DOI: 10.3724/SP.J.1264.2011.00009

Chinese Journal of Multiple Organ Diseases in the Elderly (中华老年多器官疾病杂志) 2011/10:4 PP.321-325

Memantine for Alzheimer¢s disease: a systematic review of randomized controlled trials in China

Objective To assess the efficacy and safety of memantine for domestic patients with Alzheimer¢s disease (AD). Methods Randomized controlled trials carried in China, which compared memantine with placebo or other medicines in patients with AD, were searched from the electronic bibliographic databases, references listed in articles and journals. A systematic review was conducted based on the methods recommended by the Cochrane Collaboration. Results Nine trials involving 1273 patients were included, of which two were placebo-controlled trials and seven non-placebo-controlled trials (piacetam and donepezil). Two placebo-controlled trials, in which neurological changes were assessed by some neuropsychometric questionnaires, showed that there were significant differences in mini-mental state examination(MMSE), Severe Impairment Battery(SIB), Alzheimer¢s Disease Cooperative Study-Activities of Daily Living Inventory(ADCS-ADL19) and Alzheimer¢s Disease Assessment Scale-Cognitive Subscale(ADAS-Cog) scores between two groups (P<0.05=, and there was no significant difference in Neuropsychiatric Inventory(NPI) score (P>0.05) although memantine group had better score than placebo group. Six donepezil-controlled trials showed that there was no significant difference in MMSE, ADAS-Cog, Activities of Daily Living Scale(ADL), Blessed-Roth, NPI and Clinician¢s Interview Based Impression of Change-Plus Caregiver Input(CIBIC-Plus) scores between two groups (P>0.05). One piacetam-controlled trial showed that there were significant differences in MMSE and Barthel Index(BI) scores between two groups (P<0.05=. One blank-controlled trial showed that there were significant differences in MMSE and ADL scores between the two groups (P<0.05=. Adverse reactions associated with medicines were reported in seven trials, including doze, fatigue, dizziness, confusion, deliria, agitation, anorexia, nausea, etc. However, no severe adverse reaction was reported. Conclusions Memantine can improve the general condition of patients with AD, including the cognitive function, daily life ability, mental behavior and global function. It has better therapeutic effects than piacetam, and at least equal tharapeutic effects to donepezil. It is safe for patients with AD.

Key words:memantine,Alzheimer¢s disease,review, systematic,randomized controlled trial

ReleaseDate:2014-07-21 15:56:19

[1] 胡洪涛, 张振馨, 姚景莉, 等. 盐酸美金刚治疗阿尔茨海默病多中心随机对照临床试验[J]. 中华内科杂志, 2006, 45(4): 277-280.

[2] 陈 霞, 张振馨, 王新德, 等. 美金刚在阿尔茨海默病患者中的疗效与耐受性多中心研究[J]. 中华神经科杂志, 2007, 40(6): 364-368.

[3] 张 楠, 程 焱, 杜红坚. 盐酸美金刚治疗阿尔茨海默病的临床研究[J]. 中国神经精神疾病杂志, 2008, 34(1): 6-9.

[4] 李 霞, 肖世富, 李华芳, 等. 美金刚治疗阿尔茨海默病的随机双盲对照试验[J]. 中国临床药学杂志, 2008, 17(3): 132-135.

[5] 赵 瑾, 王 琳, 贾晓军, 等. 美金刚治疗阿尔茨海默病的临床研究[J]. 重庆医学, 2008, 37(7): 712-713.

[6] 邹瑜驰, 杜晓红. 美金刚治疗阿尔茨海默病疗效观察[J]. 中国临床保健杂志, 2008, 11(6): 637-638.

[7] 程 焱, 张 楠, 杜红坚, 等. 盐酸美金刚治疗阿尔茨海默病的多中心随机对照研究[J]. 中华神经科杂志, 2009, 42(4): 268-272.

[8] 赵莘瑜, 许予明, 常 程. 美金刚治疗轻中度阿尔茨海默病32例临床观察[J]. 山东医药, 2009, 49(43): 90-91.

[9] 张永东, 廖远高, 杨期明, 等. 盐酸美金刚片治疗中、重度阿尔茨海默病的临床研究[J]. 中南药学, 2010, 8(4): 311-313.

[10] Robinson DM, Keating GM. Memantine: a review of its use in Alzheimer¢s disease [J]. Drugs, 2006, 66(11): 1515-1534.

[11] Thomas S, Grossberg GT. Memantine: a review of studies into its safety and efficacy in treating Alzheimer¢s disease and other dementias [J]. Clin Interv Aging, 2009, 4: 367-377.

[12] 吴泰相, 刘关键. 隐藏分组(分配隐藏)和盲法的概念、实施与报告[J]. 中国循证医学杂志, 2007, 7(3): 222-225.

[13] Clerici F, Vanacore N, Elia A, et al. Memantine in moderately-severe-to-severe Alzheimer¢s disease: a postmarketing surveillance study [J]. Drugs Aging, 2009, 26(4): 321-332.

[14] Jones R, Sheehan B, Philips P, et al. DOMINO-AD protocol: donepezil and memantine in moderate to severe Alzheimer¢s disease—a multicentre RCT Trials[J]. 2009, 10(1): 57-67.