Memantine treatment for Japanese patients with moderate to severe Alzheimer’s disease: a meta-analysis of double-blind, randomized, placebo-controlled trials

Memantine treatment for Japanese patients with moderate to severe Alzheimer’s disease: a meta-analysis of double-blind, randomized, placebo-controlled trials

Taro Kishi,1,* Shinji Matsunaga,1,2,* Nakao Iwata1 1Department of Psychiatry, Fujita Health University School of Medicine, Toyoake, Aichi 470-1192, Japan; 2Department of Geriatrics and Cognitive Disorders, Fujita Health University School of Medicine, Toyoake, Aichi 470-1192, Japan *These authors c...

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Autores principales: Kishi T, Matsunaga S, Iwata N
Formato: article
Lenguaje:EN
Publicado: Dove Medical Press 2018
Materias:
Japanese patients
Alzheimer’s disease
memantine
cognitive functions
behavioral disturbances
meta-analysis
Neurosciences. Biological psychiatry. Neuropsychiatry
RC321-571
Neurology. Diseases of the nervous system
RC346-429
Acceso en línea:https://doaj.org/article/3ec67a78498f4e618110e3ad6effe6c1
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spelling oai:doaj.org-article:3ec67a78498f4e618110e3ad6effe6c12021-12-02T07:33:25ZMemantine treatment for Japanese patients with moderate to severe Alzheimer’s disease: a meta-analysis of double-blind, randomized, placebo-controlled trials1178-2021https://doaj.org/article/3ec67a78498f4e618110e3ad6effe6c12018-10-01T00:00:00Zhttps://www.dovepress.com/memantine-treatment-for-japanese-patients-with-moderate-to-severe-alzh-peer-reviewed-article-NDThttps://doaj.org/toc/1178-2021Taro Kishi,1,* Shinji Matsunaga,1,2,* Nakao Iwata1 1Department of Psychiatry, Fujita Health University School of Medicine, Toyoake, Aichi 470-1192, Japan; 2Department of Geriatrics and Cognitive Disorders, Fujita Health University School of Medicine, Toyoake, Aichi 470-1192, Japan *These authors contributed equally to this work Purpose: Although previous meta-analyses of randomized trials in the world literature have provided strong evidence that supports the efficacy and safety of memantine for the treatment of patients with Alzheimer’s disease (AD), it is unclear whether the drug is beneficial in the treatment of Japanese patients with moderate to severe AD because of differences in the formulation and regimen of memantine and the cholinesterase inhibitor (ChEI) used in combination with memantine between the drugs made in Japan and those made in other countries. To address this issue, we conducted a meta-analysis on the efficacy and safety of memantine using data from only double-blind, randomized, placebo-controlled trials (DBRPCTs) in Japan on Japanese patients with moderate to severe AD.Patients and methods: Our primary analysis was conducted using data from both memantine monotherapy (memantine vs placebo) and memantine combination therapy (memantine+ChEI vs ChEI+placebo) studies. The primary outcomes measured were cognitive function and behavioral disturbances. The secondary outcomes measured were the subscale scores of Behavioral Pathology in Alzheimer’s Disease (Behave-AD), discontinuation rate, and individual adverse events.Results: Four DBRPCTs (n=1,328) were detected. Memantine was superior to the control in cognitive functions (standardized mean difference [SMD]=−0.31, 95% CI=−0.53, −0.10) and behavioral disturbances (SMD=−0.16, 95% CI=−0.28, −0.05). Only memantine monotherapy was superior in both outcomes. It was also superior to the control in delusions, aggression, and diurnal rhythm disturbances based on the Behave-AD subscale scores. Although memantine was associated with a lower incidence of AD progression than that of the control, the incidence of somnolence was higher with memantine. There were no significant differences in other safety outcomes, including all-cause discontinuation, between the groups.Conclusion: Our results suggest that memantine is useful for the treatment of patients in Japan with moderate to severe AD even though our meta-analysis comprised only four DBRPCTs. Keywords: Japanese patients, Alzheimer’s disease, memantine, cognitive functions, behavioral disturbances, meta-analysisKishi TMatsunaga SIwata NDove Medical PressarticleJapanese patientsAlzheimer’s diseasememantinecognitive functionsbehavioral disturbancesmeta-analysisNeurosciences. Biological psychiatry. NeuropsychiatryRC321-571Neurology. Diseases of the nervous systemRC346-429ENNeuropsychiatric Disease and Treatment, Vol Volume 14, Pp 2915-2922 (2018)
institution DOAJ
