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Memantina para la demencia
Rupert McShanea, Maggie J Westbya, Emmert Roberts, Neda Minakaran, Lon Schneider, Lucy E Farrimond, Nicola Maayan, Jennifer Ware, Jean Debarros | 20 marzo 2019

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Comparison 1 Memantine vs placebo for moderate‐to‐severe Alzheimer's disease. 6 month studies. ITT‐LOCF data., Outcome 1 Clinical Global: CIBIC+ (24‐28 weeks).
Figuras y tablas -
Analysis 1.1

Comparison 1 Memantine vs placebo for moderate‐to‐severe Alzheimer's disease. 6 month studies. ITT‐LOCF data., Outcome 1 Clinical Global: CIBIC+ (24‐28 weeks).

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Comparison 1 Memantine vs placebo for moderate‐to‐severe Alzheimer's disease. 6 month studies. ITT‐LOCF data., Outcome 2 Cognitive function: SIB (change from baseline at 24‐28 weeks).
Figuras y tablas -
Analysis 1.2

Comparison 1 Memantine vs placebo for moderate‐to‐severe Alzheimer's disease. 6 month studies. ITT‐LOCF data., Outcome 2 Cognitive function: SIB (change from baseline at 24‐28 weeks).

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Comparison 1 Memantine vs placebo for moderate‐to‐severe Alzheimer's disease. 6 month studies. ITT‐LOCF data., Outcome 3 Activities of daily living: ADCS‐ADLsev19 (change from baseline at 24‐28 weeks).
Figuras y tablas -
Analysis 1.3

Comparison 1 Memantine vs placebo for moderate‐to‐severe Alzheimer's disease. 6 month studies. ITT‐LOCF data., Outcome 3 Activities of daily living: ADCS‐ADLsev19 (change from baseline at 24‐28 weeks).

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Comparison 1 Memantine vs placebo for moderate‐to‐severe Alzheimer's disease. 6 month studies. ITT‐LOCF data., Outcome 4 Behaviour and mood: NPI total (change from baseline at 24‐28 weeks).
Figuras y tablas -
Analysis 1.4

Comparison 1 Memantine vs placebo for moderate‐to‐severe Alzheimer's disease. 6 month studies. ITT‐LOCF data., Outcome 4 Behaviour and mood: NPI total (change from baseline at 24‐28 weeks).

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Comparison 1 Memantine vs placebo for moderate‐to‐severe Alzheimer's disease. 6 month studies. ITT‐LOCF data., Outcome 5 Number of dropouts.
Figuras y tablas -
Analysis 1.5

Comparison 1 Memantine vs placebo for moderate‐to‐severe Alzheimer's disease. 6 month studies. ITT‐LOCF data., Outcome 5 Number of dropouts.

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Comparison 1 Memantine vs placebo for moderate‐to‐severe Alzheimer's disease. 6 month studies. ITT‐LOCF data., Outcome 6 Number suffering at least one adverse event.
Figuras y tablas -
Analysis 1.6

Comparison 1 Memantine vs placebo for moderate‐to‐severe Alzheimer's disease. 6 month studies. ITT‐LOCF data., Outcome 6 Number suffering at least one adverse event.

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Comparison 1 Memantine vs placebo for moderate‐to‐severe Alzheimer's disease. 6 month studies. ITT‐LOCF data., Outcome 7 Number suffering agitation as an adverse event.
Figuras y tablas -
Analysis 1.7

Comparison 1 Memantine vs placebo for moderate‐to‐severe Alzheimer's disease. 6 month studies. ITT‐LOCF data., Outcome 7 Number suffering agitation as an adverse event.

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Comparison 2 Memantine vs placebo for mild‐to‐moderate Alzheimer's disease. Published, 6 month studies. ITT‐LOCF data, Outcome 1 Clinical global: CIBIC+ (at 24 weeks).
Figuras y tablas -
Analysis 2.1

Comparison 2 Memantine vs placebo for mild‐to‐moderate Alzheimer's disease. Published, 6 month studies. ITT‐LOCF data, Outcome 1 Clinical global: CIBIC+ (at 24 weeks).

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Comparison 2 Memantine vs placebo for mild‐to‐moderate Alzheimer's disease. Published, 6 month studies. ITT‐LOCF data, Outcome 2 Cognitive function: ADAS‐Cog (change from baseline at 24 weeks).
Figuras y tablas -
Analysis 2.2

Comparison 2 Memantine vs placebo for mild‐to‐moderate Alzheimer's disease. Published, 6 month studies. ITT‐LOCF data, Outcome 2 Cognitive function: ADAS‐Cog (change from baseline at 24 weeks).

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Comparison 2 Memantine vs placebo for mild‐to‐moderate Alzheimer's disease. Published, 6 month studies. ITT‐LOCF data, Outcome 3 Activities of daily living: ADCS‐ADL23 (change from baseline at 24 weeks).
Figuras y tablas -
Analysis 2.3

Comparison 2 Memantine vs placebo for mild‐to‐moderate Alzheimer's disease. Published, 6 month studies. ITT‐LOCF data, Outcome 3 Activities of daily living: ADCS‐ADL23 (change from baseline at 24 weeks).

