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


CONCLUSIONS
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.
Wilkinson
David
D
Memory Assessment and Research Centre, Moorgreen Hospital, Southampton, UK. david.wilkinson@wht.nhs.uk
Andersen
Henning Friis
HF
D000203:Activities of Daily Living / Q000145:classification; D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000188:drug therapy*; D004185:Disability Evaluation; D018450:Disease Progression; D004311:Double-Blind Method; D018691:Excitatory Amino Acid Antagonists / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008559:Memantine / Q000009:adverse effects / Q000627:therapeutic use*; D008609:Mental Status Schedule; D009483:Neuropsychological Tests; D018697:Nootropic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic
D018691:Excitatory Amino Acid Antagonists; D018697:Nootropic Agents; D008559:Memantine