The following article is part of conference coverage from the 2019 American Academy of Neurology Annual Meeting (AAN 2019) in Philadelphia, PA. Neurology Advisor’s staff will be reporting breaking news associated with research conducted by leading experts in neurology. Check back for the latest news from AAN 2019.


PHILADELPHIA — Cognition among individuals with moderate to severe Alzheimer disease has shown early and significant improvements through the use of combination memantine and cholinesterase inhibitor therapy. Memantine has demonstrated an association with better maintenance of memory, language, and praxis with concurrent cholinesterase inhibitor treatment. This research was recently presented at the 2019 American Academy of Neurology’s Annual Meeting, held May 4-10, in Philadelphia.

This study included data from 2 phase 3, randomized, double-blind, placebo-controlled trials from 2004 and 2013, each 24 weeks long and including individuals with moderate to severe Alzheimer disease (defined as a baseline Mini-Mental State Examination score <20). Participants were given the Severe Impairment Battery (SIB) at weeks 0, 4, 8, 12, 18, and 24. Domains in the SIB were clustered to form larger-scale memory domains, including attention, memory, orientation, and orienting to name, as well as language and praxis domains.

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Persons given memantine and cholinesterase inhibitor therapy showed significant improvements in SIB scores at weeks 8, 12, 18, and 24 compared with persons given placebo and cholinesterase inhibitor (P <.05 for all). Memantine and cholinesterase inhibitor therapy also demonstrated more benefits on memory and language at weeks 12, 18, and 24 (P <.05 for all), as well as significant effects at weeks 4, 8, 12, 18, and 24 (P <.05).

The study researchers concluded that the “combination of [memantine] with a [cholinesterase inhibitor] produced early and consistent improvements in cognition for patients with moderate to severe [Alzheimer disease]. Analysis of higher-order domains on the SIB further supported the efficacy of [memantine] in maintaining key cognitive functions (memory, language, and praxis), even when these patients are receiving the standard of ongoing [cholinesterase inhibitor] treatment.”

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Reference

Schmitt FA, Grossberg GT, Tariot PN, Hendrix S, Ellison N, Kerolous M. Efficacy of memantine added to cholinesterase inhibitors on SIB higher-order cognitive domains: pooled post hoc analysis of 2 randomized controlled trials in patients with moderate to severe AD. Poster presented at: 2019 American Academy of Neurology (AAN) Annual Meeting; May 4-10, 2019; Philadelphia, PA.