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Comparison 2 Memantine vs placebo for mild‐to‐moderate Alzheimer's disease. Published, 6 month studies. ITT‐LOCF data, Outcome 4 Mood and behaviour: NPI total (change from baseline at 24 weeks).
Figuras y tablas -
Analysis 2.4

Comparison 2 Memantine vs placebo for mild‐to‐moderate Alzheimer's disease. Published, 6 month studies. ITT‐LOCF data, Outcome 4 Mood and behaviour: NPI total (change from baseline at 24 weeks).

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Comparison 2 Memantine vs placebo for mild‐to‐moderate Alzheimer's disease. Published, 6 month studies. ITT‐LOCF data, Outcome 5 Number of dropouts.
Figuras y tablas -
Analysis 2.5

Comparison 2 Memantine vs placebo for mild‐to‐moderate Alzheimer's disease. Published, 6 month studies. ITT‐LOCF data, Outcome 5 Number of dropouts.

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Comparison 2 Memantine vs placebo for mild‐to‐moderate Alzheimer's disease. Published, 6 month studies. ITT‐LOCF data, Outcome 6 Number suffering agitation as an adverse event.
Figuras y tablas -
Analysis 2.6

Comparison 2 Memantine vs placebo for mild‐to‐moderate Alzheimer's disease. Published, 6 month studies. ITT‐LOCF data, Outcome 6 Number suffering agitation as an adverse event.

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Comparison 2 Memantine vs placebo for mild‐to‐moderate Alzheimer's disease. Published, 6 month studies. ITT‐LOCF data, Outcome 7 Number suffering fall as an adverse event.
Figuras y tablas -
Analysis 2.7

Comparison 2 Memantine vs placebo for mild‐to‐moderate Alzheimer's disease. Published, 6 month studies. ITT‐LOCF data, Outcome 7 Number suffering fall as an adverse event.

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Comparison 2 Memantine vs placebo for mild‐to‐moderate Alzheimer's disease. Published, 6 month studies. ITT‐LOCF data, Outcome 8 Number suffering somnolence as an adverse event.
Figuras y tablas -
Analysis 2.8

Comparison 2 Memantine vs placebo for mild‐to‐moderate Alzheimer's disease. Published, 6 month studies. ITT‐LOCF data, Outcome 8 Number suffering somnolence as an adverse event.

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Comparison 2 Memantine vs placebo for mild‐to‐moderate Alzheimer's disease. Published, 6 month studies. ITT‐LOCF data, Outcome 9 Number suffering confusion as an adverse event.
Figuras y tablas -
Analysis 2.9

Comparison 2 Memantine vs placebo for mild‐to‐moderate Alzheimer's disease. Published, 6 month studies. ITT‐LOCF data, Outcome 9 Number suffering confusion as an adverse event.

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Comparison 2 Memantine vs placebo for mild‐to‐moderate Alzheimer's disease. Published, 6 month studies. ITT‐LOCF data, Outcome 10 Number suffering at least one adverse event.
Figuras y tablas -
Analysis 2.10

Comparison 2 Memantine vs placebo for mild‐to‐moderate Alzheimer's disease. Published, 6 month studies. ITT‐LOCF data, Outcome 10 Number suffering at least one adverse event.

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Comparison 2 Memantine vs placebo for mild‐to‐moderate Alzheimer's disease. Published, 6 month studies. ITT‐LOCF data, Outcome 11 Number suffering depression as an adverse event.
Figuras y tablas -
Analysis 2.11

Comparison 2 Memantine vs placebo for mild‐to‐moderate Alzheimer's disease. Published, 6 month studies. ITT‐LOCF data, Outcome 11 Number suffering depression as an adverse event.

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Comparison 3 Memantine vs placebo for mild‐to‐moderate vascular dementia. 6 month studies. LOCF or OC data, Outcome 1 Clinical Global: CGI (at 28 weeks) ITT‐LOCF or OC.
Figuras y tablas -
Analysis 3.1

Comparison 3 Memantine vs placebo for mild‐to‐moderate vascular dementia. 6 month studies. LOCF or OC data, Outcome 1 Clinical Global: CGI (at 28 weeks) ITT‐LOCF or OC.

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Comparison 3 Memantine vs placebo for mild‐to‐moderate vascular dementia. 6 month studies. LOCF or OC data, Outcome 2 Cognitive function ADAS‐Cog (change from baseline at 28 weeks) ITT‐LOCF.
Figuras y tablas -
Analysis 3.2

Comparison 3 Memantine vs placebo for mild‐to‐moderate vascular dementia. 6 month studies. LOCF or OC data, Outcome 2 Cognitive function ADAS‐Cog (change from baseline at 28 weeks) ITT‐LOCF.

