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Memantine + Stable Acetylcholinesterase Inhibitor Provides Benefits to Alzheimer's Disease Patients: Presented at AAN
By Jill Stein
SAN FRANCISCO, CA -- April 30, 2004 -- Memantine treatment in conjunction with ongoing donepezil therapy is associated with less functional and behavioural deterioration in Alzheimer's disease than donepezil therapy alone, researchers said on April 29th here at the American Academy of Neurology 56th Annual Meeting.
Memantine is a low-moderate affinity, uncompetitive N-methyl-D-aspartate (NMDA) receptor antagonist that is thought to allow normal physiological activation while blocking prolonged pathological activation of the NMDA receptor -- a factor implicated in the pathology of AD.
Donepezil is an acetylcholinesterase inhibitor.
Jeffrey Cummings, MD, University of California, Los Angeles, United States reported the results of a 24-week trial, in which 395 patients with moderate to severe AD who were on a stable donepezil regimen were randomised to memantine or placebo.
At enrollment, the mean score on the Mini-Mental State Exam (MMSE) was 10.
Baseline characteristics between the 2 treatment groups were comparable.
Results showed that therapeutic benefits of memantine in this population of patients with moderate to severe AD taking a stable dose of a commonly used acetylcholinesterase inhibitor were observed for functional and behavioural measures.
Function was assessed using the Alzheimer's Disease Cooperative Study – Activities of Daily Living Scale (ADCS-ADL19). Function and behaviour were assessed using the Behavioural Rating Scale for Geriatric Patients (BGP). Behaviour was assessed using the Neuropsychiatric Inventory (NPI).
Among the 19 ADCS-ADL19 single-item functional domains, memantine/donepezil treatment resulted in significantly greater functional ability compared to placebo/donepezil for grooming, watching television, being left alone, toileting, and finding belongings.
A statistically significant response in favour of memantine/donepezil treatment was measured on the total NPI score as well as on particular NPI domains: agitation/aggression, irritability/lability, and appetite/eating change.
This study was sponsored by Forest Laboratories, Inc., New York, United States.
[Presentation title: "Functional and Behavioral Effects of Memantine in Alzheimer's Disease. Abstract #P04.107]
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