Combination therapy with cholinesterase inhibitors and memantine for Alzheimer's disease: a systematic review and meta-analysis.

We performed an updated meta-analysis of randomized controlled trials of combination therapy with cholinesterase inhibitors and memantine in patients with Alzheimer's disease.
We reviewed cognitive function, activities of daily living, behavioral disturbance, global assessment, discontinuation rate, and individual side effects.
Seven studies (total n=2182) were identified. Combination therapy significantly affected behavioral disturbance scores (standardized mean difference=-0.13), activity of daily living scores (standardized mean difference=-0.10), and global assessment scores (standardized mean difference=-0.15). In addition, cognitive function scores (standardized mean difference=-0.13, P=.06) exhibited favorable trends with combination therapy. The effects of combination therapy were more significant in the moderate-to-severe Alzheimer's disease subgroup in terms of all efficacy outcome scores. The discontinuation rate was similar in both groups, and there were no significant differences in individual side effects.
Combination therapy was beneficial for the treatment of moderate-to-severe Alzheimer's disease in terms of cognition, behavioral disturbances, activities of daily living, and global assessment was well tolerated.
AuthorsShinji Matsunaga, Taro Kishi, Nakao Iwata
JournalThe international journal of neuropsychopharmacology / official scientific journal of the Collegium Internationale Neuropsychopharmacologicum (CINP) (Int J Neuropsychopharmacol) Vol. 18 Issue 5 (Mar 2015) ISSN: 1469-5111 [Electronic] England
PMID25548104 (Publication Type: Journal Article, Meta-Analysis, Review)
Copyright© The Author 2015. Published by Oxford University Press on behalf of CINP.
Chemical References
  • Antiparkinson Agents
  • Cholinesterase Inhibitors
  • Memantine
  • Activities of Daily Living (psychology)
  • Aged
  • Aged, 80 and over
  • Alzheimer Disease (drug therapy, psychology)
  • Antiparkinson Agents (therapeutic use)
  • Cholinesterase Inhibitors (administration & dosage, adverse effects, therapeutic use)
  • Cognition (drug effects)
  • Combined Modality Therapy (adverse effects, methods)
  • Female
  • Humans
  • Male
  • Memantine (administration & dosage, adverse effects, therapeutic use)
  • Treatment Outcome

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