The efficacy of a combination therapy with memantine and an acetylcholinesterase inhibitor in alzheimer's disease: a systematic review and meta-analysis
Dania, Anna (2014)
2014
Kansanterveystiede - Public Health
Terveystieteiden yksikkö - School of Health Sciences
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Hyväksymispäivämäärä
2014-09-11
Julkaisun pysyvä osoite on
https://urn.fi/URN:NBN:fi:uta-201409182132
https://urn.fi/URN:NBN:fi:uta-201409182132
Tiivistelmä
Background: To date, clinical trials have reported inconsistent results on the efficacy of the combination therapy of Memantine plus an acetylcholinesterase inhibitor (AChEI) over a single-drug therapy in the treatment of Alzheimer s disease. This meta-analysis aim is to assess the efficacy of the combination therapy of Memantine plus an AChEI in the treatment of Alzheimer s disease compared with a single-drug therapy using an AChEI.
Methods: PubMed, Embase, and Cochrane library databases were searched through December 2013. Seven randomized controlled trials were included in the meta-analysis. A random-effects meta-analysis was used. Heterogeneity and publication bias were assessed.
Results: A combination therapy of an AChEI with memantine was associated with modestly better effects in terms of cognition and global function compared to a monotherapy with an AChEI. The effects of the combination therapy were no better than a monotherapy for daily living activity. However, the combination therapy showed benefits over a monotherapy for the behavioral outcome and the effect was independent of the stage of the disease. Moreover, the rate of adverse effects did not differ between a combination therapy and a single therapy.
Conclusions: The findings of this meta-analysis suggest that the combination therapy is more appropriate and should be administered for patients in more advanced stages. However, not all patients may benefit from the combination treatment. Identification of subgroups of patients with Alzheimer s disease who will benefit more from the combination treatment is needed.
Methods: PubMed, Embase, and Cochrane library databases were searched through December 2013. Seven randomized controlled trials were included in the meta-analysis. A random-effects meta-analysis was used. Heterogeneity and publication bias were assessed.
Results: A combination therapy of an AChEI with memantine was associated with modestly better effects in terms of cognition and global function compared to a monotherapy with an AChEI. The effects of the combination therapy were no better than a monotherapy for daily living activity. However, the combination therapy showed benefits over a monotherapy for the behavioral outcome and the effect was independent of the stage of the disease. Moreover, the rate of adverse effects did not differ between a combination therapy and a single therapy.
Conclusions: The findings of this meta-analysis suggest that the combination therapy is more appropriate and should be administered for patients in more advanced stages. However, not all patients may benefit from the combination treatment. Identification of subgroups of patients with Alzheimer s disease who will benefit more from the combination treatment is needed.