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Memantine in moderate to severe Alzheimer's disease: a meta-analysis of randomised clinical trials

Bengt Winblad1, Roy W Jones, Yvonne Wirth

  • 1Karolinska Institutet, Stockholm, Sweden.

Dementia and Geriatric Cognitive Disorders
|May 15, 2007
PubMed

Insights

Memantine demonstrates significant efficacy for patients with moderate to severe Alzheimer's disease (AD). This meta-analysis confirms its benefits across global status, cognition, function, and behavior, with good tolerability.

Area of Science:

  • Neuroscience
  • Pharmacology
  • Geriatrics

Background:

  • Alzheimer's disease (AD) is a progressive neurodegenerative disorder.
  • Memantine is approved for AD treatment, with recent European label expansion for moderate to severe stages.
  • Previous trials investigated memantine's efficacy, necessitating a consolidated analysis for specific patient subgroups.

Purpose of the Study:

  • To evaluate the efficacy of memantine in patients with moderate to severe Alzheimer's disease (AD) using a meta-analysis.
  • To assess memantine's impact on global status, cognition, function, and behavior in this patient population.
  • To consolidate evidence from randomized, placebo-controlled phase III trials.

Main Methods:

  • Meta-analysis of six randomized, placebo-controlled phase III trials involving 1,826 patients with moderate to severe AD (Mini-Mental State Exam score < 20).
  • Efficacy assessment included Clinician's Interview-Based Impression of Change Plus Caregiver Input (global status), Alzheimer's Disease Assessment Scale - Cognitive Subscale/Severe Impairment Battery (cognition), Alzheimer's Disease Cooperative Study Activities of Daily Living scales (function), and Neuropsychiatric Inventory (behavior).
  • Analysis considered results without replacement of missing values.

Main Results:

  • Memantine showed statistically significant improvements compared to placebo across all assessed domains: global status, cognition, function, and behavior.
  • The drug was well tolerated, with adverse event rates comparable to placebo.
  • No significant differences in adverse event incidence were observed between memantine and placebo groups.

Conclusions:

  • This meta-analysis provides robust support for the clinically relevant efficacy of memantine in patients with moderate to severe Alzheimer's disease.
  • Memantine is a well-tolerated treatment option for this patient group.
  • The findings align with the expanded indication for memantine in Europe.

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