Effect of long-term treatment with memantine on mortality in patients with major cognitive disorders: A systematic review and meta-analysis.

BACKGROUND

Dementia is responsible for a reduction in life expectancy, and the effect of memantine on mortality is still poorly understood. Our aim was to evaluate the effect of long-term treatment with memantine on all-cause mortality.

METHODS

In this systematic review and meta-analysis, we searched five databases from their creation to June 2024.

RESULTS

We found 12 randomized trials ( = 4266) and 7 observational studies ( = 20,216). Treatment with memantine was associated with a reduction in all-cause mortality (risk ratios [RRs] 0.81, 95% CI: 0.72-0.92,  = 0.001). In the sensitivity analysis, the pooled RR was similar for randomized controlled trials (RCT) (RR 0.86) and non-randomized studies (RR 0.81) but pooled results from RCTs did not reach statistical significance (95% confidence interval [CI]: 0.59-1.26,  = 0.45), while they did for observational studies (95% CI: 0.70-0.95,  = 0.008), so we consider the overall evidence as of low certainty.

CONCLUSION

Our results suggest that the use of memantine in patients with dementia may be associated with a reduction in all-cause mortality.

HIGHLIGHTS

Dementia reduces patients' survival and the effect of long-term use of memantine on all-cause mortality is not well known.This systematic review and metanalysis included 19 studies including more than 24000 patients.We found that memantine in patients with dementia may be associated with a reduction in all-cause mortality.