Attention caregivers for patients with mild to moderate Alzheimer’s Disease: A new study published in the Archives of Neurology found that memantine, a drug commonly prescribed (under the brand name Namenda) for Alzheimer’s patients, was not effective to treat mild or early stage Alzheimer’s and evidence is meager as to its effectiveness to treat moderate stage Alzheimer’s.
The drug, sold under the brand Namenda by Forest Laboratories Inc and Germany’s Merz Pharma, had U.S. sales of about $1.2 billion last year, according to Reuters.
Image shows a PET scan of the brain with Alzheimer’s Tangles.
Memantine is intended to treat moderate to severe Alzheimer’s, but in practice, even though not approved by the FDA for treatment of mild Alzheimer’s, it is commonly prescribed (“off label”) to mild Alzheimer’s patients, according to the study’s authors.
This study calls into question that practice. In doing so, the study may serve to alert caregivers for patients with mild Alzheimer’s to question a prescription of this medication for their patients, and to examine carefully its possible side effects, balanced against its possible lack of efficacy, as suggested by these study results.
The study, entitled “Lack of Evidence for the Efficacy of Memantine in Mild Alzheimer Disease,” was published in the April 11, 2011 issue of the Archives of Neurology, a publication of the American Medical Association.
In the study, researchers at the University of Southern California Keck School of Medicine, the Medical Research Council Biostatistics Unit, Institute of Public Health in Cambridge, England, and the Cochrane Dementia and Cognitive Improvement Group, Nuffield Department of Medicine at University of Oxford, Oxford, England, analyzed the data collected in three published studies that examined the effectiveness of memantine (the generic form of Namenda) in the treatment of mild Alzheimer’s Disease. The studies included data on 431 patients with mild Alzheimer’s and 697 patients with moderate levels of the disease.
They found that memantine worked no better than a placebo (dummy pill) at treating mild Alzheimer’s Disease, and that there is little evidence that it works in moderate Alzheimer’s.
“Despite its frequent off-label use, evidence is lacking for a benefit of memantine in mild Alzheimer’s disease, and there is meager evidence for its efficacy in moderate Alzheimer’s disease,” the authors wrote. They said more scientifically rigorous studies are needed to show whether the drug works, either alone or in combination with another drug.
“Prospective trials are needed to further assess the potential for efficacy of memantine either alone or added to cholinesterase inhibitors in mild and moderate AD [Alzheimer's Disease],” they wrote. Cholinesterase inhibitors, often prescribed along with memantine, increase levels of the brain chemical acetylcholine, which are thought potentially to slow mental decline in Alzheimer’s patients, according to the study’s authors.
The study’s findings again serve to highlight the need for new and better treatments for Alzheimer’s Disease, the most common form of dementia.
Alzheimer’s Disease affects 26 million people globally, and can extend on for years, slowly robbing patients of their mind, memories, and ability to perform even the common tasks of daily living. Yet, memantine is one of the few approved drugs aimed at trying to slow the progression of moderate AD. There are currently no drugs that can actually cure the disease or prevent it from progressing, according to the Alzheimer’s Association. For further information on Alzheimer’s and its current treatments, or lack thereof, see the resources referenced below.
Bill Thies, chief medical and scientific officer of the Alzheimer’s Association, in commending on the study, told Reuters, “All the drugs we have for Alzheimer’s disease have modest effects and they are transient because the underlying disease is continuing to get worse while these drugs are being given. Eventually, that overcomes any benefit you get from the drug.” Thies also said that patients respond differently to the drug, with some patients benefiting and others not. “Unfortunately, we don’t know how to pick those people out ahead of time,” Thies said.
The new study is available from the Archives of Neurology.
For more information on Alzheimer’s Disease and its treatment, see our Alzheimer’s/ Dementia resource pages, including our page on Alzheimer’s/ Dementia Treatment, and the many resources and sources of professional information linked there.
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