Tacrine treatment and nursing home placement: Application of the cox proportional hazards model with time-dependent covariates

Fraser Smith, Stephen Gracon, David S Knopman, Lon Schneider

Research output: Contribution to journalArticle

Abstract

Cox proportional hazards regressions with time-dependent covariates were used to determine the effect of continuous, long-term, open-label tacrine hydrochloride (Cognex®) treatment on nursing home placement in patients with Alzheimer's disease (AD). The results were compared with those obtained using logistic regression analyses, life table survival plots, and Kaplan-Meier estimates. Patients with probable AD (NINCDS criteria) initially randomized in a 30-week double-blind, placebo-controlled, parallel-group, high-dose study of tacrine could continue on long-term, open-label treatment at doses up to 160 mg/day. The population of interest consisted of patients who remained on tacrine or were off tacrine for only a short period of time (1–60 days) prior to an event. Using last tacrine dose, the Cox proportional hazards regression approach with time-dependent covariates demonstrated there was a dose-response trend favoring higher doses (risk ratio = 1.7, p = 0.056) and a statistically significant difference favoring medium and higher doses combined (risk ratio = 1.8, p = 0.014).

Original languageEnglish (US)
Pages (from-to)729-735
Number of pages7
JournalTherapeutic Innovation and Regulatory Science
Volume32
Issue number3
DOIs
StatePublished - 1998
Externally publishedYes

Keywords

  • Cox proportional hazards
  • Nursing home placement
  • Survival analysis
  • Tacrine hydrochloride
  • Time-dependent covariates

ASJC Scopus subject areas

  • Pharmacology, Toxicology and Pharmaceutics (miscellaneous)
  • Public Health, Environmental and Occupational Health
  • Pharmacology (medical)

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