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Intramuscular desferrioxamine in patients with Alzheimer's disease
Crapper McLachlan DR, Dalton AJ, Kruck TP, Bell MY, Smith WL, Kalow W, Andrews DF.. Lancet (London, England), 1991-06-01
Topic: Amyloid, tau and blood-test diagnosis
Although epidemiological and biochemical evidence suggests that aluminium may be associated with Alzheimer's disease (AD), there is no convincing proof of a causal link for aluminium in disease progression. We have completed a two year, single-blind study to investigate whether the progression of dementia could be slowed by the trivalent ion chelator, desferrioxamine. 48 patients with probable AD were randomly assigned to receive desferrioxamine (125 mg intramuscularly twice daily, 5 days per week, for 24 months), oral placebo (lecithin), or no treatment. No significant differences in baseline measures of intelligence, memory, or speech ability existed between groups. Activities of daily living were assessed and videorecorded at 6, 12, 18, and 24 month intervals. There were no differences in the rate of deterioration of patients receiving either placebo or no treatment. Desferrioxamine treatment led to significant reduction in the rate of decline of daily living skills as assessed by both group means (p = 0.03) and variances (p less than 0.04). The mean rate of decline was twice as rapid for the no-treatment group. Appetite (n = 4) and weight (n = 1) loss were the only reported side-effects. We conclude that sustained administration of desferrioxamine may slow the clinical progression of the dementia associated with AD.
Key findings
- Although epidemiological and biochemical evidence suggests that aluminium may be associated with Alzheimer's disease (AD), there is no convincing proof of a causal link for aluminium in disease progression.
- No significant differences in baseline measures of intelligence, memory, or speech ability existed between groups.
- Desferrioxamine treatment led to significant reduction in the rate of decline of daily living skills as assessed by both group means (p = 0.03) and variances (p less than 0.04).
- We conclude that sustained administration of desferrioxamine may slow the clinical progression of the dementia associated with AD.
Why it matters
In this two-year single-blind study of 48 patients with probable Alzheimer's disease, desferrioxamine treatment led to a significant reduction in the rate of decline of daily living skills, while placebo and no-treatment groups did not differ. The authors concluded that sustained desferrioxamine may slow clinical progression, though the study was small and single-blind.
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Study details
- Participants48
- Evidence strengthLow
How this study scored 70/100
Published in a top-tier journal, and it is a randomised controlled trial. Scored zero for effect reported because the record does not state it. We have no data on senior author's track record, so that was left out: it earned 67 of the 96 points we could judge it on, which is 70 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 10 / 10 | Tier 1 — top-tier general journal (Lancet (London, England)) |
| Journal's citation record | 4 / 4 | The Lancet: journal h-index 1,205 (OpenAlex, 2026-10-29) |
| Study design | 11 / 12 | A randomised controlled trial (from PubMed type “Randomized Controlled Trial”) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 1991 — older than 20 years, still counted |
| Sample size | 1 / 4 | 48 participants |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 2 / 2 | Randomised and blinded or placebo-controlled (as stated in the record) |
| Times cited | 6 / 7 | Cited 762 times (OpenAlex, 2026-10-10) |
| Citations per year | 4 / 5 | 20.6 citations a year over 37 year(s) since 1991 |
| Impact for its field and year | 4 / 6 | Cited 17.1× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 3 / 6 | Cited by 20 other studies in this library |
| Still being cited | 3 / 4 | Cited 78 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | — / 4 | OpenAlex's profile for last-listed author McLachlan Dr holds only 6 work(s), too few to judge a track record — left out of this score |
| Institution's track record | 2 / 3 | University of Toronto: institution h-index 1,923 (OpenAlex) |
| Multi-centre collaboration | 0 / 3 | OpenAlex lists 1 institution(s) in 1 country — scores zero (affiliation lists can be incomplete) |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 1674295) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Points | 67 / 96 | Scored on 19 of 20 parts. We have no data for the rest, so they are left out: 67 of the 96 points we could judge it on is 70 out of 100. |
| Total | 70 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
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Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record names 7 authors; APA and Vancouver show the first six, BibTeX and the downloads carry all of them. Check the citation against the original before you use it.
APA 7th
Crapper McLachlan, D. R., Dalton, A. J., Kruck, T. P., Bell, M. Y., Smith, W. L., Kalow, W., et al. (1991). Intramuscular desferrioxamine in patients with Alzheimer's disease. Lancet (London, England). https://doi.org/10.1016/0140-6736(91)92978-b
Vancouver
Crapper McLachlan DR, Dalton AJ, Kruck TP, Bell MY, Smith WL, Kalow W, et al. Intramuscular desferrioxamine in patients with Alzheimer's disease. Lancet (London, England). 1991. doi:10.1016/0140-6736(91)92978-b. PMID: 1674295.
BibTeX
@article{crappermclachlan1991-1674295,
author = {Crapper McLachlan, D. R. and Dalton, A. J. and Kruck, T. P. and Bell, M. Y. and Smith, W. L. and Kalow, W. and Andrews, D. F.},
title = {{Intramuscular desferrioxamine in patients with Alzheimer's disease}},
journal = {Lancet (London, England)},
year = {1991},
doi = {10.1016/0140-6736(91)92978-b},
pmid = {1674295},
url = {https://doi.org/10.1016/0140-6736(91)92978-b}
}
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