Skip to main content
Erschienen in: Journal of Neurology 3/2007

01.03.2007 | ORIGINAL COMMUNICATION

Open label, multicenter, 28-week extension study of the safety and tolerability of memantine in patients with mild to moderate Alzheimer’s disease

verfasst von: Brian R. Ott, Lesley M. Blake, Ethel Kagan, Malca Resnick, for the Memantine MEM-MD-11AB Study Group

Erschienen in: Journal of Neurology | Ausgabe 3/2007

Einloggen, um Zugang zu erhalten

Abstract

Background

Memantine, an N-methyl-D-aspartate (NMDA) receptor antagonist, has been shown to be safe and to have beneficial effects on cognition, function, behavior, and global patient status in patients with Alzheimer’s disease (AD) in studies lasting 3–6 months. It is approved in the U.S. and Europe for the treatment of moderate to severe AD and is currently under investigation for mild to moderate AD.

Objective

To evaluate the long-term safety of memantine in patients with mild to moderate AD and to investigate the tolerability of once-daily dose administration.

Methods

This 28-week study enrolled 314 patients with mild to moderate AD who had completed a 24-week, double-blind, placebo-controlled lead-in clinical trial of memantine in AD. Following an 8-week double-blind dose titration phase (used to assess the tolerability of different dosing regimens), subjects were assigned to continuous open label memantine (10 mg, bi.d.) treatment for 20 weeks. Safety outcome measures included treatment-emergent adverse events (AEs), deaths, vital signs, electrocardiograms, and laboratory parameters.

Results

During the 28-week study (Phase A + Phase B), the most common AEs were falls and other injuries (both 10.8%). AEs resulted in treatment discontinuation in 6.7% of patients. Discontinuations due to AEs were similar in the once-daily dosing groups compared to the twice-daily dosing groups. During dose titration, completion rates were greater than 90% for both groups. Conversion to once-daily dosing in patients already receiving twice-daily doses of memantine was also well tolerated.

