すでにドネペジルを投与されている中等度から重度のアルツハイマー病患者のメンタン治療:ランダム化制御試験
Pierre N Tariot1, Martin R Farlow, George T Grossberg
1Department of Psychiatry, University of Rochester Medical Center, Monroe Community Hospital, Rochester, NY 14620, USA. pierre_tariot@urmc.rochester.edu
JAMA
|January 22, 2004
まとめ
メマンチンは,すでにドネペジルを服用している中等度から重度のアルツハイマー病 (AD) 患者で認知機能と日常生活活動を改善しました. このアルツハイマー病の治療法はよく耐えており,プラセボよりも良い結果を示しました.
科学分野:
- 神経科学は神経科学である.
- 薬理学 薬理学とは
- ゲリアトリクス ゲリアトリクス
背景:
- メマンチン (Memantine) は,N-メチル-D-アスパルテート受容体の抗体である.
- 以前の試験では,中等度から重度のアルツハイマー病 (AD) の単独治療におけるメマンタインの有効性が確認されました.
- メマンチンとコレネステラゼ阻害剤の併用を評価した以前の試験はありませんでした.
研究 の 目的:
- メマンチンの有効性と安全性をプラセボと比較して評価する.
- すでに安定したドネペジル治療を受けている中等度から重度のAD患者におけるメマンチンの有効性を評価する.
主な方法:
- 24週間のランダム化,ダブルブラインド,プラセボ対照試験で,中等度から重度のADの404人の患者が参加しました.
- 患者はMini-Mental State Examinationのスコアが5から14の間で,ドネペジル投与量が安定していた.
- 主なアウトカムには,重症障害バッテリー (SIB) とAD共同研究-日常生活の活動 (ADCS-ADL19) のスコアの変化が含まれていました.
主要な成果:
- メマンチンは,SIBスコア (P<.001) とADCS-ADL19スコア (P=.03) でプラセボに比べて有意な改善を示した.
- グローバルアウトカム指標 (CIBIC-Plus) もメマンチン (P=.03) を好みました.
- プラセボ (プラセボ12.4%) と比較して,有害事象 (7.4%) のためにメマンチン投与を中止した患者は少なくなった.
結論:
- メマンチン併用療法により,ドネペジルで治療されたAD患者の認知機能,日常生活活動,および全体的なアウトカムが著しく改善されました.
- メマンチンは,この患者集団でよく耐えました.
- これらの発見は,中等から重度のアルツハイマー病の貴重な治療選択肢としてメマンチンを支持しています.
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