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Comparison 3 Memantine vs placebo for mild‐to‐moderate vascular dementia. 6 month studies. LOCF or OC data, Outcome 3 Activities of daily living : NOSGER self care subscale (change from baseline at 28 weeks) OC.
Figuras y tablas -
Analysis 3.3

Comparison 3 Memantine vs placebo for mild‐to‐moderate vascular dementia. 6 month studies. LOCF or OC data, Outcome 3 Activities of daily living : NOSGER self care subscale (change from baseline at 28 weeks) OC.

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Comparison 3 Memantine vs placebo for mild‐to‐moderate vascular dementia. 6 month studies. LOCF or OC data, Outcome 4 Behaviour: NOSGER disturbing behaviour subscale (change from baseline at 28 weeks) OC.
Figuras y tablas -
Analysis 3.4

Comparison 3 Memantine vs placebo for mild‐to‐moderate vascular dementia. 6 month studies. LOCF or OC data, Outcome 4 Behaviour: NOSGER disturbing behaviour subscale (change from baseline at 28 weeks) OC.

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Comparison 4 Memantine vs placebo for severe Alzheimer disease, vascular and mixed dementia (12 weeks), Outcome 1 Activities of daily living (change from baseline at 12 weeks).
Figuras y tablas -
Analysis 4.1

Comparison 4 Memantine vs placebo for severe Alzheimer disease, vascular and mixed dementia (12 weeks), Outcome 1 Activities of daily living (change from baseline at 12 weeks).

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Comparison 4 Memantine vs placebo for severe Alzheimer disease, vascular and mixed dementia (12 weeks), Outcome 2 CGIC (numbers improved at 12 weeks).
Figuras y tablas -
Analysis 4.2

Comparison 4 Memantine vs placebo for severe Alzheimer disease, vascular and mixed dementia (12 weeks), Outcome 2 CGIC (numbers improved at 12 weeks).

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Comparison 4 Memantine vs placebo for severe Alzheimer disease, vascular and mixed dementia (12 weeks), Outcome 3 Number of drop‐outs.
Figuras y tablas -
Analysis 4.3

Comparison 4 Memantine vs placebo for severe Alzheimer disease, vascular and mixed dementia (12 weeks), Outcome 3 Number of drop‐outs.

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Comparison 4 Memantine vs placebo for severe Alzheimer disease, vascular and mixed dementia (12 weeks), Outcome 4 Number suffering at least one adverse event.
Figuras y tablas -
Analysis 4.4

Comparison 4 Memantine vs placebo for severe Alzheimer disease, vascular and mixed dementia (12 weeks), Outcome 4 Number suffering at least one adverse event.

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Comparison 5 Memantine vs placebo for dementia (cause not specified) (4‐6 weeks), Outcome 1 Global.
Figuras y tablas -
Analysis 5.1

Comparison 5 Memantine vs placebo for dementia (cause not specified) (4‐6 weeks), Outcome 1 Global.

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Comparison 5 Memantine vs placebo for dementia (cause not specified) (4‐6 weeks), Outcome 2 Cognition.
Figuras y tablas -
Analysis 5.2

Comparison 5 Memantine vs placebo for dementia (cause not specified) (4‐6 weeks), Outcome 2 Cognition.

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Comparison 5 Memantine vs placebo for dementia (cause not specified) (4‐6 weeks), Outcome 3 Activities of daily living.
Figuras y tablas -
Analysis 5.3

Comparison 5 Memantine vs placebo for dementia (cause not specified) (4‐6 weeks), Outcome 3 Activities of daily living.

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Comparison 5 Memantine vs placebo for dementia (cause not specified) (4‐6 weeks), Outcome 4 Mood and behaviour.
Figuras y tablas -
Analysis 5.4

Comparison 5 Memantine vs placebo for dementia (cause not specified) (4‐6 weeks), Outcome 4 Mood and behaviour.

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Comparison 5 Memantine vs placebo for dementia (cause not specified) (4‐6 weeks), Outcome 5 Number of dropouts.
Figuras y tablas -
Analysis 5.5

Comparison 5 Memantine vs placebo for dementia (cause not specified) (4‐6 weeks), Outcome 5 Number of dropouts.

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Comparison 5 Memantine vs placebo for dementia (cause not specified) (4‐6 weeks), Outcome 6 Number suffering at least one adverse event.
Figuras y tablas -
Analysis 5.6

Comparison 5 Memantine vs placebo for dementia (cause not specified) (4‐6 weeks), Outcome 6 Number suffering at least one adverse event.

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Comparison 5 Memantine vs placebo for dementia (cause not specified) (4‐6 weeks), Outcome 7 Number suffering agitation as an adverse event.
Figuras y tablas -
Analysis 5.7

Comparison 5 Memantine vs placebo for dementia (cause not specified) (4‐6 weeks), Outcome 7 Number suffering agitation as an adverse event.

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Comparison 5 Memantine vs placebo for dementia (cause not specified) (4‐6 weeks), Outcome 8 Number suffering restlessness as an adverse event.
Figuras y tablas -
Analysis 5.8

Comparison 5 Memantine vs placebo for dementia (cause not specified) (4‐6 weeks), Outcome 8 Number suffering restlessness as an adverse event.

