Efficacy of Memantine, Donepezil, or Their Association in Moderate-Severe Alzheimer’s Disease: A Review of Clinical Trials
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,...
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| Format: | Article |
| Language: | English |
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Wiley
2013-01-01
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| Series: | The Scientific World Journal |
| Online Access: | http://dx.doi.org/10.1155/2013/925702 |
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| author | Ivana Molino Luisa Colucci Angiola M. Fasanaro Enea Traini Francesco Amenta |
| author_facet | Ivana Molino Luisa Colucci Angiola M. Fasanaro Enea Traini Francesco Amenta |
| author_sort | Ivana Molino |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-59250cbeb48c434bbcaa1f7c5806b0f8 |
| institution | Kabale University |
| issn | 1537-744X |
| language | English |
| publishDate | 2013-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | The Scientific World Journal |
| spelling | doaj-art-59250cbeb48c434bbcaa1f7c5806b0f82025-02-03T06:06:23ZengWileyThe Scientific World Journal1537-744X2013-01-01201310.1155/2013/925702925702Efficacy of Memantine, Donepezil, or Their Association in Moderate-Severe Alzheimer’s Disease: A Review of Clinical TrialsIvana Molino0Luisa Colucci1Angiola M. Fasanaro2Enea Traini3Francesco Amenta4Centro Ricerche Cliniche, Telemedicina e Telefarmacia, Università di Camerino, Via Madonna delle Carceri 9, 62032 Camerino, ItalyCentro Ricerche Cliniche, Telemedicina e Telefarmacia, Università di Camerino, Via Madonna delle Carceri 9, 62032 Camerino, ItalyUnità Valutativa Alzheimer e Malattie Involutive Cerebrali, Azienda Ospedaliera Rilievo Nazionale A. Cardarelli, 80131 Napoli, ItalyCentro Ricerche Cliniche, Telemedicina e Telefarmacia, Università di Camerino, Via Madonna delle Carceri 9, 62032 Camerino, ItalyCentro Ricerche Cliniche, Telemedicina e Telefarmacia, Università di Camerino, Via Madonna delle Carceri 9, 62032 Camerino, ItalyBackground. 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.http://dx.doi.org/10.1155/2013/925702 |
| spellingShingle | Ivana Molino Luisa Colucci Angiola M. Fasanaro Enea Traini Francesco Amenta Efficacy of Memantine, Donepezil, or Their Association in Moderate-Severe Alzheimer’s Disease: A Review of Clinical Trials The Scientific World Journal |
| title | Efficacy of Memantine, Donepezil, or Their Association in Moderate-Severe Alzheimer’s Disease: A Review of Clinical Trials |
| title_full | Efficacy of Memantine, Donepezil, or Their Association in Moderate-Severe Alzheimer’s Disease: A Review of Clinical Trials |
| title_fullStr | Efficacy of Memantine, Donepezil, or Their Association in Moderate-Severe Alzheimer’s Disease: A Review of Clinical Trials |
| title_full_unstemmed | Efficacy of Memantine, Donepezil, or Their Association in Moderate-Severe Alzheimer’s Disease: A Review of Clinical Trials |
| title_short | Efficacy of Memantine, Donepezil, or Their Association in Moderate-Severe Alzheimer’s Disease: A Review of Clinical Trials |
| title_sort | efficacy of memantine donepezil or their association in moderate severe alzheimer s disease a review of clinical trials |
| url | http://dx.doi.org/10.1155/2013/925702 |
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