OBJECTIVE: At present, inhibition of cholines-terase is the treatment of choice for subjects with mild-to-moderate Alzheimer's disease (AD). Memantine, a noncompetitive antagonist at N-methyl-d-aspartate receptors, is currently used to treat subjects with moderate-to-severe AD. The goal of this multicenter, open-label pilot study was to investigate whether combination therapy with memantine added to rivastigmine is safe and beneficial in subjects with mild-to-moderate AD. METHOD:Patients with a DSM-IV diagnosis of dementia of the Alzheimer's type (N = 95), who were treated with rivastigmine (6-12 mg/day) for a maximum duration of 24 weeks prior to baseline, received memantine (5-20 mg/day) in combination with rivastigmine for 12 weeks. The primary efficacy variable was the change in the Alzheimer's Disease Assessment Scale-cognitive subscale (ADAS-cog) total score at the end of 12 weeks compared with baseline. The study was conducted between September 15, 2003, and May 27, 2004. RESULTS: There was a statistically significant difference between baseline and week 12 for the ADAS-cog total score, showing a positive effect of combination therapy. Combination therapy did not evidence any unexpected safety concerns and was well-tolerated by most patients. CONCLUSION:Memantine in combination with rivastigmine appears to be safe and beneficial in patients with mild-to-moderate AD. Our results need to be confirmed in a large, long-term, randomized, double-blind, placebo-controlled clinical trial.
RCT Entities:
OBJECTIVE: At present, inhibition of cholines-terase is the treatment of choice for subjects with mild-to-moderate Alzheimer's disease (AD). Memantine, a noncompetitive antagonist at N-methyl-d-aspartate receptors, is currently used to treat subjects with moderate-to-severe AD. The goal of this multicenter, open-label pilot study was to investigate whether combination therapy with memantine added to rivastigmine is safe and beneficial in subjects with mild-to-moderate AD. METHOD:Patients with a DSM-IV diagnosis of dementia of the Alzheimer's type (N = 95), who were treated with rivastigmine (6-12 mg/day) for a maximum duration of 24 weeks prior to baseline, received memantine (5-20 mg/day) in combination with rivastigmine for 12 weeks. The primary efficacy variable was the change in the Alzheimer's Disease Assessment Scale-cognitive subscale (ADAS-cog) total score at the end of 12 weeks compared with baseline. The study was conducted between September 15, 2003, and May 27, 2004. RESULTS: There was a statistically significant difference between baseline and week 12 for the ADAS-cog total score, showing a positive effect of combination therapy. Combination therapy did not evidence any unexpected safety concerns and was well-tolerated by most patients. CONCLUSION:Memantine in combination with rivastigmine appears to be safe and beneficial in patients with mild-to-moderate AD. Our results need to be confirmed in a large, long-term, randomized, double-blind, placebo-controlled clinical trial.
Authors: Barry Reisberg; Rachelle Doody; Albrecht Stöffler; Frederick Schmitt; Steven Ferris; Hans Jörg Möbius Journal: N Engl J Med Date: 2003-04-03 Impact factor: 91.245
Authors: Krista L Lanctôt; Nathan Herrmann; Kenneth K Yau; Lyla R Khan; Barbara A Liu; Maysoon M LouLou; Thomas R Einarson Journal: CMAJ Date: 2003-09-16 Impact factor: 8.262
Authors: T Darreh-Shori; O Almkvist; Z Z Guan; A Garlind; B Strandberg; A-L Svensson; H Soreq; E Hellström-Lindahl; A Nordberg Journal: Neurology Date: 2002-08-27 Impact factor: 9.910
Authors: Oliver Peters; Manuel Fuentes; Lisa Katharina Joachim; Frank Jessen; Christian Luckhaus; Johannes Kornhuber; Johannes Pantel; Michael Hüll; Klaus Schmidtke; Eckart Rüther; Hans-Jürgen Möller; Alexander Kurz; Jens Wiltfang; Wolfgang Maier; Birgitt Wiese; Lutz Frölich; Isabella Heuser Journal: Alzheimers Dement (N Y) Date: 2015-10-19