Memantine in Japanese patients with moderate to severe Alzheimer's disease: meta-analysis of multiple-index responder analyses.

BACKGROUND: Responder analyses assessing clinical worsening have attempted to clarify clinically meaningful drug efficacy enhancements in patients with Alzheimer's disease (AD). RESEARCH DESIGN AND METHODS: This was a meta-analysis of two multicenter, randomized, double-blind, parallel-group, 24-week studies of 633 Japanese patients with moderate to severe AD receiving memantine 20 mg/day (n = 318) or placebo (n = 315). The clinical trial registration number is UMIN000026013. RESULTS: Overall odds ratios (OR) for a reduced likelihood of clinical worsening (memantine versus placebo) were statistically significant on the following individual and combined rating scales: Severe Impairment Battery-Japanese version (SIB-J, OR 0.52; 95% CI: 0.37, 0.73; p = 0.0001); Behavioral Pathology in AD Rating Scale (BEHAVE-AD, OR 0.53; 95% CI: 0.37, 0.75; p = 0.0003); and SIB-J + Clinician's Interview-Based Impression of Change-plus-Japanese version (SIB-J + CIBIC-plus-J; OR 0.53; 95% CI: 0.37, 0.77; p = 0.0009). A significantly reduced risk of triple worsening was evident in the memantine versus placebo group on the combined SIB-J + CIBIC-plus-J + BEHAVE-AD rating scales (OR 0.38; 95% CI: 0.22, 0.65; p = 0.0003). CONCLUSIONS: Memantine is a viable treatment option for patients with AD presenting not only with cognitive impairment, but also with a broader range of symptoms, including the behavioral and psychological symptoms of dementia.

Abnormal collateral arterial systems in Takayasu's arteritis and Leriche's syndrome evaluated by whole body acquisition using multislice computed tomography.

Takayasu's arteritis causes various arterial changes, including wall thickening, occlusion, aneurysm, and calcification. Similarly, Leriche's syndrome causes occlusion of the abdominal aorta or iliac arteries accompanied by ischemic symptoms of the distal lower extremities. Both diseases are potentially associated with the development of unexpected collateral arteries throughout the body. We evaluated whole body arteries in subjects with Takayasu's arteritis and Leriche's syndrome using 16-slice multislice CT and concluded that it was a useful tool to detect unexpected collateral arterial systems in Takayasu's arteritis or Leriche's syndrome in a non-invasive fashion.