Memantine (compared with placebo) may increase the numbers of people discontinuing treatment because of adverse events (RR 2.12, 95% CI 1.03 to 4.39).ģ.
There is less certainty in the CGR evidence, which also suggests there may be no difference: 0.09 CIBIC+ points (95% CI ‐0.12 to 0.30). Mild AD (Mini Mental State Examination (MMSE) 20 to 23): mainly moderate‐certainty evidence based on post‐hoc subgroups from up to four studies in around 600 participants suggests there is probably no difference between memantine and placebo for CF: 0.21 ADAS‐Cog points (95% CI ‐0.95 to 1.38) performance on ADL: ‐0.07 ADL 23 points (95% CI ‐1.80 to 1.66) and BM: ‐0.29 NPI points (95% CI ‐2.16 to 1.58). The presence of concomitant ChEI does not impact on the difference between memantine and placebo, with the possible exceptions of the BM outcome (larger effect in people taking ChEIs) and the CF outcome (smaller effect).Ģ.
Cohen Mansfield Agitation Inventory: clinical benefit of 0.50 CMAI points, 95% CI ‐3.71 to 4.71). Although there is moderate‐certainty evidence that fewer people taking memantine experience agitation as an adverse event: RR 0.81 (95% CI 0.66 to 0.99) (25 fewer people per 1000, 95% CI 1 to 44 fewer), there is also moderate‐certainty evidence, from three additional studies, suggesting that memantine is not beneficial as a treatment for agitation (e.g.
There may be no difference in the number of people discontinuing memantine compared to placebo: risk ratio (RR) 0.93 (95% CI 0.83 to 1.04) corresponding to 13 fewer people per 1000 (95% CI 31 fewer to 7 more). High‐certainty evidence from up to 14 studies in around 3700 participants consistently shows a small clinical benefit for memantine versus placebo: clinical global rating (CGR): 0.21 CIBIC+ points (95% confidence interval (CI) 0.14 to 0.30) cognitive function (CF): 3.11 Severe Impairment Battery (SIB) points (95% CI 2.42 to 3.92) performance on activities of daily living (ADL): 1.09 ADL19 points (95% CI 0.62 to 1.64) and behaviour and mood (BM): 1.84 Neuropsychiatric Inventory (NPI) points (95% CI 1.05 to 2.76). Moderate‐to‐severe AD (with or without concomitant ChEIs). The majority of trials (29 in 7885 participants) were conducted in people with AD.ġ.
For nearly half the studies, relevant data were obtained from unpublished sources. Across all types of dementia, data were available from almost 10,000 participants in 44 included trials, most of which were at low or unclear risk of bias.
0 kommentar(er)
