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| |  Memantine Provides Significant Effects on 3 Key Cognitive Domains in Patients With Alzheimer's Disease: Presented at ENS By Judith Moser, MD NICE, France -- June 13, 2008 -- Patients with moderate to severe Alzheimer's disease (AD) showed significantly better outcomes in terms of language, memory, and praxis after 3 and 6 months of treatment with memantine compared with patients who received placebo, according to a meta-analysis of 6 studies. The post-hoc analysis, presented here at the 18th Meeting of the European Neurological Society (ENS), evaluated the effects of memantine on specific cognitive domains in patients with moderate to severe AD on the basis of data pooled from 6 randomised, double-blind, placebo-controlled studies. All trials included patients treated with memantine 20 mg QD or placebo for 24 or 28 weeks. Patients selected had a Mini Mental State Examination score below 20. "We decided to select these patients in order to achieve a more homogeneous population," explained Patrizia Mecocci, MD, PhD, Institute of Gerontology and Geriatrics, University of Perugia, Perugia, Italy, at a poster presentation on June 11. Of the 1,826 patients selected, 959 were treated with memantine and 867 with placebo. There were no clinically relevant differences in baseline demographics and patient characteristics between the memantine and the placebo groups. The assessment focused on 3 constructed cognitive clusters, which represented the cognitive domains of language, memory, and praxis. They were comprised of individual items from the Alzheimer's Disease Assessment Scale cognitive subscale (ADAS-cog) and the Severe Impairment Battery (SIB). Post-hoc responder analyses were performed using 3 cut-offs: (1) any improvement (ADAS-cog <0; SIB >0); (2) no change/any improvement (ADAS-cog <= 0; SIB >=0); and any worsening (ADAS-cog >0; SIB <0) from baseline. "In all evaluated areas, patients under treatment with memantine showed more frequently improvement or no change/any improvement, whereas worsening was seen more frequently in subjects under placebo," Dr. Mecocci summarised. In comparison with placebo patients, a significantly higher proportion of patients treated with memantine showed any improvement of language (39% vs 32%, P < .01), memory (47% vs 39%, P < .001), and praxis (34% vs 27%, P < .01) after 24 weeks in the last-observation-carried-forward (LOCF) cohort. Similar statistically significant results were obtained in week 12 and 24 in the observed cases (OC) analysis. Likewise, a significantly higher proportion of memantine-treated patients showed no change/any improvement in language, memory, and praxis at week 12 (OC) and 24 (OC and LOCF). The reverse was shown for the any-worsening cut-off, with a significantly smaller proportion of memantine-treated patients displaying any worsening on any of the 3 clusters for all time points (OC and LOCF). These results can be regarded as favourable considering that the patients were at a very advanced stage of their disease, Dr. Mecocci concluded. Funding for this study was provided by LundbeckA/S.
[Presentation title: Effects of Memantine Treatment on Discrete Cognitive Domains in Patients With Moderate to Severe Alzheimer's Disease. Abstract P789]
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