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• W2083401617 abstract "Memantine, a low-moderate affinity, uncompetitive N-methyl-d-aspartate (NMDA) receptor antagonist, is a novel Alzheimer's disease (AD) therapy approved in the U.S. for the treatment of moderate to severe AD and is available in Europe. Evidence for its 6-month efficacy in AD comes from six large-scale, placebo-controlled trials: three in moderate to severe AD and three in mild to moderate AD. To conduct a meta-analysis of six 6-month memantine trials on cognitive, global, functional, and behavioral measures in patients with AD. The six 6-month trials were randomized, placebo-controlled, parallel-group designs comparing memantine (20 mg/day) to placebo. Two trials included patients on stable cholinesterase inhibitor treatment, one in moderate to severe AD (donepezil only), and the other in mild to moderate AD. Measures analyzed included cognition (ADAS-cog; SIB), function (ADCS-ADL19 or ADCS-ADL23), global status (CIBIC-Plus), and behavior (NPI). Standardized mean differences (SMD) and odds ratios (OR) were calculated using fixed effect models; random effects models were used when there was evidence of heterogeneity between trials. A statistically significant benefit of memantine was demonstrated on measures of cognition (SMD (random)=-0.21 {95% CI -0.34, -0.08}, N=2255, P=.001), function (SMD=-0.10 {CI 0.01, -0.18}, N=2249, P=.02), and global status (SMD=-0.19 {CI -0.27, -0.10}, N=2245, P<.0001), but not behavior (SMD=-0.09 {CI -0.22, 0.04}, N=2188, P=.16). Evidence of heterogeneity occurred on measures of cognition (LOCF only), behavior (LOCF only), and function (OC only). There was no evidence that efficacy was driven by an outlier trial. OC findings were similar in magnitude to those computed using an LOCF approach. The rate of all cause discontinuations for memantine (16.8%) was lower than for placebo (19.9%); OR (random)=0.86 {CI 0.62, 1.19}, N=2311, but not significant (P=.35). Regarding safety, the rate of serious adverse events for memantine was similar to placebo and was not statistically significant (11.8% vs. 12.1%; Peto OR=1.02 {0.79, 1.31}, P=.89). This meta-analysis of 6-month trials in AD indicates that memantine imparts a statistically significant benefit over placebo on measures of cognition, function, and global status with good safety and tolerability." @default.
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• W2083401617 date "2005-07-01" @default.
• W2083401617 modified "2023-09-27" @default.
• W2083401617 title "[P-186]: Meta-analysis of 6-month memantine clinical trials in Alzheimer's disease" @default.
• W2083401617 doi "https://doi.org/10.1016/j.jalz.2005.06.245" @default.
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