Azienda Sanitaria Provinciale Catanzaro, Primary Care Departiment, Center for Cognitive Disorders and Dementia, Catanzaro, Italy.
Health Authority and Services of Modena (AUSL di Modena), Geriatric Service-Cognitive Disorders and Dementia Unit, Modena, Italy.
J Alzheimers Dis. 2021;79(4):1509-1515. doi: 10.3233/JAD-201211.
Background: Citicoline has been proven to have beneficial effects in patients with cognitive impairment. In previous studies, combined treatment with memantine and acetylcholinesterase inhibitors (AChEIs) maintained cognitive function in patients with Alzheimer's disease (AD) better than memantine or AChEIs alone.
To evaluate the effectiveness and safety of a combination therapy of oral citicoline, memantine, and an AChEI in AD when compared with memantine and an AChEI without citicoline.
This was a retrospective multi-centric case-control study, conducted in Italian Centers for Cognitive Impairment and Dementia. Overall, 170 patients were recruited (34.11%of men, mean age 76,81±4.93 years): 48.8%treated with memantine and donepezil; 48.2%with memantine and rivastigmine; 2.9%with memantine and galantamine. 89 patients (control-group) were treated with memantine and an AChEI, whereas 81 patients (case-group) were treated with oral citicoline 1000 mg/day added to memantine and an AChEI given orally. Cognitive functions, activities of daily living, instrumental activities of daily living, comorbidities, mood and behavioral disturbances were assessed at baseline, month 6, and month 12.
In the case group, MMSE score had a statistically significant increasing trend between T0 and T2 (14.88±2.95 versus 15.09±3.00; p = 0.040), whereas in the control group, MMSE score showed a statistically significant decrease trend (14.37±2.63 versus 14.03±2.92 p = 0.024).
In older patients with AD, a triple therapy with citicoline, memantine, and AChEI was more effective than memantine and AChEI without citicoline in maintaining the MMSE total score after 12 months.
已有研究证明胞磷胆碱对认知障碍患者有益。在既往研究中，与单用美金刚或乙酰胆碱酯酶抑制剂（AChEI）相比，美金刚联合 AChEI 与胞磷胆碱治疗阿尔茨海默病（AD）患者的认知功能保持效果更好。
评估 AD 患者在接受美金刚联合 AChEI 与胞磷胆碱治疗与接受美金刚联合 AChEI 治疗相比的有效性和安全性。
这是一项在意大利认知障碍和痴呆中心进行的回顾性多中心病例对照研究。共纳入 170 例患者（34.11%为男性，平均年龄 76.81±4.93 岁）：48.8%接受美金刚和多奈哌齐治疗；48.2%接受美金刚和利斯的明治疗；2.9%接受美金刚和加兰他敏治疗。89 例患者（对照组）接受美金刚和 AChEI 治疗，81 例患者（病例组）接受胞磷胆碱 1000 mg/天联合美金刚和 AChEI 治疗。在基线、第 6 个月和第 12 个月评估认知功能、日常生活活动、工具性日常生活活动、合并症、情绪和行为障碍。
在病例组中，MMSE 评分在 T0 与 T2 之间呈统计学显著增加趋势（14.88±2.95 与 15.09±3.00；p=0.040），而在对照组中，MMSE 评分呈统计学显著下降趋势（14.37±2.63 与 14.03±2.92；p=0.024）。
在老年 AD 患者中，与美金刚联合 AChEI 治疗相比，美金刚联合 AChEI 与胞磷胆碱治疗在 12 个月后更能维持 MMSE 总分。
