Effectiveness of adding memantine to an Alzheimer dementia treatment regimen which already includes stable donepezil therapy: a critically appraised topic.
Neurologist
; 17(2): 121-3, 2011 Mar.
Article
em En
| MEDLINE
| ID: mdl-21364371
ABSTRACT
BACKGROUND:
Alzheimer dementia (AD) is a major cause of debility and economic strain in aging societies around the world. The only 2 medication classes approved specifically for the treatment of AD are the cholinesterase inhibitors (donepezil, rivastigmine, and galantamine) and memantine. Evidence that the use of memantine in a patient already on cholinesterase inhibitor therapy can provide a clinically significant benefit is limited.OBJECTIVE:
To review the evidence supporting the addition of memantine therapy in patients with moderate-to-severe AD who are already receiving treatment with a cholinesterase inhibitor.METHODS:
The objective was addressed through the development of a critically appraised topic which included a clinical scenario, structured question, search strategy, critical appraisal, results, evidence summary, commentary, and bottom line conclusions. Included were neurology consultants and residents, a medical librarian, clinical epidemiologists, and content experts in the field of behavioral neurology.RESULTS:
One article was selected for review. Patients receiving memantine for 24 weeks experienced a statistically significant change from baseline on a modified 19-item AD Cooperative Study-Activities of Daily Living Inventory (P=0.03) and on the Severe Impairment Battery (P=0.001) when compared with placebo. The change in mean scores in the memantine group versus placebo on the 19-item AD Cooperative Study-Activities of Daily Living Inventory were -2.0 versus -3.4 and on the Severe Impairment Battery 0.9 versus -2.5 which indicate improved performance or reduced deterioration in the memantine group. The number needed to treat and the effect size could not be calculated from the data provided.CONCLUSIONS:
The addition of memantine to donepezil in patients with moderate-to-severe AD provides a statistically significant improvement in several AD-oriented outcome measures, however, the clinical relevance of this benefit remains unclear.
Texto completo:
1
Eixos temáticos:
Pesquisa_clinica
Base de dados:
MEDLINE
Assunto principal:
Piperidinas
/
Dopaminérgicos
/
Memantina
/
Inibidores da Colinesterase
/
Doença de Alzheimer
/
Indanos
Tipo de estudo:
Clinical_trials
Limite:
Aged
/
Humans
/
Male
Idioma:
En
Ano de publicação:
2011
Tipo de documento:
Article