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BMJ Open. 2014 Jul 3;4(7):e005158. doi: 10.1136/bmjopen-2014-005158.

Treatment effect of memantine on survival in dementia with Lewy bodies and Parkinson's disease with dementia: a prospective study.

Author information

1
Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden Department of Rheumatology, Skaraborg Central Hospital, Skövde, Sweden.
2
Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden.
3
Wolfson Centre for Age Related Diseases, King's College London, London, UK.
4
Center for Age-Related Medicine, Stavanger University Hospital, Stavanger, Norway Department of NVS, Neurobiology Ward Sciences and Society, Alzheimer's Disease Research Center, Karolinska Institutet, Stockholm, Sweden.

Abstract

OBJECTIVE:

To investigate the effect on survival of treatment with memantine in patients with dementia with Lewy bodies (DLB) and Parkinson's disease with dementia (PDD).

METHODS:

75 patients with DLB and PDD were included in a prospective double-blinded randomised placebo-controlled trial (RCT) of memantine, of whom long-term follow-up was available for 42. Treatment response was recorded 24 weeks from baseline and measured by Clinical Global Impression of Change (CGIC). The participants were grouped as responders (CGIC 1-3) or non-responders (CGIC 4-7). The 24-week RCT was followed by open-label treatment and survival was recorded at 36 months.

RESULTS:

After 36-month follow-up, patients in the memantine group had a longer length of survival compared with patients in the placebo group (log rank x²=4.02, p=0.045). Within the active treatment group, survival analysis 36 months from baseline showed that the memantine responders, based on CGIC, had higher rates of survival compared with the non-responders (log rank x²=6.595, p=0.010). Similar results were not seen in the placebo group.

CONCLUSIONS:

Early treatment with memantine and a positive clinical response to memantine predicted longer survival in patients with DLB and PDD. This suggests a possible disease-modifying effect and also has implications for health economic analysis. However, owing to the small study sample, our results should merely be considered as generating a hypothesis which needs to be evaluated in larger studies.

TRIAL REGISTRATION NUMBER:

ISRCTN89624516.

PMID:
24993765
PMCID:
PMC4091277
DOI:
10.1136/bmjopen-2014-005158
[Indexed for MEDLINE]
Free PMC Article

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