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Studies Find Memantine Treatment Improves Specific Symptoms of Alzheimer's Disease: Presented at ECNP

By Mark Pownall

AMSTERDAM, THE NETHERLANDS -- October 26, 2005 -- Treatment with memantine appears to reduce the decline in individual function in patients with moderate to severe Alzheimer's disease, according to an analysis of 2 placebo-controlled trials.

In 1 trial 252 patients were randomized to memantine or placebo as monotherapy, and in another a total of 403 patients were randomized to memantine or placebo in addition to stable donezepil therapy at a mean dose of 9 mg per day.

Previously, studies demonstrated that memantine, an N-methyl-D-aspartate receptor antagonist, has positive effects on global, functional, and behavioral measures in patients with moderate to severe Alzheimer's disease.

Howard Feldman, MD, head, division of neurology, University of British Columbia, Vancouver, British Columbia, Canada, presented data here on October 24^th at the 18^th Congress of the European College of Neuropsychopharmacology (ECNP), to show that treatment significantly reduced the decline in patients' ability to dispose of litter, clear a table, hold a conversation, find their belongings, watch television, and groom themselves compared with placebo.

Dr. Feldman said that memantine also provided benefits compared with placebo on autonomy, simple motor skills and praxis, higher-level functions, and basic activities of daily living.

Autonomy assessed ability to use a telephone, watching television, traveling, and being left alone; simple motor skills included clearing litter, turning a tap on and off, and turning a light on. Higher-level functions included holding a conversation, finding belongings, getting a drink, and turning a light off. The basic activities of daily living were listed as eating, walking, going to the toilet, bathing, grooming, dressing, and clearing a table.

The post hoc analysis looked at the total scores, individual items, and subscales on the intention-to-treat populations. There were no differences between the placebo- and memantine-treated groups at baseline in the analyzed studies. The patients had a mean age of 76, and 63 to 72 percent were women. About 90 percent were white and Mini Mental State Examination (MMSE) scores were 8.1 for the placebo group and 7.7 in the memantine monotherapy trial, and 10.2 for placebo and 9.9 for the memantine-treated group in the combination with donezepil group.

The studies had previously reported improvement in the total score of the 19-item Alzheimer's Disease Cooperative Study-Activities of Daily Living Inventory (ADCS-ADL-19), suggesting that memantine treatment improved functional decline relative to placebo.

Dr Feldman said a health economics analysis of the trial that added memantine to stable donezepil therapy was needed to assess the impact of the functional improvements noted. A previous Resource Utilization in Dementia (RUD) study of the monotherapy trial, he commented, indicated that memantine treatment in patients with moderate to severe Alzheimer's disease reduces total healthcare and societal costs.

'Treatments that reduce functional deterioration may reduce caregiver and health care provider burden, as well as maximizing the quality of life for individuals with Alzheimer's disease," Dr Feldman said.

The research was funded by Forest Laboratories Inc.

Citation: Journal of the European College of Neuropsychopharmacology. 2005;15 (suppl 3):S570.


[Presentation title: Memantine and Individual Activities of Daily Living in Moderate to Severe Alzheimer's Disease. Abstract P.5.031]

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