A Randomized, Double-Blind, Placebo-Controlled Evaluation of the Safety and Efficacy of Memantine in Patients With Moderate-to-Severe Dementia of the Alzheimer's Type
Overview
- Phase
- Phase 3
- Intervention
- Placebo
- Conditions
- Dementia of the Alzheimer's Type
- Sponsor
- Forest Laboratories
- Enrollment
- 677
- Locations
- 83
- Primary Endpoint
- Change From Baseline in Severe Impairment Battery (SIB) at Week 24 (LOCF)
- Status
- Completed
- Last Updated
- 15 years ago
Overview
Brief Summary
The objective of this study is to evaluate the safety, tolerability, and efficacy of memantine compared to placebo in outpatients diagnosed with moderate-to-severe dementia of the Alzheimer's type on a concurrent acetylcholinesterase inhibitor (AChEI).
Detailed Description
Memantine is a therapeutic agent that represents a unique class of Alzheimer's disease (AD) treatment options. A once daily (QD) dosing regimen in an AD population would simplify administration for the caregiver. The purpose of this study is to evaluate the safety and efficacy of modified release memantine taken once daily in outpatients with moderate-to-severe AD on a concurrent AChEI.
Investigators
Eligibility Criteria
Inclusion Criteria
- •Ambulatory patients aged \>/= 50 years
- •Diagnostic evidence of probable Alzheimer's disease consistent with criteria from the National Institute of Neurological and Communicative Disorders and Stroke-Alzheimer's Disease and Related Disorders Association (NINCDS-ADRDA) and the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR)
- •Confirmatory magnetic resonance imaging (MRI) or computed tomographic (CT) scan within the prior 12 months.
- •Mini-Mental State Examination (MMSE) scores \>/= 3 and \</= 14 at Screening (Visit 1) and Baseline (Visit 2)
- •Ongoing daily acetylcholinesterase inhibitor (AChEI) therapy at a stable dose for at least 3 months prior to Screening (Visit 1). It is preferred that patients continue to receive the same AChEI therapy for the duration of the study.
Exclusion Criteria
- •Patients with a modified Hachinski Ischemia Score greater than 4 at Screening.
- •Patients who have taken memantine within one month of Screening (Visit 1)
- •Patients who have a known hypersensitivity to memantine, neramexane, rimantadine, or amantadine.
- •Patients whose AChEI therapy is likely to be interrupted or discontinued during the course of the study.
- •Patients who are receiving therapy with more than one AChEI.
- •Patients with computed tomography (CT) or magnetic resonance imaging (MRI) evidence of hydrocephalus, stroke, a space-occupying lesion, cerebral infection, or any clinically significant central nervous system disease other than Alzheimer's disease.
- •Patients with a DSM-IV Axis I disorder other than Alzheimer's disease, including amnestic disorders, schizophrenia or schizoaffective disorder, bipolar disorder, current major depressive episode, psychosis, panic, or post-traumatic stress disorder.
- •Patients who, in the clinician's judgement, are likely to be placed in a nursing home within the next 6 months.
- •Patients who had evidence of other neurological disorders that included, but were not limited to, stroke, Parkinson's disease, seizure disorder, or head injury with loss of consciousness within the prior 5 years
- •Patients who had dementia that was complicated by other organic disease
Arms & Interventions
Placebo
Oral administration, once daily.
Intervention: Placebo
Memantine ER
28mg, once daily. Oral administration for 24 weeks.
Intervention: memantine ER
Outcomes
Primary Outcomes
Change From Baseline in Severe Impairment Battery (SIB) at Week 24 (LOCF)
Time Frame: Baseline to week 24
The SIB was developed for the evaluation of cognitive function in patients with more advanced dementia, and evaluates the areas of memory, language, praxis, orientation, and attention. The SIB test items consist of simple, one-step commands presented with gestural cues that are repeated if necessary. The test contains 51 items, and the range of possible scores is 0 to 100 (with 0 being the worst result). The SIB has been shown to be a valid and reliable instrument sensitive to longitudinal change.
Clinician's Interview-Based Impression of Change With Caregiver Input (CIBIC-plus) at Week 24 (LOCF)
Time Frame: Week 24
The CIBIC-Plus is a measure of an overall clinical effect and is based on a comprehensive evaluation at Baseline and later visits of four domains: general (overall clinical status), functional (including activities of daily living), cognitive, and behavioral. A skilled clinician interviews the patient, and includes information supplied by a knowledgeable caregiver. The CIBIC-Plus is a rating of the patient's global status relative to Baseline, ranging from a score of 1, indicating "marked improvement" to a score of 4, indicating "no change" to a score of 7, indicating "marked worsening."
Secondary Outcomes
- Change From Baseline in the 19-Item Alzheimer's Disease Cooperative Study-Activities of Daily Living (ADCS-ADL19) Scale at Week 24 (LOCF)(Baseline to week 24)