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Comparison 6 Memantine vs placebo for mild to severe dementia. All published, 6 month studies, Outcome 1 Clinical Global: CIBIC+ or CGI‐C.
Figuras y tablas -
Analysis 6.1

Comparison 6 Memantine vs placebo for mild to severe dementia. All published, 6 month studies, Outcome 1 Clinical Global: CIBIC+ or CGI‐C.

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Comparison 6 Memantine vs placebo for mild to severe dementia. All published, 6 month studies, Outcome 2 Cognitive function: standardised.
Figuras y tablas -
Analysis 6.2

Comparison 6 Memantine vs placebo for mild to severe dementia. All published, 6 month studies, Outcome 2 Cognitive function: standardised.

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Comparison 6 Memantine vs placebo for mild to severe dementia. All published, 6 month studies, Outcome 3 Activities of daily living: standardised.
Figuras y tablas -
Analysis 6.3

Comparison 6 Memantine vs placebo for mild to severe dementia. All published, 6 month studies, Outcome 3 Activities of daily living: standardised.

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Comparison 6 Memantine vs placebo for mild to severe dementia. All published, 6 month studies, Outcome 4 Behaviour and mood: standardised.
Figuras y tablas -
Analysis 6.4

Comparison 6 Memantine vs placebo for mild to severe dementia. All published, 6 month studies, Outcome 4 Behaviour and mood: standardised.

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Comparison 6 Memantine vs placebo for mild to severe dementia. All published, 6 month studies, Outcome 5 Number of dropouts.
Figuras y tablas -
Analysis 6.5

Comparison 6 Memantine vs placebo for mild to severe dementia. All published, 6 month studies, Outcome 5 Number of dropouts.

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Comparison 6 Memantine vs placebo for mild to severe dementia. All published, 6 month studies, Outcome 6 Number suffering at least one adverse event.
Figuras y tablas -
Analysis 6.6

Comparison 6 Memantine vs placebo for mild to severe dementia. All published, 6 month studies, Outcome 6 Number suffering at least one adverse event.

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Comparison 6 Memantine vs placebo for mild to severe dementia. All published, 6 month studies, Outcome 7 Number suffering agitation as an adverse event.
Figuras y tablas -
Analysis 6.7

Comparison 6 Memantine vs placebo for mild to severe dementia. All published, 6 month studies, Outcome 7 Number suffering agitation as an adverse event.

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Comparison 6 Memantine vs placebo for mild to severe dementia. All published, 6 month studies, Outcome 8 Number suffering confusion as an adverse event.
Figuras y tablas -
Analysis 6.8

Comparison 6 Memantine vs placebo for mild to severe dementia. All published, 6 month studies, Outcome 8 Number suffering confusion as an adverse event.

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Comparison 6 Memantine vs placebo for mild to severe dementia. All published, 6 month studies, Outcome 9 Number suffering hypertension.
Figuras y tablas -
Analysis 6.9

Comparison 6 Memantine vs placebo for mild to severe dementia. All published, 6 month studies, Outcome 9 Number suffering hypertension.

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Comparison 6 Memantine vs placebo for mild to severe dementia. All published, 6 month studies, Outcome 10 Number suffering dizziness as an adverse event.
Figuras y tablas -
Analysis 6.10

Comparison 6 Memantine vs placebo for mild to severe dementia. All published, 6 month studies, Outcome 10 Number suffering dizziness as an adverse event.

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Comparison 6 Memantine vs placebo for mild to severe dementia. All published, 6 month studies, Outcome 11 Number suffering headache as an adverse event.
Figuras y tablas -
Analysis 6.11

Comparison 6 Memantine vs placebo for mild to severe dementia. All published, 6 month studies, Outcome 11 Number suffering headache as an adverse event.

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Comparison 6 Memantine vs placebo for mild to severe dementia. All published, 6 month studies, Outcome 12 Number suffering fall as an adverse event.
Figuras y tablas -
Analysis 6.12

Comparison 6 Memantine vs placebo for mild to severe dementia. All published, 6 month studies, Outcome 12 Number suffering fall as an adverse event.

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Comparison 6 Memantine vs placebo for mild to severe dementia. All published, 6 month studies, Outcome 13 Number suffering insomnia as an adverse event.
Figuras y tablas -
Analysis 6.13

Comparison 6 Memantine vs placebo for mild to severe dementia. All published, 6 month studies, Outcome 13 Number suffering insomnia as an adverse event.

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Comparison 6 Memantine vs placebo for mild to severe dementia. All published, 6 month studies, Outcome 14 Number suffering accidental injury as an adverse event.
Figuras y tablas -
Analysis 6.14

Comparison 6 Memantine vs placebo for mild to severe dementia. All published, 6 month studies, Outcome 14 Number suffering accidental injury as an adverse event.

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Comparison 6 Memantine vs placebo for mild to severe dementia. All published, 6 month studies, Outcome 15 Number suffering urinary incontinence as an adverse event.
Figuras y tablas -
Analysis 6.15

Comparison 6 Memantine vs placebo for mild to severe dementia. All published, 6 month studies, Outcome 15 Number suffering urinary incontinence as an adverse event.

