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P4‐193: COMBINATION THERAPY WITH CHOLINESTERASE INHIBITORS AND MEMANTINE FOR ALZHEIMER'S DISEASE: SYSTEMATIC REVIEW AND META‐ANALYSIS
Author(s) -
Matsunaga Shinji,
Kishi Taro,
Iwata Nakao
Publication year - 2014
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.2014.05.1710
Subject(s) - memantine , discontinuation , meta analysis , medicine , combination therapy , randomized controlled trial , galantamine , dementia , strictly standardized mean difference , cholinesterase , subgroup analysis , donepezil , disease
Background: We performed an updated meta-analysis of randomized controlled trials of combination therapy with cholinesterase inhibitors and memantine in patients with Alzheimer’s disease. Methods: We reviewed cognitive function, activities of daily living, behavioral disturbance, global assessment, discontinuation rate, and individual side effects. Results: Seven studies (total n = 2182) were identified. Combination therapy significantly affected behavioral disturbance scores (standardized mean difference = −0.13), activity of daily living scores (standardized mean difference = −0.10), and global assessment scores (standardized mean difference = −0.15). In addition, cognitive function scores (standardized mean difference = −0.13, P = .06) exhibited favorable trends with combination therapy. The effects of combination therapy were more significant in the moderate-to-severe Alzheimer’s disease subgroup in terms of all efficacy outcome scores. The discontinuation rate was similar in both groups, and there were no significant differences in individual side effects. Conclusions: Combination therapy was beneficial for the treatment of moderate-to-severe Alzheimer’s disease in terms of cognition, behavioral disturbances, activities of daily living, and global assessment was well tolerated.