Date of Award

2018

Degree Type

Selective Evidence-Based Medicine Review

Degree Name

Master of Science in Health Sciences - Physician Assistant

Department

Physician Assistant Studies

Department Chair

John Cavenagh, MBA, PhD, PA-C

Abstract

OBJECTIVE The objective of this selective EBM review is to determine whether or not memantine is a safe and effective treatment for Alzheimer’s disease in patients over the age of 50.

STUDY DESIGN Systematic review of two randomized controlled trials published in 2006 and 2013 and one randomized controlled trial pooled analysis published in 2014.

DATA SOURCES Two randomized controlled trials and one pooled analysis were obtained using PubMed.

OUTCOMES MEASURED Efficacy of memantine as compared to control groups based on cognition, behavior, and adverse events. These were measured using Severe Impairment Battery (SIB), Neuropsychiatric Inventory (NPI), and Behavioral Pathology in AD Rating Scale (BEHAVE-AD).

RESULTS Herrmann et al. (2013) and Peskind et al. (2006) failed to show superiority of memantine over a placebo. Nakamura et al. (2014) showed that memantine produced statistically better outcomes compared to the placebo in terms of behavior and cognitive function. In all three studies, the overall incidence of adverse events was similar between the memantine and placebo groups.

CONCLUSION The trials analyzed in this selective EBM review showed conflicting evidence regarding the efficacy of memantine in the treatment of Alzheimer’s disease. Further investigation is warranted to definitively evaluate the efficacy of memantine at improving cognition and behavior.

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