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Comparison 6 Memantine vs placebo for mild to severe dementia. All published, 6 month studies, Outcome 16 Number suffering from diarrhoea as an adverse event.
Figuras y tablas -
Analysis 6.16

Comparison 6 Memantine vs placebo for mild to severe dementia. All published, 6 month studies, Outcome 16 Number suffering from diarrhoea as an adverse event.

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Comparison 6 Memantine vs placebo for mild to severe dementia. All published, 6 month studies, Outcome 17 Number suffering from influenza like symptoms as an adverse event.
Figuras y tablas -
Analysis 6.17

Comparison 6 Memantine vs placebo for mild to severe dementia. All published, 6 month studies, Outcome 17 Number suffering from influenza like symptoms as an adverse event.

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Comparison 7 Memantine vs placebo for mild to severe dementia. All 4‐12 week studies, Outcome 1 Clinical Global: standardised.
Figuras y tablas -
Analysis 7.1

Comparison 7 Memantine vs placebo for mild to severe dementia. All 4‐12 week studies, Outcome 1 Clinical Global: standardised.

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Comparison 7 Memantine vs placebo for mild to severe dementia. All 4‐12 week studies, Outcome 2 Cognitive function: standardised.
Figuras y tablas -
Analysis 7.2

Comparison 7 Memantine vs placebo for mild to severe dementia. All 4‐12 week studies, Outcome 2 Cognitive function: standardised.

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Comparison 7 Memantine vs placebo for mild to severe dementia. All 4‐12 week studies, Outcome 3 Activities of daily living: standardised.
Figuras y tablas -
Analysis 7.3

Comparison 7 Memantine vs placebo for mild to severe dementia. All 4‐12 week studies, Outcome 3 Activities of daily living: standardised.

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Comparison 7 Memantine vs placebo for mild to severe dementia. All 4‐12 week studies, Outcome 4 Mood and behaviour: standardised.
Figuras y tablas -
Analysis 7.4

Comparison 7 Memantine vs placebo for mild to severe dementia. All 4‐12 week studies, Outcome 4 Mood and behaviour: standardised.

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Comparison 7 Memantine vs placebo for mild to severe dementia. All 4‐12 week studies, Outcome 5 Number of drop‐outs.
Figuras y tablas -
Analysis 7.5

Comparison 7 Memantine vs placebo for mild to severe dementia. All 4‐12 week studies, Outcome 5 Number of drop‐outs.

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Comparison 7 Memantine vs placebo for mild to severe dementia. All 4‐12 week studies, Outcome 6 Number suffering at least one adverse event.
Figuras y tablas -
Analysis 7.6

Comparison 7 Memantine vs placebo for mild to severe dementia. All 4‐12 week studies, Outcome 6 Number suffering at least one adverse event.

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Comparison 7 Memantine vs placebo for mild to severe dementia. All 4‐12 week studies, Outcome 7 Number suffering agitation as an adverse event.
Figuras y tablas -
Analysis 7.7

Comparison 7 Memantine vs placebo for mild to severe dementia. All 4‐12 week studies, Outcome 7 Number suffering agitation as an adverse event.

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Table 1. Baseline characteristics of participants in the included studies

Study

Number randomized

Diagnosis

Severity of disease

Mean age (s.e.)

Mean MMSE (s.e.)

Mean SCAG (s.e.)

Mean ADAS‐Cog (s.e.)

% female

duration (weeks)

Ditzler 1991

66

AD (6%), VD (79%), MD (15%)

mild to moderate

72.2

63.3

65

6

Gortelmeyer 1992

88

AD (9%), VD (76%), MD (15%)

mild to moderate

71.5

24.1

64.2

68

6

9408/Orgogozo 2002

321

VD

mild to moderate

76.4 (6.7)

16.9 (2.5)

21.0 (9.1)

47

28

Pantev 1993

60

all dementias

mild to moderately severe

72.4 (5.7)

85.3 (3.8)

75

4

9605/Reisberg 2003

252

AD

moderately severe to severe

76.1(8.07)

7,9 (3,64)

67

28

9202/Wilcock 2002

579

VD

mild to moderate

77

17.6 (3.25)

48

28

Winblad 1999

167

AD (48%), VD + MD (52%)

severe

71.6 (5.6)

6.3 (2.7)

58

12

MD‐02/Tariot 2004

404

AD

moderate to severe

75.5

9,9 (3,13)

64,8

24

MD‐10/Peskind 2004

403

AD

mild to moderate

77.5 (7.8)

17.1 (3.6)

27.3 (10.6)

58.8

24

MD‐01

350

AD

moderate to severe

78.2 (7.9)

71.4

24

MD‐12

432

AD

mild to moderate

24

99679

470

AD

mild to moderate

26

MRZ‐9104

56

AD

13

MRZ‐9105

27

primary dementia

mild to severe

12

MRZ‐9206

56

VD

moderate to severe

77.5 (7.8)

M: 17.2 (3.4), P: 17.4 (3.7)

