Memantine in Vascular Dementia

Möbius H.J. and Stöffler A.

International Psychogeriatrics 2003, 15 Suppl 1: 207-213

Analyses based on studies in patients with mild to moderate vascular dementia:

Orgogozo et al. (2002) (MMM300)

Wilcock et al. (2002) (MMM500)

ADAS-cog analysis by severity at baseline:

MMSE 20-22

MMSE 15-19

MMSE 10-14

ADAS-cog analysis by neuroradiological findings at baseline:

Macrolesions, “Large Vessel Disease”

No macrolesions, “Small Vessel Disease”

Memantine in Vascular Dementia: Subgroup Analyses

Möbius and Stöffler, Int Psychogeriatr 2003

Patients with “Large Vessel Disease” Hardly Show Cognitive Decline

Möbius and Stöffler, Int Psychogeriatr 2003

AD

AS

-co

g s

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ce -2

-1

0

1

2

3

ADAS-cog mean change from baseline ITT, LOCF, N = 214

Impr

ovem

ent

Wor

seni

ng

0 12 28

Memantine (20 mg/day)

Placebo

Week

Pooled data

Significant Benefit of Memantine in Patients with “Small Vessel Disease”

AD

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g s

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Möbius and Stöffler, Int Psychogeriatr 2003

* p = 0.002 versus placebo

ADAS-cog mean change from baseline ITT, LOCF, N = 553

Impr

ovem

ent

Wor

seni

ng

0 12 28

Memantine (20 mg/day)

Placebo

*

-2

-1

0

1

2

3

Week

Pooled data

Largest Benefit of Memantine in More Severely Demented Patients

Möbius and Stöffler, Int Psychogeriatr 2003

AD

AS

-co

g s

co

re d

iffe

ren

ce

MMM500 MMM300

0.32 0.530.95

1.35

2.43

4.12

-1.38-0.80

0.940.50

0.99

4.40

Mean ADAS-cog change from baseline ITT, LOCF

-2

-1

0

1

2

3

4

5

Memantine (20 mg/day)

Placebo

20 - 22 15 - 19 10 - 14 20 - 22 15 - 19 10 - 14 MMSE at baseline

Impr

ovem

ent

Wor

seni

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Summary

The strongest effect of memantine on cognition was shown

in the moderately demented patient population (MMSE < 15 at baseline)

and

in the subgroup of patients with “small vessel disease” (no macrolesions in CT/MRI)

Möbius and Stöffler, Int Psychogeriatr 2003