Conclusions

Memantine monotherapy in patients with mild to moderate AD is safe and well tolerated for at least one year. Once-daily dosing during titration and short-term maintenance therapy is safe and well tolerated.
Literatur
1.
Zurück zum Zitat Alva G, Farlow M, Lee G, Wirth Y, Graham SM (2005) Update of memantine safety in short- and long-term treatment of dementia. Int Psychogeriatr 17(S2):200 Alva G, Farlow M, Lee G, Wirth Y, Graham SM (2005) Update of memantine safety in short- and long-term treatment of dementia. Int Psychogeriatr 17(S2):200
2.
Zurück zum Zitat American Psychiatric Association (ed) (1994) Diagnostic and Statistical Manual of Mental Disorders DSM-IV. APA, Washington D.C American Psychiatric Association (ed) (1994) Diagnostic and Statistical Manual of Mental Disorders DSM-IV. APA, Washington D.C
3.
Zurück zum Zitat Bleich S, Romer K, Wiltfang J (2003) Glutamate and the glutamate receptor system: a target for drug action. Int J Geriatr Psychiatry 18:S33–S40PubMedCrossRef Bleich S, Romer K, Wiltfang J (2003) Glutamate and the glutamate receptor system: a target for drug action. Int J Geriatr Psychiatry 18:S33–S40PubMedCrossRef
4.
Zurück zum Zitat Blesa R, Davidson M, Kurz A, Reichman W, van Baelen B, Schwalen S (2003) Galantamine provides sustained benefits in patients with ‘advanced moderate’ Alzheimer’s disease for at least 12 months. Dement Geriatr Cogn Disord 15:79–87PubMedCrossRef Blesa R, Davidson M, Kurz A, Reichman W, van Baelen B, Schwalen S (2003) Galantamine provides sustained benefits in patients with ‘advanced moderate’ Alzheimer’s disease for at least 12 months. Dement Geriatr Cogn Disord 15:79–87PubMedCrossRef
5.
Zurück zum Zitat Cummings JL, Mega M, Gray K, Rosenberg-Thompson S, Carusi DA, Gornbein J (1994) The Neuropsychiatric Inventory: comprehensive assessment of psychopathology in dementia. Neurology 44:2308–2314PubMed Cummings JL, Mega M, Gray K, Rosenberg-Thompson S, Carusi DA, Gornbein J (1994) The Neuropsychiatric Inventory: comprehensive assessment of psychopathology in dementia. Neurology 44:2308–2314PubMed
6.
Zurück zum Zitat Danysz W, Parsons CG (2003) The NMDA receptor antagonist memantine as a symptomatological and neuroprotective treatment for Alzheimer’s disease: preclinical evidence. Int J Geriatr Psychiatry 18:S23–32PubMedCrossRef Danysz W, Parsons CG (2003) The NMDA receptor antagonist memantine as a symptomatological and neuroprotective treatment for Alzheimer’s disease: preclinical evidence. Int J Geriatr Psychiatry 18:S23–32PubMedCrossRef
7.
Zurück zum Zitat Danysz W, Parsons CG, Bresink I, Quack G (1995) Glutamate in CNS disorders. Drug News and Perspectives 8:261–277 Danysz W, Parsons CG, Bresink I, Quack G (1995) Glutamate in CNS disorders. Drug News and Perspectives 8:261–277
8.
Zurück zum Zitat Doody RS, Geldmacher DS, Gordon B, Perdomo CA, Pratt RD (2001) Open-label, multicenter, phase 3 extension study of the safety and efficacy of donepezil in patients with Alzheimer disease. Arch Neurol 58:427–433PubMedCrossRef Doody RS, Geldmacher DS, Gordon B, Perdomo CA, Pratt RD (2001) Open-label, multicenter, phase 3 extension study of the safety and efficacy of donepezil in patients with Alzheimer disease. Arch Neurol 58:427–433PubMedCrossRef
9.
Zurück zum Zitat Folstein MF, Folstein SE, McHugh PR (1975) Mini-mental state. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 12:189–198PubMedCrossRef Folstein MF, Folstein SE, McHugh PR (1975) Mini-mental state. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 12:189–198PubMedCrossRef
10.
Zurück zum Zitat Galasko D, Bennett D, Sano M, Ernesto C, Thomas R, Grundman M, Ferris S (1997) An inventory to assess activities of daily living for clinical trials in Alzheimer’s disease. The Alzheimer’s Disease Cooperative Study. Alzheimer Dis Assoc Disord 11(Suppl 2)S33–S39PubMedCrossRef Galasko D, Bennett D, Sano M, Ernesto C, Thomas R, Grundman M, Ferris S (1997) An inventory to assess activities of daily living for clinical trials in Alzheimer’s disease. The Alzheimer’s Disease Cooperative Study. Alzheimer Dis Assoc Disord 11(Suppl 2)S33–S39PubMedCrossRef
11.
Zurück zum Zitat Jones R, Bayer A, Inglis F, Phul R (2005) Once-daily dosing of memantine found to be as safe and tolerable as twice-daily dosing in a 12-week, double-blind study in moderate to severe Alzheimer’s diease. In: 12th International Congress of the International Psychogeriatric Assocation (IPA). Stockholm, Sweden Jones R, Bayer A, Inglis F, Phul R (2005) Once-daily dosing of memantine found to be as safe and tolerable as twice-daily dosing in a 12-week, double-blind study in moderate to severe Alzheimer’s diease. In: 12th International Congress of the International Psychogeriatric Assocation (IPA). Stockholm, Sweden
12.
Zurück zum Zitat McKhann G, Drachman D, Folstein M, Katzman R, Price D, Stadlan EM (1984) Clinical diagnosis of Alzheimer’s disease: report of the NINCDS-ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer’s Disease. Neurology 34:939–944PubMed McKhann G, Drachman D, Folstein M, Katzman R, Price D, Stadlan EM (1984) Clinical diagnosis of Alzheimer’s disease: report of the NINCDS-ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer’s Disease. Neurology 34:939–944PubMed
13.
