Memantine Slows Progression to Behavioural Symptoms in Alzheimer's Patients: Presented at ICAD

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Title: Memantine Slows Progression to Behavioural Symptoms in Alzheimer's Patients: Presented at ICAD
URL: http://www.pslgroup.com/dg/226C8A.htm
Doctor's Guide
August 1, 2008

By Ed Susman

CHICAGO -- August 1, 2008 -- Treatment with the N-methyl-D-aspartic acid-receptor antagonist memantine may slow the progression of behavioural symptoms and may even prevent those symptoms from emerging among patients diagnosed with Alzheimer's disease.

"Symptoms [of Alzheimer's disease] such as agitation and irritability can be amongst the most challenging to manage and often trigger a patient's transfer to institutional care," said Serge Gauthier, MD, Alzheimer's Disease Research Unit, McGill Centre for Studies in Aging, Douglas Mental Health University Institute, Montreal, Quebec.

"These studies, therefore, may mean that treatment with memantine can help reduce caregiver stress and delay patient institutionalisation," Dr. Gauthier said at his poster presentation on July 30 at the 2008 International Conference on Alzheimer's Disease (ICAD).

Dr. Gauthier and colleagues gathered data from 6 phase 3, randomised, double-blind, placebo-controlled, 6-month clinical studies of memantine. The researchers compared outcomes as they applied to the Neuropsychiatry Inventory (NPI) scale, a tool used to assess behavioural symptoms of advanced Alzheimer's disease. The analysis focused on a subgroup of patients with moderate to severe disease as measured by a score of less than 20 on the Mini Mental State Examination.

They identified 1,717 patients enrolled in the 6 clinical trials; of these, 907 were treated with memantine and 810 with placebo. From baseline to the end of the studies, memantine reduced the NPI cluster score as compared with placebo, with a weighted mean difference of .78 on the 12-item scale. This difference in favour of memantine treatment was statistically significant (P = .006), said Dr. Gauthier.

A 60% greater risk of the emergence of symptoms was seen in patients randomised to receive placebo rather than memantine. That difference also was statistically significant (P = .009), he said.

Memantine is indicated for the treatment of moderate to severe Alzheimer's disease.

"Several studies have demonstrated the efficacy of memantine in moderate to severe Alzheimer's disease, producing significant improvements in overall domain scores, as well as specific items of cognition, function, and behaviour," Dr. Gauthier said.

The NPI cluster of symptoms that has been successfully treated with memantine therapy includes delusions, irritability, night-time behaviour, appetite and eating changes, agitation, and aggression, he said.

The pooled data analyses also showed that memantine is safe in the treatment of patients with Alzheimer's disease who have behavioural disturbances.

Funding for the study was provided by Lundbeck France.

[Presentation title: Memantine Decreases, and Prevents the Emergence of, Key Behavioural Symptoms of Alzheimer's Disease. Abstract P4-317]

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