M: 27.3 (9.7) P: 27.2 (11)

58.8

14
Figuras y tablas -
Table 1. Baseline characteristics of participants in the included studies
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Table 2. Outcome measures

Study

ADAS‐Cog

SIB

ADCS‐ADL

ADL

BGP

CIBIC‐Plus

CGIC

NPI

Other

9202/Wilcock 2002

X

X

NOSGER

9408/Orgogozo 2000

X

X

X

GBS, MMSE, NOSGER

9403/Winblad 1999

X

X

9605/Reisberg 2003

X

X

X

X

FAST, SIB

Ditzler 1991

X

Physician's Global Impression, Syndrom Kurztest, SCAG

Gortelmeyer 1992

X

CGI, GBS, Tapping test, Trace test, SCAG

99679 (Lundbeck)

MD‐01

X

X

X

X

X

FAST, SIB

MD‐02/Tariot 2004

X

X

X

X

X

SIB

MD‐10/Peskind 2004

X

X

X

X

MD‐12

MRZ‐9104

MRZ‐9105

MRZ‐9206

Pantev 1993

X

Global assessment of clinical efficacy, NOSIE‐Index, Physician's global rating of tolerability, SCAG

Figuras y tablas -
Table 2. Outcome measures
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Comparison 1. Memantine vs placebo for moderate‐to‐severe Alzheimer's disease. 6 month studies. ITT‐LOCF data.

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Clinical Global: CIBIC+ (24‐28 weeks) Show forest plot

3

964

Mean Difference (IV, Fixed, 95% CI)

0.28 [0.15, 0.41]

2 Cognitive function: SIB (change from baseline at 24‐28 weeks) Show forest plot

3

976

Mean Difference (IV, Fixed, 95% CI)

2.97 [1.68, 4.26]

3 Activities of daily living: ADCS‐ADLsev19 (change from baseline at 24‐28 weeks) Show forest plot

3

978

Mean Difference (IV, Fixed, 95% CI)

1.27 [0.44, 2.09]

4 Behaviour and mood: NPI total (change from baseline at 24‐28 weeks) Show forest plot

3

936

Mean Difference (IV, Fixed, 95% CI)

2.76 [0.88, 4.63]

5 Number of dropouts Show forest plot

3

1006

Odds Ratio (M‐H, Fixed, 95% CI)

0.66 [0.49, 0.88]

6 Number suffering at least one adverse event Show forest plot

3

1005

Odds Ratio (M‐H, Fixed, 95% CI)

1.13 [0.84, 1.52]

7 Number suffering agitation as an adverse event Show forest plot

3

1005

Odds Ratio (M‐H, Fixed, 95% CI)

0.60 [0.42, 0.86]
Figuras y tablas -
Comparison 1. Memantine vs placebo for moderate‐to‐severe Alzheimer's disease. 6 month studies. ITT‐LOCF data.
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Comparison 2. Memantine vs placebo for mild‐to‐moderate Alzheimer's disease. Published, 6 month studies. ITT‐LOCF data

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Clinical global: CIBIC+ (at 24 weeks) Show forest plot

3

1281

Mean Difference (IV, Fixed, 95% CI)

0.13 [0.01, 0.25]

2 Cognitive function: ADAS‐Cog (change from baseline at 24 weeks) Show forest plot

3

1279

Mean Difference (IV, Fixed, 95% CI)

0.99 [0.21, 1.78]

3 Activities of daily living: ADCS‐ADL23 (change from baseline at 24 weeks) Show forest plot

3

1271

Mean Difference (IV, Fixed, 95% CI)

0.20 [‐0.87, 1.27]

4 Mood and behaviour: NPI total (change from baseline at 24 weeks) Show forest plot

3

1252

Mean Difference (IV, Fixed, 95% CI)

‐0.25 [‐1.48, 0.98]

5 Number of dropouts Show forest plot

3

1306

Odds Ratio (M‐H, Fixed, 95% CI)

1.16 [0.83, 1.60]

6 Number suffering agitation as an adverse event Show forest plot

3

1306

Odds Ratio (M‐H, Fixed, 95% CI)

0.91 [0.57, 1.46]

7 Number suffering fall as an adverse event Show forest plot

2

836

Odds Ratio (M‐H, Fixed, 95% CI)

0.83 [0.41, 1.67]

8 Number suffering somnolence as an adverse event Show forest plot

1

403

Odds Ratio (M‐H, Fixed, 95% CI)

7.49 [1.68, 33.38]

9 Number suffering confusion as an adverse event Show forest plot

2

836

Odds Ratio (M‐H, Fixed, 95% CI)

1.40 [0.72, 2.70]

10 Number suffering at least one adverse event Show forest plot

3

1306

Odds Ratio (M‐H, Fixed, 95% CI)

1.04 [0.81, 1.33]

11 Number suffering depression as an adverse event Show forest plot

2

836

Odds Ratio (M‐H, Fixed, 95% CI)

