Format

Send to

Choose Destination
Alzheimers Res Ther. 2016 Nov 15;8(1):47.

Effect of concomitant use of memantine on mortality and efficacy outcomes of galantamine-treated patients with Alzheimer's disease: post-hoc analysis of a randomized placebo-controlled study.

Author information

1
Clinic for Medicine of the Elderly, Hannover, Germany.
2
Janssen Research and Development, LLC, Titusville, NJ, USA. abaseman@its.jnj.com.
3
Janssen Research and Development, LLC, 850 Ridgeview Drive, Horsham, PA, 19044, USA. abaseman@its.jnj.com.
4
Janssen Research and Development, LLC, Titusville, NJ, USA.
5
The Mount Sinai Medical Center, New York, NY, USA.
6
Synaptec Inc, Palm Beach Gardens, FL, USA.

Abstract

BACKGROUND:

A large, prospective, 2-year, randomized study in patients with mild-to-moderate Alzheimer's disease or mixed dementia demonstrated reductions in mortality and cognitive/functional decline in galantamine-treated patients. A post-hoc analysis was conducted to study the effect of (the presence or absence of) concomitant memantine use on treatment outcome.

METHODS:

Randomized patients (N = 2045) were divided into subgroups based on memantine use. Analyses included demographic and clinical characteristics (age, nursing home placement, Mini-Mental State Examination (MMSE) and Disability Assessment for Dementia (DAD) scores) and mortality endpoints.

RESULTS:

Overall, 496 (24.3 %) patients were memantine users and were older (mean (SD), 74.0 (8.76) vs 72.8 (8.76), p = 0.008), with lower MMSE scores (18.2 (4.16) vs 19.2 (4.02), p < 0.0001) and DAD scores (58.0 (23.49) vs 62.5 (20.52), p < 0.0001) than nonusers. Mortality rates (per 100 patient-years) in memantine nonusers (n = 1549) were lower for galantamine (1.39) vs placebo-treated patients (4.15). In memantine users, mortality rates were similar for placebo-treated (4.49) and galantamine-treated patients (5.57). In memantine nonusers at 24 months, the decline in MMSE scores (effect size (95 % CI) 0.25 (0.14; 0.36)) and DAD scores (0.17 (0.06; 0.28)) from baseline was lower in galantamine patients vs placebo patients. The absence of these benefits in memantine users could not be explained by baseline age, MMSE, or DAD scores.

CONCLUSION:

This post-hoc analysis shows that the beneficial effects of galantamine at 2 years post treatment were not observed in patients who had been placed on background memantine. The reasons for memantine treatment and the possibility of interaction between memantine and galantamine merit further investigation.

TRIAL REGISTRATION:

ClinicalTrials.gov NCT00679627 . Registered 15 May 2008.

KEYWORDS:

Alzheimer’s disease; Baseline scores; Galantamine; Memantine; Mortality

PMID:
27846868
PMCID:
PMC5111338
DOI:
10.1186/s13195-016-0214-x
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for BioMed Central Icon for PubMed Central
Loading ...
Support Center