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

AbstractBACKGROUND:
We performed an updated meta-analysis of randomized controlled trials of combination therapy with cholinesterase inhibitors and memantine in patients with Alzheimer's disease.
METHODS:
We reviewed cognitive function, activities of daily living, behavioral disturbance, global assessment, discontinuation rate, and individual side effects.
RESULTS:
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.
CONCLUSIONS:
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
Topics
  • 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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