collection DOAJ
language EN
topic Japanese patients
Alzheimer’s disease
memantine
cognitive functions
behavioral disturbances
meta-analysis
Neurosciences. Biological psychiatry. Neuropsychiatry
RC321-571
Neurology. Diseases of the nervous system
RC346-429
spellingShingle Japanese patients
Alzheimer’s disease
memantine
cognitive functions
behavioral disturbances
meta-analysis
Neurosciences. Biological psychiatry. Neuropsychiatry
RC321-571
Neurology. Diseases of the nervous system
RC346-429
Kishi T
Matsunaga S
Iwata N
Memantine treatment for Japanese patients with moderate to severe Alzheimer’s disease: a meta-analysis of double-blind, randomized, placebo-controlled trials
description Taro Kishi,1,* Shinji Matsunaga,1,2,* Nakao Iwata1 1Department of Psychiatry, Fujita Health University School of Medicine, Toyoake, Aichi 470-1192, Japan; 2Department of Geriatrics and Cognitive Disorders, Fujita Health University School of Medicine, Toyoake, Aichi 470-1192, Japan *These authors contributed equally to this work Purpose: Although previous meta-analyses of randomized trials in the world literature have provided strong evidence that supports the efficacy and safety of memantine for the treatment of patients with Alzheimer’s disease (AD), it is unclear whether the drug is beneficial in the treatment of Japanese patients with moderate to severe AD because of differences in the formulation and regimen of memantine and the cholinesterase inhibitor (ChEI) used in combination with memantine between the drugs made in Japan and those made in other countries. To address this issue, we conducted a meta-analysis on the efficacy and safety of memantine using data from only double-blind, randomized, placebo-controlled trials (DBRPCTs) in Japan on Japanese patients with moderate to severe AD.Patients and methods: Our primary analysis was conducted using data from both memantine monotherapy (memantine vs placebo) and memantine combination therapy (memantine+ChEI vs ChEI+placebo) studies. The primary outcomes measured were cognitive function and behavioral disturbances. The secondary outcomes measured were the subscale scores of Behavioral Pathology in Alzheimer’s Disease (Behave-AD), discontinuation rate, and individual adverse events.Results: Four DBRPCTs (n=1,328) were detected. Memantine was superior to the control in cognitive functions (standardized mean difference [SMD]=−0.31, 95% CI=−0.53, −0.10) and behavioral disturbances (SMD=−0.16, 95% CI=−0.28, −0.05). Only memantine monotherapy was superior in both outcomes. It was also superior to the control in delusions, aggression, and diurnal rhythm disturbances based on the Behave-AD subscale scores. Although memantine was associated with a lower incidence of AD progression than that of the control, the incidence of somnolence was higher with memantine. There were no significant differences in other safety outcomes, including all-cause discontinuation, between the groups.Conclusion: Our results suggest that memantine is useful for the treatment of patients in Japan with moderate to severe AD even though our meta-analysis comprised only four DBRPCTs. Keywords: Japanese patients, Alzheimer’s disease, memantine, cognitive functions, behavioral disturbances, meta-analysis
format article
author Kishi T
Matsunaga S
Iwata N
author_facet Kishi T
Matsunaga S
Iwata N
author_sort Kishi T
title Memantine treatment for Japanese patients with moderate to severe Alzheimer’s disease: a meta-analysis of double-blind, randomized, placebo-controlled trials
title_short Memantine treatment for Japanese patients with moderate to severe Alzheimer’s disease: a meta-analysis of double-blind, randomized, placebo-controlled trials
title_full Memantine treatment for Japanese patients with moderate to severe Alzheimer’s disease: a meta-analysis of double-blind, randomized, placebo-controlled trials
title_fullStr Memantine treatment for Japanese patients with moderate to severe Alzheimer’s disease: a meta-analysis of double-blind, randomized, placebo-controlled trials
title_full_unstemmed Memantine treatment for Japanese patients with moderate to severe Alzheimer’s disease: a meta-analysis of double-blind, randomized, placebo-controlled trials
title_sort memantine treatment for japanese patients with moderate to severe alzheimer’s disease: a meta-analysis of double-blind, randomized, placebo-controlled trials
publisher Dove Medical Press
publishDate 2018
url https://doaj.org/article/3ec67a78498f4e618110e3ad6effe6c1
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