Serum VEGF predicts clinical improvement induced by Cerebrolysin plus donepezil in patients with advanced Alzheimer's disease.

Serum vascular endothelial growth factor (VEGF) increases with Alzheimer's disease (AD) severity and may prevent cognitive decline. However, information on the influence of AD drug therapy on circulating VEGF is limited. This study assessed changes in serum VEGF levels and its association with clinical and functional responses in mild to moderate AD patients who were treated with Cerebrolysin, donepezil, or the combined therapy in a randomized, controlled trial (RCT). Treatment with Cerebrolysin plus donepezil reduced elevated serum VEGF levels, and improved functioning and cognition significantly compared to donepezil alone in patients with advanced AD; and treatment differences were more pronounced in patients with higher VEGF levels. Our results indicate that the combined therapy reversed the increase of serum VEGF in advanced AD, which was associated with cognitive and functional responses, particularly in patients with high baseline VEGF.