0.71 [0.38, 1.32]
Figuras y tablas -
Comparison 2. Memantine vs placebo for mild‐to‐moderate Alzheimer's disease. Published, 6 month studies. ITT‐LOCF data
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Comparison 3. Memantine vs placebo for mild‐to‐moderate vascular dementia. 6 month studies. LOCF or OC data

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Clinical Global: CGI (at 28 weeks) ITT‐LOCF or OC Show forest plot

2

775

Mean Difference (IV, Fixed, 95% CI)

0.03 [‐0.13, 0.19]

2 Cognitive function ADAS‐Cog (change from baseline at 28 weeks) ITT‐LOCF Show forest plot

2

815

Mean Difference (IV, Fixed, 95% CI)

1.85 [0.88, 2.83]

3 Activities of daily living : NOSGER self care subscale (change from baseline at 28 weeks) OC Show forest plot

2

542

Mean Difference (IV, Fixed, 95% CI)

0.12 [‐0.43, 0.67]

4 Behaviour: NOSGER disturbing behaviour subscale (change from baseline at 28 weeks) OC Show forest plot

2

541

Mean Difference (IV, Fixed, 95% CI)

0.48 [0.06, 0.91]
Figuras y tablas -
Comparison 3. Memantine vs placebo for mild‐to‐moderate vascular dementia. 6 month studies. LOCF or OC data
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Comparison 4. Memantine vs placebo for severe Alzheimer disease, vascular and mixed dementia (12 weeks)

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Activities of daily living (change from baseline at 12 weeks) Show forest plot

1

166

Mean Difference (IV, Fixed, 95% CI)

‐2.0 [‐5.65, 1.65]

1.1 Dose 10 mg/day, BGP subscore care dependence (change from baseline at 12 weeks)

1

166

Mean Difference (IV, Fixed, 95% CI)

‐2.0 [‐5.65, 1.65]

2 CGIC (numbers improved at 12 weeks) Show forest plot

1

166

Odds Ratio (M‐H, Fixed, 95% CI)

3.30 [1.72, 6.33]

2.1 Dose 10mg/day

1

166

Odds Ratio (M‐H, Fixed, 95% CI)

3.30 [1.72, 6.33]

3 Number of drop‐outs Show forest plot

1

166

Odds Ratio (M‐H, Fixed, 95% CI)

1.03 [0.25, 4.25]

4 Number suffering at least one adverse event Show forest plot

1

166

Odds Ratio (M‐H, Fixed, 95% CI)

1.03 [0.49, 2.16]
Figuras y tablas -
Comparison 4. Memantine vs placebo for severe Alzheimer disease, vascular and mixed dementia (12 weeks)
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Comparison 5. Memantine vs placebo for dementia (cause not specified) (4‐6 weeks)

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Global Show forest plot

3

213

Std. Mean Difference (IV, Fixed, 95% CI)

‐0.76 [‐1.04, ‐0.48]

1.1 Dose 30mg/day, Physicians global impression (6 weeks)

1

66

Std. Mean Difference (IV, Fixed, 95% CI)

‐0.82 [‐1.33, ‐0.32]

1.2 Dose 30mg/day, SCAG Clinical global impression of disturbances (4 weeks)

1

59

Std. Mean Difference (IV, Fixed, 95% CI)

‐1.04 [‐1.58, ‐0.49]

1.3 Dose 20mg/day, CGI (6 weeks)

1

88

Std. Mean Difference (IV, Fixed, 95% CI)

‐0.55 [‐0.98, ‐0.13]

2 Cognition Show forest plot

1

59

Mean Difference (IV, Fixed, 95% CI)

‐3.04 [‐5.68, ‐0.40]

2.1 Dose 30mg/day, SKT (change from baseline at 6 weeks)

1

59

Mean Difference (IV, Fixed, 95% CI)

‐3.04 [‐5.68, ‐0.40]

3 Activities of daily living Show forest plot

2

126

Std. Mean Difference (IV, Fixed, 95% CI)

‐1.34 [‐1.73, ‐0.94]

3.1 Dose 30mg/day, BGP care dependence subsscale (change from baseline at 6 weeks)

1

60

Std. Mean Difference (IV, Fixed, 95% CI)

‐2.05 [‐2.68, ‐1.42]

3.2 Dose 30mg/day, ADL‐test total time (6 weeks)

1

66

Std. Mean Difference (IV, Fixed, 95% CI)

‐0.88 [‐1.39, ‐0.37]

4 Mood and behaviour Show forest plot

3

208

Std. Mean Difference (IV, Fixed, 95% CI)

‐1.16 [‐1.46, ‐0.86]

4.1 Dose 30mg/day, NOSIE (change from baseline at 4 weeks)

1

60

Std. Mean Difference (IV, Fixed, 95% CI)

‐2.02 [‐2.65, ‐1.39]

4.2 Dose 30mg/day, SCAG total (change from baseline at 6 weeks)

2

148

Std. Mean Difference (IV, Fixed, 95% CI)

‐0.91 [‐1.25, ‐0.57]

5 Number of dropouts Show forest plot

2

154

Odds Ratio (M‐H, Fixed, 95% CI)

