Department of Psychiatry and Behavioral Health, Stony Brook University Renaissance School of Medicine, 101 Nicolls Rd, 11794, Stony Brook, NY, USA.
Psychiatry Res. 2020 Nov;293:113409. doi: 10.1016/j.psychres.2020.113409. Epub 2020 Aug 18.
Alzheimer's disease (AD) is the most prevalent form of dementia in the elderly population worldwide. Despite the major unmet clinical need, no new medications for the treatment of AD have been approved since 2003. Galantamine is an acetylcholinesterase inhibitor that is also a positive allosteric modulator at the α4β2 and α7nACh receptors. Memantine is an N-methyl-d-aspartate receptor modulator/agonist. Both galantamine and memantine are FDA-approved medications for the treatment of AD. The objective of this review is to highlight the potential of the galantamine-memantine combination to conduct randomized controlled trials (RCTs) in AD. Several studies have shown the combination to be effective. Neurodegenerative diseases involve multiple pathologies; therefore, combination treatment appears to be a rational approach. Although underutilized, the galantamine-memantine combination is the standard of care in the treatment of AD. Positive RCTs with the combination with concurrent improvement in symptoms and biomarkers may lead to FDA approval, which may lead to greater utilization of this combination in clinical practice.
阿尔茨海默病（AD）是全球老年人群中最常见的痴呆症形式。尽管存在重大的未满足的临床需求，但自 2003 年以来，尚无新的 AD 治疗药物获得批准。加兰他敏是一种乙酰胆碱酯酶抑制剂，也是α4β2 和 α7nACh 受体的正变构调节剂。美金刚是一种 N-甲基-D-天冬氨酸受体调节剂/激动剂。加兰他敏和美金刚均为 FDA 批准用于治疗 AD 的药物。本综述的目的是强调加兰他敏-美金刚联合用于 AD 的随机对照试验（RCT）的潜力。多项研究表明该联合具有疗效。神经退行性疾病涉及多种病理学；因此，联合治疗似乎是一种合理的方法。尽管未得到充分利用，但加兰他敏-美金刚联合是 AD 治疗的标准护理。具有联合治疗并同时改善症状和生物标志物的阳性 RCT 可能会导致 FDA 批准，这可能会导致该联合在临床实践中的更多应用。
