Objectives To examine whether exposure to anti-herpetic drugs (AHDs: acyclovir, valacyclovir, famciclovir) is associated with reduced risk of Alzheimer's disease (AD) treatment initiation. Design Population-based retrospective matched cohort study.
Setting University Groningen community pharmacy database IADB.nl, covering approximately 125 Dutch pharmacies (1994 - 2024). Participants 262 757 adults aged 50 - 80 years without prior dementia or AD treatment.
Exposed individuals with antiherpetic prescriptions (n=23 887) were matched 1:10 to unexposed controls (n=238 870) by age, sex and calendar time. Intervention AHDs: acyclovir, valacyclovir, famciclovir.
Main outcome measures Initiation of AD drug treatment, defined as at least two prescriptions for rivastigmine, donepezil, galantamine or memantine within 1 year. Cox proportional hazards models estimated HRs with 95% CIs, adjusted for comorbidities and medications.
Analyses were stratified by period (1994 - 2018 vs 2019 - 2024) and drug type. Results During follow-up, 2495 participants initiated AD treatment.
The age of the participants was 65 (SD 9), and 59% were female.
BMJ Open published a clinical update in Research Highlights on 15 Jun 2026.
The item focuses on Association between the use of anti-herpetic drugs and subsequent initiation of Alzheimers disease drug treatment: Dutch population-based inception cohort study.
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