Poster Presentations

Session Title: Alzheimer's Disease (AD) including Non-Cognitive Aspects
Presentation Date: Friday, March 14 – Saturday, March 15, 2009

EFFECTS OF MEMANTINE ON INSTRUMENTAL ACTIVITIES OF DAILY LIVING IN A LARGE GREEK OBSERVATIONAL STUDY

S. Stamouli¹, M. Tzanakaki², N. Laggis³, K. Giatas⁴, G. Georgiadis⁵, E. Papalexi^6
1Psychiatric Clinic, Eginition University Hosp of Athens, Athens, Greece, ²Center of Mental Health, Chania, Greece, ³“Elpis” General Hosp of Athens, Department of Neurology, Athens, Greece, ⁴251 Military Hosp of Athens, Department of Neurology, Athens, Greece, ⁵Ippokrateion Hosp of Thessaloniki, Department of Neurology, Thessaloniki, Greece, ⁶Lundbeck Hellas S.A., Athens, Greece

Memantine, an NMDA-R antagonist, is approved for the treatment of moderate-to-severe (MMSE< 20) Alzheimer's disease (AD). This study was conducted in order to evaluate the efficacy and safety of memantine in naturalistic settings.
The 6-month, observational, open-label study in 202 specialist centers in Greece evaluated the efficacy of memantine using the MMSE and Instrumental Activities of Daily Living (IADL) scale at baseline, 3 and 6 months. Safety was assessed by spontaneously reported adverse events (AEs). Efficacy analyses were performed in the Intent-To-Treat dataset (ITT) with at least one post-baseline evaluation.
2570 AD patients (74.8±6.8 years, 54.6% women, MMSE: 18.0±5.0) were included in the current study, 34.2% of which had received previous treatment with acetylocholinesterase inhibitors (AChEIs), while for 65.8% memantine was the first treatment option. At baseline, 91.5% were prescribed memantine as monotherapy, the remainder also received AChEIs. The 8-item IADL scale, assessing complex activities such as doing laundry or managing money, was corrected to 100 with exclusion of non-applicable questions from the total score to avoid gender bias. IADL scores were significantly improved from baseline (45.8±27.1) to 3 (49.3±26.7) and 6 months (51.4±26.2, p< 0.001, repeated measures analysis of variance Hotelling's test, ITT). At 6 months, the change from baseline increased significantly with the severity of illness (p< 0.001, Scheffe test).
7.1% of patients reported AEs, 0.3% of which were severe. Only 0.7% of patients terminated treatment prematurely due to AEs.
The results support the excellent efficacy and tolerability profile of memantine in routine clinical practice.