0.86 [0.27, 2.67]

6 Number suffering at least one adverse event Show forest plot

1

82

Odds Ratio (M‐H, Fixed, 95% CI)

2.00 [0.83, 4.81]

7 Number suffering agitation as an adverse event Show forest plot

1

59

Odds Ratio (M‐H, Fixed, 95% CI)

2.7 [0.48, 15.19]

8 Number suffering restlessness as an adverse event Show forest plot

1

59

Odds Ratio (M‐H, Fixed, 95% CI)

13.5 [2.71, 67.18]
Figuras y tablas -
Comparison 5. Memantine vs placebo for dementia (cause not specified) (4‐6 weeks)
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Comparison 6. Memantine vs placebo for mild to severe dementia. All published, 6 month studies

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Clinical Global: CIBIC+ or CGI‐C Show forest plot

8

3020

Stand. Tx effect (Fixed, 95% CI)

0.15 [0.07, 0.23]

2 Cognitive function: standardised Show forest plot

8

3070

Stand. Tx effect (Fixed, 95% CI)

0.24 [0.17, 0.30]

3 Activities of daily living: standardised Show forest plot

8

2791

Stand. Tx effect (Fixed, 95% CI)

0.08 [0.01, 0.15]

4 Behaviour and mood: standardised Show forest plot

8

2729

Stand. tx effect (Fixed, 95% CI)

0.11 [0.04, 0.19]

5 Number of dropouts Show forest plot

8

3212

Odds Ratio (M‐H, Fixed, 95% CI)

0.91 [0.76, 1.09]

6 Number suffering at least one adverse event Show forest plot

8

3211

Odds Ratio (M‐H, Fixed, 95% CI)

1.09 [0.93, 1.27]

7 Number suffering agitation as an adverse event Show forest plot

8

3612

Odds Ratio (M‐H, Fixed, 95% CI)

0.78 [0.61, 0.99]

8 Number suffering confusion as an adverse event Show forest plot

6

2489

Odds Ratio (M‐H, Fixed, 95% CI)

1.31 [0.93, 1.87]

9 Number suffering hypertension Show forest plot

1

350

Odds Ratio (M‐H, Fixed, 95% CI)

3.59 [1.16, 11.12]

10 Number suffering dizziness as an adverse event Show forest plot

6

2489

Odds Ratio (M‐H, Fixed, 95% CI)

1.18 [0.86, 1.60]

11 Number suffering headache as an adverse event Show forest plot

4

1765

Odds Ratio (M‐H, Fixed, 95% CI)

1.02 [0.67, 1.56]

12 Number suffering fall as an adverse event Show forest plot

6

2420

Odds Ratio (M‐H, Fixed, 95% CI)

0.96 [0.71, 1.30]

13 Number suffering insomnia as an adverse event Show forest plot

4

1614

Odds Ratio (M‐H, Fixed, 95% CI)

0.92 [0.59, 1.43]

14 Number suffering accidental injury as an adverse event Show forest plot

6

2308

Odds Ratio (M‐H, Fixed, 95% CI)

0.70 [0.50, 0.98]

15 Number suffering urinary incontinence as an adverse event Show forest plot

3

1234

Odds Ratio (M‐H, Fixed, 95% CI)

1.12 [0.67, 1.85]

16 Number suffering from diarrhoea as an adverse event Show forest plot

4

1584

Odds Ratio (M‐H, Fixed, 95% CI)

0.86 [0.56, 1.33]

17 Number suffering from influenza like symptoms as an adverse event Show forest plot

4

1589

Odds Ratio (M‐H, Fixed, 95% CI)

1.08 [0.72, 1.63]
Figuras y tablas -
Comparison 6. Memantine vs placebo for mild to severe dementia. All published, 6 month studies
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Comparison 7. Memantine vs placebo for mild to severe dementia. All 4‐12 week studies

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Clinical Global: standardised Show forest plot

4

377

Stand. Tx effect (Fixed, 95% CI)

0.62 [0.41, 0.82]

2 Cognitive function: standardised Show forest plot

1

59

Stand. Tx effect (Fixed, 95% CI)

0.59 [0.11, 1.07]

3 Activities of daily living: standardised Show forest plot

3

292

Stand. Tx effect (Fixed, 95% CI)

0.73 [0.50, 0.96]

4 Mood and behaviour: standardised Show forest plot

3

208

Stand. Tx effect (Fixed, 95% CI)

1.27 [0.99, 1.54]

5 Number of drop‐outs Show forest plot

3

320

Odds Ratio (M‐H, Fixed, 95% CI)

0.92 [0.38, 2.23]

6 Number suffering at least one adverse event Show forest plot

2

248

Odds Ratio (M‐H, Fixed, 95% CI)

1.36 [0.77, 2.38]

7 Number suffering agitation as an adverse event Show forest plot

1

59

Odds Ratio (M‐H, Fixed, 95% CI)

2.7 [0.48, 15.19]
Figuras y tablas -
Comparison 7. Memantine vs placebo for mild to severe dementia. All 4‐12 week studies
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