Analysis of the effect of memantine in reducing the worsening of clinical symptoms in patients with moderate to severe Alzheimer's disease

Dement Geriatr Cogn Disord. 2007;24(2):138-45. doi: 10.1159/000105162. Epub 2007 Jul 4.

Abstract

Background: Alzheimer's disease (AD) is a progressive neurodegenerative disorder and delaying disease worsening is a relevant treatment outcome.

Methods: Data from 6 randomized, double-blind, placebo-controlled, 6-month studies were pooled and a subgroup of patients (867 on placebo, 959 on memantine) with moderate to severe AD (Mini- Mental State Examination <20) was analyzed. 'Any clinical worsening' was defined as a decline on the Alzheimer's Disease Assessment Scale - Cognitive Subscale (ADAS-cog) or the Severe Impairment Battery (SIB) and on the Clinician's Interview-Based Impression of Change Plus Caregiver Input (CIBIC-plus) and the Alzheimer's Disease Cooperative Study - Activities of Daily Living Inventory (ADCS-ADL), and 'marked clinical worsening' as > or = 4 points decline on the ADAS-cog or > or = 5 points on the SIB and decline on the CIBIC-plus and the ADCS-ADL.

Results: More placebo-treated than memantine-treated patients showed any clinical worsening (28 vs. 18%; p < 0.001), and 21% placebo-treated patients compared to 11% memantine-treated patients had marked clinical worsening (p < 0.001).

Conclusion: In this population of moderate and severe AD patients, treatment with memantine was associated with reducing worsening of clinical symptoms in AD during the 6-month study period.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Activities of Daily Living / classification
  • Aged
  • Aged, 80 and over
  • Alzheimer Disease / drug therapy*
  • Disability Evaluation
  • Disease Progression
  • Double-Blind Method
  • Excitatory Amino Acid Antagonists / adverse effects
  • Excitatory Amino Acid Antagonists / therapeutic use*
  • Female
  • Humans
  • Male
  • Memantine / adverse effects
  • Memantine / therapeutic use*
  • Mental Status Schedule
  • Neuropsychological Tests
  • Nootropic Agents / adverse effects
  • Nootropic Agents / therapeutic use*
  • Randomized Controlled Trials as Topic

Substances

  • Excitatory Amino Acid Antagonists
  • Nootropic Agents
  • Memantine