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

Abstract

BACKGROUND:

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.

• Authors: Shinji Matsunaga, Taro Kishi, Nakao Iwata
• Journal: The international journal of neuropsychopharmacology (Int J Neuropsychopharmacol) Vol. 18 Issue 5 (Dec 28 2014) ISSN: 1469-5111 [Electronic] England
• PMID: 25548104 (Publication Type: Journal Article, Meta-Analysis, Review, Systematic 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