A report published by the Institute for Quality and Efficiency in Health Care (IQWiG) has concluded that there is no scientific proof that patients with moderate or severe Alzheimer’s disease benefit from drugs containing the agent memantine.
Memantine is approved for moderate to severe Alzheimer’s disease and has been used in the treatment of Alzheimer’s disease since 2002. Memantine is marketed under the brands Axura, Akatinol, Namenda, Ebixa, Abixa and Memox.
Image: Memantine 3D sticks.
Memantine is intended to prevent an excess of glutamate from damaging the brain. Glutamate is a neurotransmitter, in other words a substance that transmits neural signals. Animal experiments have shown that patients suffering from Alzheimer’s disease might have a permanent excess of glutamate, which leads to neural cells dying. Memantine is intended to prevent this without affecting the normal transmission of neural signals.
The scientists searched for studies which investigated outcomes that were relevant to patients and their families: this includes cognitive function (e.g. memory capacity) and activities of daily living (e.g. personal hygiene) as well as mental concomitant symptoms (e.g. depression, agitation), quality of life and avoiding being put in a nursing home.
IQWiG was able to include in its assessment 7 studies, in which a total of 1913 patients suffering from Alzheimer’s disease were treated with memantine over a period of 16 to 28 weeks. In 5 of these studies, the subjects received only memantine, in the remaining 2 the substance was administered as an add-on to an existing therapy with a cholinesterase inhibitor. Each study had a comparator control group, in which the patients took a placebo. No evidence was found that patients benefit more from memantine than from a placebo for any aspect of Alzheimer’s disease, not even for memory performance or activities of daily living.
IQWiG did not only consider the Alzheimer’s patients but also their families. The study results did not provide any proof that taking memantine reduces their burden, for instance, by lessening the amount of care required or the emotional burden.
“The number of elderly people is growing and so are the medical and social problems associated with Alzheimer’s disease. I don’t think that we will find a simple solution to this problem in the near future. That’s why it is important at this stage to provide better social and medical care to patients and to relieve the burden for family caregivers. And it is surely better to ‘invest’ in this rather than in drugs, where we don’t know whether they actually provide a benefit.” comments Peter Sawicki, Director of IQWiG.
References:
1. Institute for Quality and Efficiency in Health Care.
2. Image by Sbrools.
