a HCD. Only 28% had previously discussed HCD treatment with their oncologist; however, 96% of participants wanted to discuss an expensive drug as an option, even if they were unlikely able to afford it. CONCLUSIONS: Women with breast cancer have a strong desire to be active participants in their cancer treatment and wish to be fully informed of potential treatment options, including HCDs. Nondisclosure of information, including HCDs, can result in patient dissatisfaction.