Memantine in severe dementia: results of the 9 M‐best study (benefit and efficacy in severly demented patients during treatment with memantine)

Memantine in severe dementia: results of the 9 M‐best study (benefit and efficacy in severly... Objectives To assess clinical efficacy and safety of memantine—an uncompetitive N‐methyl‐d‐aspartate (NMDA) antagonist—in moderately severe to severe primary dementia. Materials and methods Dementia was defined by DSM‐III‐R criteria and severity was assessed by the Global Deterioration Scale (stages 5–7) and the Mini‐Mental State Examination (<10 points). Primary endpoints were the Clinical Global Impression of Change (CGI‐C) rated by the physician, and the Behavioural Rating Scale for Geriatric Patients (BGP), subscore ‘care dependence’, rated by the nursing staff. Secondary endpoints included the modified D‐Scale (Arnold/Ferm). Results The ITT sample comprised 166 patients and 151 patients were treated per protocol. At 12‐week ITT endpoint analysis, 82 received memantine 10 mg per day, 84 placebo. Dementia was in 49% of the Alzheimer type and in 51% of the vascular type (CT, Hachinski score). A positive response in the CGI‐C was seen in 73% versus 45% in favour of memantine (stratified Wilcoxon p<0.001), independent of the etiology of dementia. The results in the BGP subscore ‘care dependence’ were 3.1 points improvement under memantine and 1.1 points under placebo (p=0.016). A coincident response of the two independent target variables was observed in 61.3% (memantine) versus 31.6% (placebo). Secondary endpoint analysis of the D‐Scale assessing basic ADL functions support the primary results. Regarding the safety profile, no significant differences between treatment groups were observed. Conclusions The results of this trial support the hypothesis that memantine treatment leads to functional improvement and reduces care dependence in severely demented patients. Copyright © 1999 John Wiley & Sons, Ltd. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png International Journal of Geriatric Psychiatry Wiley

Memantine in severe dementia: results of the 9 M‐best study (benefit and efficacy in severly demented patients during treatment with memantine)

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Publisher
Wiley
Copyright
Copyright © 1999 John Wiley & Sons, Ltd.
ISSN
0885-6230
eISSN
1099-1166
D.O.I.
10.1002/(SICI)1099-1166(199902)14:2<135::AID-GPS906>3.0.CO;2-0
Publisher site
See Article on Publisher Site

Abstract

Objectives To assess clinical efficacy and safety of memantine—an uncompetitive N‐methyl‐d‐aspartate (NMDA) antagonist—in moderately severe to severe primary dementia. Materials and methods Dementia was defined by DSM‐III‐R criteria and severity was assessed by the Global Deterioration Scale (stages 5–7) and the Mini‐Mental State Examination (<10 points). Primary endpoints were the Clinical Global Impression of Change (CGI‐C) rated by the physician, and the Behavioural Rating Scale for Geriatric Patients (BGP), subscore ‘care dependence’, rated by the nursing staff. Secondary endpoints included the modified D‐Scale (Arnold/Ferm). Results The ITT sample comprised 166 patients and 151 patients were treated per protocol. At 12‐week ITT endpoint analysis, 82 received memantine 10 mg per day, 84 placebo. Dementia was in 49% of the Alzheimer type and in 51% of the vascular type (CT, Hachinski score). A positive response in the CGI‐C was seen in 73% versus 45% in favour of memantine (stratified Wilcoxon p<0.001), independent of the etiology of dementia. The results in the BGP subscore ‘care dependence’ were 3.1 points improvement under memantine and 1.1 points under placebo (p=0.016). A coincident response of the two independent target variables was observed in 61.3% (memantine) versus 31.6% (placebo). Secondary endpoint analysis of the D‐Scale assessing basic ADL functions support the primary results. Regarding the safety profile, no significant differences between treatment groups were observed. Conclusions The results of this trial support the hypothesis that memantine treatment leads to functional improvement and reduces care dependence in severely demented patients. Copyright © 1999 John Wiley & Sons, Ltd.

Journal

International Journal of Geriatric PsychiatryWiley

Published: Feb 1, 1999

References

  • Mini‐mental state: a practical method for grading the cognitive state of patients for the clinician
    Folstein, Folstein; Folstein, Folstein; McHugh, McHugh
  • Contractures and loss of function in patients with Alzheimer's disease
    Souren, Souren; Franssen, Franssen; Reisberg, Reisberg
  • Uncompetitive NMDA receptor antagonists attenuate NMDA‐induced impairment of passive avoidance learning and LTP
    Zajaczkowski, Zajaczkowski; Frankiewicz, Frankiewicz; Parsons, Parsons; Danysz, Danysz

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