To the Editor.
—It seems unlikely that the recently published trial of tacrine1 will solve the controversy that surrounds its use in Alzheimer's disease. Indeed, although the study is labeled as a straightforward parallel-group, double-blind comparison, the published analysis raises so many questions that the issue of the clinical value of tacrine remains unsettled.Excluding 195 (42%) of 468 patients raises several statistical questions. The comparison between the treatment groups should have been based on the 273 patients instead of on all patients, as was done. The conclusion from the study pertains to only 37 patients in the 80-mg tacrine group: too few to allow clinically relevant conclusions. It is debatable whether a comparison with placebo could be based on only 37 of the 78 patients who should have constituted this group according to randomization (468÷6=78).The reasons for excluding patients relate to the study medication. Therefore, the results
Dom R. Tacrine in Alzheimer's Disease. JAMA. 1993;269(22):2848–2849. doi:10.1001/jama.1993.03500220034019
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