Source: DGNews  |  Posted 1 year ago

By Jenny Powers

GENEVA -- September 29, 2010 -- Patients with moderate to severe Alzheimer’s
disease (AD) showed significantly greater improvement in cognition, function,
behaviour, and global outcome after combination treatment with memantine and
donepezil versus placebo plus donepezil treatment, according to a study
presented here at the 14th Congress of the European Federation of Neurological
Societies (EFNS). Caregivers may also benefit from combination therapy.

Memantine, a selective N-methyl-D-aspartic acid receptor antagonist,
and cholinesterase inhibitors such as donepezil have demonstrated efficacy in
clinical trials. Preclinical evidence suggests that the 2 drugs may act
synergistically to produce a significantly greater increase in acetylcholine to
that seen with donepezil treatment alone, because of their different modes of
action.

Serge Gauthier, MD, FRCPC, MCSA Alzheimer’s Disease Research Unit, McGill
Centre for Studies in Aging, Verdun, Quebec, presented a review of
the clinical evidence on September 27 in support of combination therapy for
patients with AD together with the results of a 6-month trial. In this study,
404 patients with moderate to severe AD were randomised to receive memantine or
placebo in addition to existing stable treatment with donepezil.

Combination treatment with memantine and donepezil resulted in significant
benefits compared with donepezil plus placebo at 24 weeks. Improvements were
seen in cognition (Severe Impairment Battery score 1.0 vs -2.44, P
<.001), function (Alzheimer’s Disease Cooperative Study Activities of Daily
Living score 01.7 vs -3.3, P =.02), behaviour (Interview Based
Impression of Change Plus score 4.38 vs 4.64, P =.03), global
outcome (Neuropsychiatric Inventory score -0.5 vs 2.9, P =.01), and
care dependency (Janene Batten Care Dependency Scale score 0.6 vs 2.2,
P =.001).

Dr. Gauthier concluded that these results were in accord with data from other
studies that reported slower decline in cognitive function of AD patients with
combination treatment of memantine and a cholinesterase inhibitor. Combination
treatment produced consistent benefit across all domains in this study, and the
results warrant study in patients with mild AD. Furthermore, the significant
clinical benefit translates into improvements for caregivers.

Funding for this study was provided by H. Lundbeck AS.

[Presentation title: Benefits of Combination Treatment in Alzheimer’s
Disease. Abstract P2007]