A responder analysis of memantine treatment in patients with Alzheimer disease maintained on donepezil

Christopher H. Van Dyck, Frederick A. Schmitt, Jason T. Olin

Research output: Contribution to journalArticlepeer-review

48 Scopus citations

Abstract

Objective: The objective of this study was to examine the clinical utility of memantine for moderate-to-severe Alzheimer disease (AD) using responder analyses. Method: Data from a previously published 24-week, randomized, double-blind, placebo-controlled trial of 10 mg memantine twice a day in patients with moderate-to-severe AD (N= 404) on stable donepezil therapy were evaluated using three sets of responder criteria. Response rates were calculated and analyzed for the intention-to-treat population using a generalized estimating equations model. The following outcomes were examined separately and in combination: the Alzheimer's Disease Cooperative Study-Activities of Daily Living 19-Item Inventory (ADCS-ADL19), Severe Impairment Battery (SIB), Clinician's Interview-Based Impression of Change Plus Caregiver Input (CIBIC-Plus), and Neuropsychiatric Inventory (NPI). Results: When treatment response required cognitive improvement relative to baseline, memantine yielded higher response rates than placebo. When treatment response was defined as stabilization of individual outcomes, memantine resulted in significantly higher-response rates than placebo for all outcomes, with number needed to treat (NNT) ranging from 8-10. More conservative definitions of response that required simultaneous stabilization on multiple outcome measures again favored memantine treatment for six of 10 combinatorial definitions. Conclusions: These responder analyses may assist clinicians in evaluating the impact of memantine in a relevant clinical scenario, i.e., in patients with AD previously stabilized on a cholinesterase inhibitor. The current results indicate that in this setting, memantine produces both improvement and stabilization of symptoms, across multiple outcomes, and thus provides a clinically important treatment benefit for patients with moderate-to-severe AD.

Original languageEnglish
Pages (from-to)428-437
Number of pages10
JournalAmerican Journal of Geriatric Psychiatry
Volume14
Issue number5
DOIs
StatePublished - May 2006

Bibliographical note

Funding Information:
This research was funded by Forest Laboratories, Inc., New York, NY.

Copyright:
Copyright 2017 Elsevier B.V., All rights reserved.

Keywords

  • Alzheimer disease
  • Memantine
  • NMDA receptor antagonist

ASJC Scopus subject areas

  • Geriatrics and Gerontology
  • Psychiatry and Mental health

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