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Commentary on “Meta‐analysis of six‐month memantine trials in Alzheimer's disease.” Wuthering forest plots: Distinguishing the forest from the plots
Author(s) -
Schneider Lon S.
Publication year - 2007
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1016/j.jalz.2006.10.003
Subject(s) - memantine , meta analysis , dementia , cochrane library , citation , medicine , psychology , library science , history , disease , computer science
The efficacy of memantine for moderate to severe Alzheimer’s disease patients was established on the basis of two 6-month and one 3-month trials showing efficacy in cognition, daily function, and clinically relevant improvement compared with placebo, and the drug was approved by the Food and Drug Administration (FDA) in 2003 on this basis. By contrast, only one of three placebo-controlled trials in mild to moderate AD patients was statistically significant on cognitive and clinical assessment. In 2005 the FDA did not approve memantine for mild AD, perhaps in part on the basis of these trials. The manufacturer-sponsored meta-analysis of six 6-month memantine trials appearing in this issue of the Journal is interesting in the context of memantine’s current FDA-approved indication for moderate to severe AD, because it statistically combines moderate to severe AD trials with mild to moderate AD trials and then claims that memantine has efficacy “across the spectrum” of AD, and that “arbitrary divisions into severity groups” might not be necessary for drug development.