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. Papalexi6
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.