Zurück zum Zitat Parsons CG, Danysz W, Quack G (1999) Memantine is a clinically well tolerated N-methyl-D-aspartate (NMDA) receptor antagonist–A review of preclinical data. Neuropharmacology 38:735–767PubMedCrossRef Parsons CG, Danysz W, Quack G (1999) Memantine is a clinically well tolerated N-methyl-D-aspartate (NMDA) receptor antagonist–A review of preclinical data. Neuropharmacology 38:735–767PubMedCrossRef
14.
Zurück zum Zitat Peskind ER, Potkin SG, Pomara N, Ott BR, Graham SM, Olin JT, McDonald S (2004) Memantine MEM-MD-10 Study Group. Memantine treatment in mild to moderate Alzheimer disease: A 24 week randomized, controlled trial. Am J Geriatr Pyschiatry. 14:704–715CrossRef Peskind ER, Potkin SG, Pomara N, Ott BR, Graham SM, Olin JT, McDonald S (2004) Memantine MEM-MD-10 Study Group. Memantine treatment in mild to moderate Alzheimer disease: A 24 week randomized, controlled trial. Am J Geriatr Pyschiatry. 14:704–715CrossRef
15.
Zurück zum Zitat Raskind MA, Peskind ER, Truyen L, Kershaw P, Damaraju CV (2004) The cognitive benefits of galantamine are sustained for at least 36 months: a long-term extension trial. Arch Neurol 61:252–256PubMedCrossRef Raskind MA, Peskind ER, Truyen L, Kershaw P, Damaraju CV (2004) The cognitive benefits of galantamine are sustained for at least 36 months: a long-term extension trial. Arch Neurol 61:252–256PubMedCrossRef
16.
Zurück zum Zitat Raskind MA, Peskind ER, Wessel T, Yuan W (2000) Galantamine in AD: A 6-month randomized, placebo-controlled trial with a 6-month extension. The Galantamine USA-1 Study Group. Neurology 54:2261–2268PubMed Raskind MA, Peskind ER, Wessel T, Yuan W (2000) Galantamine in AD: A 6-month randomized, placebo-controlled trial with a 6-month extension. The Galantamine USA-1 Study Group. Neurology 54:2261–2268PubMed
17.
Zurück zum Zitat Reisberg B, Doody R, Stoffler A, Schmitt F, Ferris S, Mobius HJ (2003) Memantine in moderate-to-severe Alzheimer’s disease. N Engl J Med 348:1333–1341PubMedCrossRef Reisberg B, Doody R, Stoffler A, Schmitt F, Ferris S, Mobius HJ (2003) Memantine in moderate-to-severe Alzheimer’s disease. N Engl J Med 348:1333–1341PubMedCrossRef
18.
Zurück zum Zitat Rogers SL, Friedhoff LT (1998) Long-term efficacy and safety of donepezil in the treatment of Alzheimer’s disease: an interim analysis of the results of a US multicentre open label extension study. Eur Neuropsychopharmacol 8:67–75PubMedCrossRef Rogers SL, Friedhoff LT (1998) Long-term efficacy and safety of donepezil in the treatment of Alzheimer’s disease: an interim analysis of the results of a US multicentre open label extension study. Eur Neuropsychopharmacol 8:67–75PubMedCrossRef
19.
Zurück zum Zitat Rosen WG, Mohs RC, Davis KL (1984) A new rating scale for Alzheimer’s disease. Am J Psychiatry 141:1356–1364PubMed Rosen WG, Mohs RC, Davis KL (1984) A new rating scale for Alzheimer’s disease. Am J Psychiatry 141:1356–1364PubMed
20.
Zurück zum Zitat Schneider LS, Olin JT, Doody RS, Clark CM, Morris JC, Reisberg B, Schmitt FA, Grundman M, Thomas RG, Ferris SH (1997) Validity and reliability of the Alzheimer’s Disease Cooperative Study-Clinical Global Impression of Change. The Alzheimer’s Disease Cooperative Study. Alzheimer Dis Assoc Disord 11(Suppl 2):S22–32PubMed Schneider LS, Olin JT, Doody RS, Clark CM, Morris JC, Reisberg B, Schmitt FA, Grundman M, Thomas RG, Ferris SH (1997) Validity and reliability of the Alzheimer’s Disease Cooperative Study-Clinical Global Impression of Change. The Alzheimer’s Disease Cooperative Study. Alzheimer Dis Assoc Disord 11(Suppl 2):S22–32PubMed
21.
Zurück zum Zitat Tariot PN, Farlow MR, Grossberg GT, Graham SM, McDonald S, Gergel I (2004) Memantine treatment in patients with moderate to severe Alzheimer disease already receiving donepezil: a randomized controlled trial. JAMA 291:317–324PubMedCrossRef Tariot PN, Farlow MR, Grossberg GT, Graham SM, McDonald S, Gergel I (2004) Memantine treatment in patients with moderate to severe Alzheimer disease already receiving donepezil: a randomized controlled trial. JAMA 291:317–324PubMedCrossRef
22.
Zurück zum Zitat Winblad B, Poritis N (1999) Memantine in severe dementia: results of the M-BEST Study (Benefit and efficacy in severely demented patients during treatment with memantine). Int J Geriatr Psychiatry 14:135–146PubMedCrossRef Winblad B, Poritis N (1999) Memantine in severe dementia: results of the M-BEST Study (Benefit and efficacy in severely demented patients during treatment with memantine). Int J Geriatr Psychiatry 14:135–146PubMedCrossRef
Metadaten
Titel
Open label, multicenter, 28-week extension study of the safety and tolerability of memantine in patients with mild to moderate Alzheimer’s disease
verfasst von
Brian R. Ott
Lesley M. Blake
Ethel Kagan
Malca Resnick
for the Memantine MEM-MD-11AB Study Group
Publikationsdatum
01.03.2007
Erschienen in
Journal of Neurology / Ausgabe 3/2007
Print ISSN: 0340-5354
Elektronische ISSN: 1432-1459
DOI
https://doi.org/10.1007/s00415-006-0374-x

Weitere Artikel der Ausgabe 3/2007

Journal of Neurology 3/2007 Zur Ausgabe

OriginalPaper

ENS COMMUNICATIONS

Leitlinien kompakt für die Neurologie

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Update Neurologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.