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每日一次美金刚治疗对中重度阿尔茨海默病患者认知和功能沟通技能的持续影响:16 周开放性试验的结果。

Sustained effects of once-daily memantine treatment on cognition and functional communication skills in patients with moderate to severe Alzheimer's disease: results of a 16-week open-label trial.

机构信息

Department of Neurology, University Medical Center, RWTH Aachen, Aachen, Germany.

出版信息

J Alzheimers Dis. 2011;25(3):463-75. doi: 10.3233/JAD-2011-101929.

Abstract

The present study evaluated the effects of once-daily memantine (20 mg) treatment on cognition and communication in patients with moderate to severe Alzheimer's disease (AD). In a multicenter, single-arm open-label study, outpatients diagnosed with AD (MMSE < 20; n = 97) were titrated from 5 mg to 20 mg once-daily memantine over 4 weeks. Once-daily memantine treatment (20 mg) was then continued for 8 weeks, followed by a 4-week wash-out period. The primary efficacy endpoint was the change from baseline in the Consortium to Establish a Registry for Alzheimer's Disease -Neuropsychological Battery (CERAD-NP) total score. Secondary efficacy endpoints included change from baseline in Functional Communication Language Inventory (FLCI) and ADCS-ADL19 total score, and the response from baseline in Clinical Global Impression of Change (CGI-C). The CERAD-NP total score improved significantly after 12 weeks of once-daily memantine treatment compared with baseline (5.9 ± 8.8; p < 0.0001). The FLCI total score improved significantly after 12 weeks compared with baseline (4.4 ± 6.8; p < 0.0001). These significant improvements were already observed after 4 and 8 weeks of once-daily memantine treatment and persisted after a 4-week wash-out period. ADCS-ADL19 total scores showed only slight increases from baseline, and CGI-C indicated that the majority of patients experienced an improvement or stabilization of the disease after 12 weeks. At least one Treatment-Emergent Adverse Event was reported by 38 (39.2%) patients. In patients with moderate to severe AD, once-daily memantine (20 mg) treatment significantly improved cognition and functional communication and was found to have a favorable safety and tolerability profile.

摘要

本研究评估了每日一次美金刚(20mg)治疗对中重度阿尔茨海默病(AD)患者认知和交流能力的影响。在一项多中心、单臂、开放标签研究中,97 例被诊断为 AD 的门诊患者(MMSE<20)经过 4 周的时间从 5mg 滴定至每日一次美金刚 20mg。随后患者接受每日一次美金刚(20mg)治疗 8 周,之后进行 4 周的洗脱期。主要疗效终点是从基线到 Consortium to Establish a Registry for Alzheimer's Disease -Neuropsychological Battery(CERAD-NP)总分的变化。次要疗效终点包括从基线到 Functional Communication Language Inventory(FLCI)和 ADCS-ADL19 总分的变化,以及从基线到 Clinical Global Impression of Change(CGI-C)的反应。与基线相比,每日一次美金刚治疗 12 周后 CERAD-NP 总分显著改善(5.9±8.8;p<0.0001)。FLCI 总分在 12 周后与基线相比显著改善(4.4±6.8;p<0.0001)。这些显著的改善在每日一次美金刚治疗 4 周和 8 周后就已经观察到,并在 4 周的洗脱期后持续存在。ADCS-ADL19 总分仅从基线略有增加,CGI-C 表明大多数患者在 12 周后病情改善或稳定。38(39.2%)例患者报告至少有一次治疗后出现的不良事件。在中重度 AD 患者中,每日一次美金刚(20mg)治疗可显著改善认知和功能交流能力,且具有良好的安全性和耐受性。

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