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ScientificWorldJournal. 2013 Oct 29;2013:925702. doi: 10.1155/2013/925702. eCollection 2013.

Efficacy of memantine, donepezil, or their association in moderate-severe Alzheimer's disease: a review of clinical trials.

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  • 1Centro Ricerche Cliniche, Telemedicina e Telefarmacia, Universit√† di Camerino, Via Madonna delle Carceri 9, 62032 Camerino, Italy.

Abstract

BACKGROUND:

Acetylcholinesterase (AChE)/cholinesterase (ChE) inhibitors (Is) and memantine are licensed for symptomatic treatment of mild-moderate and moderate-severe forms of Alzheimer's disease (AD), respectively. High doses of the AChE-I donepezil were licensed in the USA for moderate-severe AD, and the association AChE/ChE-Is plus memantine was proposed for AD at this stage.

OBJECTIVES:

This paper has reviewed evidence from clinical trials of the effectiveness of memantine, donepezil, or the two drugs in association in managing moderate-severe AD.

METHOD:

Double-blind, placebo-controlled randomized trials (RCTs) using memantine or donepezil alone or in association versus placebo in moderate-severe AD were reviewed. Analysis done in January 2013 considered the years 2007-2012.

RESULTS AND CONCLUSION:

Only 83 of the 941 papers selected were considered relevant, and only 13 met the criterion of "adequacy and representativeness." Memantine and donepezil lead to improvements in moderate-to-severe AD and the choice between the compounds should be based on their contraindications more than on disease severity. No evidence was found of advantages of the association of memantine-donepezil. The heterogeneity of conditions explored by RCTs, the relatively short time of observation (24-52 weeks), and the different cognitive assessment tools used did not allow comparing properly different trials.

PMID:
24288512
[PubMed - indexed for MEDLINE]
PMCID:
PMC3830825
Free PMC Article
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