Azienda Sanitaria Provinciale di Catanzaro, Primary Care Departiment, Center for Cognitive Disorders and Dementia, viale Crotone, 88100, Catanzaro, Italy.
Azienda Sanitaria Locale Napoli 3 sud, Internal and Geriatric Medicine Department, Center for Cognitive Disorders and Dementia, Health District no.51, Pomigliano d'Arco, Naples, Italy.
Clin Drug Investig. 2021 Feb;41(2):177-182. doi: 10.1007/s40261-020-00996-2. Epub 2021 Jan 23.
Combined therapy of memantine or acetylcholinesterase inhibitors, with cholinergic precursors such as citicoline, can be effective in Alzheimer's disease. Indeed, they are able to increase the intrasynaptic levels of acetylcholine more than the single drug. Our aim was to evaluate the efficacy and safety of oral citicoline plus memantine plus rivastigmine in patients with Alzheimer's disease.
This was a multi-centric, retrospective case-control study conducted in Italian Centers for Cognitive Impairment and Dementia on consecutive patients aged 65 years or older affected with Alzheimer's disease. Overall, 104 patients were recruited (27% male, mean age 76.04 ± 4.92 years); 41 (39.42%) treated with citicolin 1000 mg/day given orally + memantine + rivastigmine (Cases) and 63 (60.58%) treated with memantine + rivastigmine (Controls). At baseline (T0), month 6 (T1) and month 12 (T2), cognitive functions were assessed by the Mini Mental State Examination (MMSE), functional dependence by basal Activities (ADL) and Instrumental Activities of Daily Living (IADL), comorbidity by the Cumulative Illness Rating Scale (CIRS), mood by the Geriatric Depression Scale (GDS), and behavioural disturbances by the Neuropsychiatric Inventory (NPI). Adverse events were reported during the study.
The difference in MMSE score was not significant when comparing the two groups at T0, T1 or T2. However, in the case group, the MMSE total score showed a statistically significant difference at T0 versus T1 (13.63 ± 2.46 vs. 14.17 ± 2.24; p = 0.008), and at T0 versus T2 (13.63 ± 2.46 vs. 14.32 ± 2.53; p = 0.002). In the control group, no statistical differences were found at baseline (T0), T1 and T2. ADL, IADL, GDS and NPI total score did not improve during the study in either the case or the control group.
In our study we observed absence of a statistically significant difference between case and control groups for the MMSE total scores. However, in the case group in the MMSE total scores, there was a statistically significant increase between the baseline and the end of the study.
美金刚与乙酰胆碱酯酶抑制剂联合治疗，与胆碱能前体如胞磷胆碱联合应用，对阿尔茨海默病可能有效。事实上，它们能够比单一药物更有效地增加突触内乙酰胆碱的水平。我们的目的是评估口服胞磷胆碱加美金刚加利伐斯的疗效和安全性在阿尔茨海默病患者中。
这是一项多中心、回顾性病例对照研究，在意大利认知障碍和痴呆中心对 65 岁或以上患有阿尔茨海默病的连续患者进行。共纳入 104 例患者（27%为男性，平均年龄 76.04±4.92 岁）；41 例（39.42%）接受胞磷胆碱 1000mg/天口服+美金刚+利伐斯明（病例组），63 例（60.58%）接受美金刚+利伐斯明（对照组）。在基线（T0）、第 6 个月（T1）和第 12 个月（T2）时，采用简易精神状态检查（MMSE）评估认知功能，采用基础日常生活活动（ADL）和工具性日常生活活动（IADL）评估功能依赖性，采用累积疾病评分量表（CIRS）评估共病，采用老年抑郁量表（GDS）评估情绪，采用神经精神问卷（NPI）评估行为障碍。在研究期间报告了不良反应。
在 T0、T1 或 T2 时，两组间 MMSE 评分差异无统计学意义。然而，在病例组中，MMSE 总分在 T0 与 T1 时（13.63±2.46 与 14.17±2.24；p=0.008）和 T0 与 T2 时（13.63±2.46 与 14.32±2.53；p=0.002）有统计学差异。在对照组中，基线（T0）、T1 和 T2 时均无统计学差异。在病例组和对照组中，ADL、IADL、GDS 和 NPI 总分在研究期间均未改善。
在我们的研究中，我们观察到病例组和对照组之间的 MMSE 总分没有统计学差异。然而，在病例组中，MMSE 总分在基线和研究结束时呈统计学显著增加。
