Wilkinson David, Andersen Henning Friis
Memory Assessment and Research Centre, Moorgreen Hospital, Southampton, UK.
Dement Geriatr Cogn Disord. 2007;24(2):138-45. doi: 10.1159/000105162. Epub 2007 Jul 4.
Alzheimer's disease (AD) is a progressive neurodegenerative disorder and delaying disease worsening is a relevant treatment outcome.
Data from 6 randomized, double-blind, placebo-controlled, 6-month studies were pooled and a subgroup of patients (867 on placebo, 959 on memantine) with moderate to severe AD (Mini- Mental State Examination <20) was analyzed. 'Any clinical worsening' was defined as a decline on the Alzheimer's Disease Assessment Scale - Cognitive Subscale (ADAS-cog) or the Severe Impairment Battery (SIB) and on the Clinician's Interview-Based Impression of Change Plus Caregiver Input (CIBIC-plus) and the Alzheimer's Disease Cooperative Study - Activities of Daily Living Inventory (ADCS-ADL), and 'marked clinical worsening' as > or = 4 points decline on the ADAS-cog or > or = 5 points on the SIB and decline on the CIBIC-plus and the ADCS-ADL.
More placebo-treated than memantine-treated patients showed any clinical worsening (28 vs. 18%; p < 0.001), and 21% placebo-treated patients compared to 11% memantine-treated patients had marked clinical worsening (p < 0.001).
In this population of moderate and severe AD patients, treatment with memantine was associated with reducing worsening of clinical symptoms in AD during the 6-month study period.
阿尔茨海默病（AD）是一种进行性神经退行性疾病，延缓疾病恶化是一项相关的治疗结果。
汇总来自6项随机、双盲、安慰剂对照、为期6个月研究的数据，并对中度至重度AD（简易精神状态检查表<20）患者亚组（867例服用安慰剂，959例服用美金刚）进行分析。“任何临床恶化”定义为阿尔茨海默病评估量表-认知分量表（ADAS-cog）或严重损害量表（SIB）以及基于临床医生访谈的变化印象加照顾者意见（CIBIC-plus）和阿尔茨海默病协作研究-日常生活活动量表（ADCS-ADL）出现下降，“显著临床恶化”定义为ADAS-cog下降≥4分或SIB下降≥5分以及CIBIC-plus和ADCS-ADL出现下降。
服用安慰剂的患者比服用美金刚的患者出现任何临床恶化的比例更高（28%对18%；p<0.001），21%服用安慰剂的患者与1
