Memantine in Vascular Dementia Möbius H.J. and Stöffler A. International Psychogeriatrics 2003, 15...
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Transcript of Memantine in Vascular Dementia Möbius H.J. and Stöffler A. International Psychogeriatrics 2003, 15...
Memantine in Vascular Dementia
Möbius H.J. and Stöffler A.
International Psychogeriatrics 2003, 15 Suppl 1: 207-213
Analyses based on studies in patients with mild to moderate vascular dementia:
Orgogozo et al. (2002) (MMM300)
Wilcock et al. (2002) (MMM500)
ADAS-cog analysis by severity at baseline:
MMSE 20-22
MMSE 15-19
MMSE 10-14
ADAS-cog analysis by neuroradiological findings at baseline:
Macrolesions, “Large Vessel Disease”
No macrolesions, “Small Vessel Disease”
Memantine in Vascular Dementia: Subgroup Analyses
Möbius and Stöffler, Int Psychogeriatr 2003
Patients with “Large Vessel Disease” Hardly Show Cognitive Decline
Möbius and Stöffler, Int Psychogeriatr 2003
AD
AS
-co
g s
co
re d
iffe
ren
ce -2
-1
0
1
2
3
ADAS-cog mean change from baseline ITT, LOCF, N = 214
Impr
ovem
ent
Wor
seni
ng
0 12 28
Memantine (20 mg/day)
Placebo
Week
Pooled data
Significant Benefit of Memantine in Patients with “Small Vessel Disease”
AD
AS
-co
g s
co
re d
iffe
ren
ce
Möbius and Stöffler, Int Psychogeriatr 2003
* p = 0.002 versus placebo
ADAS-cog mean change from baseline ITT, LOCF, N = 553
Impr
ovem
ent
Wor
seni
ng
0 12 28
Memantine (20 mg/day)
Placebo
*
-2
-1
0
1
2
3
Week
Pooled data
Largest Benefit of Memantine in More Severely Demented Patients
Möbius and Stöffler, Int Psychogeriatr 2003
AD
AS
-co
g s
co
re d
iffe
ren
ce
MMM500 MMM300
0.32 0.530.95
1.35
2.43
4.12
-1.38-0.80
0.940.50
0.99
4.40
Mean ADAS-cog change from baseline ITT, LOCF
-2
-1
0
1
2
3
4
5
Memantine (20 mg/day)
Placebo
20 - 22 15 - 19 10 - 14 20 - 22 15 - 19 10 - 14 MMSE at baseline
Impr
ovem
ent
Wor
seni
ng
Summary
The strongest effect of memantine on cognition was shown
in the moderately demented patient population (MMSE < 15 at baseline)
and
in the subgroup of patients with “small vessel disease” (no macrolesions in CT/MRI)
Möbius and Stöffler, Int Psychogeriatr 2003