Evidence map›Paper›PMID 18580597›Full record

Trial reportAlzheimer disease and associated disorders

Long-term course and effectiveness of combination therapy in Alzheimer disease.

Alireza Atri, Lynn W Shaughnessy, Joseph J Locascio, John H Growdon

Registry-linked trialOpen access · greenAbstract readClinical Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Alzheimer disease and associated disorders. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01876823 (Effects of Combined Memantine), which is not on this map. Cited by 105 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
105citing papers in PubMed, 3 pooled it
9.5field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT01876823 phase2 / phase3completednot on this map

Effects of Combined Memantine (Namenda) Plus Escitalopram (Lexapro) Treatment in Elderly Depressed Patients With Cognitive Impairment

TypeinterventionalSponsorNew York State Psychiatric InstituteRan2006 to 2010Enrolled60ConditionsMild Cognitive Impairment, Major Depressive Disorder, Alzheimer's DiseaseArmses-citalopram, Memantine
3 · Its place in the literature

Who cites it

105 citing papers in PubMed, 3 syntheses or guidelines pooled it, 230 citations in OpenAlex.

  1. Pooled it
  2. Memantine for dementia.The Cochrane database of systematic reviews · 2019
    Pooled it
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  19. Antidementia Medication Use in Nursing Home Residents.Journal of geriatric psychiatry and neurology · 2024
    Article
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45 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 2 institutions in 1 country.

Alireza AtriDepartment of Neurology and Massachusetts Alzheimer's Disease Research Center, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA. aatri@partners.org
Lynn W Shaughnessy
Joseph J Locascio
John H Growdon
Harvard University · USMassachusetts General Hospital · US

Funding

THE ROLE OF ADVANCED CAA IN ALZHEIMER'S DEMENTIAP50AG005134 · NIA · MASSACHUSETTS GENERAL HOSPITAL · PI FROSCH, MATTHEW P · 1985 to 2018
$42.1M
Modeling cholinergic modulation of fMRI memory networks in aging & MCIK23AG027171 · NIA · MASSACHUSETTS GENERAL HOSPITAL · PI ATRI, ALIREZA · 2006 to 2010
$805k
NIA NIH HHS 1K23 AG27171-01NIA NIH HHS 5P50 AG05134NIA NIH HHS K23 AG027171NIA NIH HHS P50 AG005134
6 · The paper itself

Abstract

objectiveTo compare the real-world clinical effectiveness and long-term clinical trajectory in patients with Alzheimer disease (AD) treated with combination (COMBO) therapy consisting of cholinesterase-inhibitor (CI) plus memantine (MEM) versus CI alone versus no treatment with either.

methodsThree hundred eighty-two subjects with probable AD underwent serial clinical evaluations at a memory disorders unit. Cognition was assessed by the Information-Memory-Concentration subscale of the Blessed Dementia Scale (BDS) and function was assessed by the Weintraub Activities of Daily Living Scale (ADL) at 6-month intervals. One hundred forty-four subjects received standard care without CI or MEM (NO-RX), 122 received CI monotherapy, and 116 received COMBO therapy with CI plus MEM. Mean follow-up was 30 months (4.1 visits) and mean cumulative medication treatment time was 22.5 months. Rates of decline were analyzed using mixed-effects regression models, and Cohen's d effect sizes were calculated annually for years 1 to 4.

resultsCovarying for baseline scores, age, education, and duration of illness, the COMBO group had significantly lower mean annualized rates of deterioration in BDS and ADL scores compared with the CI (P<0.001; Cohen's dBDS=0.10-0.34 and dADL=0.23-0.46 at 1 to 2 y) and NO-RX groups (P<0.001; Cohen's dBDS=0.56-0.73 and dADL=0.32-0.48 at 1 to 2 y). For the COMBO group, Cohen's d effect sizes increased with treatment duration. Similar comparisons significantly favored the CI over the NO-RX group on the BDS.

conclusionsCOMBO therapy slows cognitive and functional decline in AD compared with CI monotherapy and no treatment. These benefits had small-to-medium effect sizes that increased with time on treatment and were sustained for years.

Indexed as

Activities of Daily LivingAgedAlzheimer DiseaseCholinesterase InhibitorsCognitionCognition DisordersDopamine AgentsDrug Therapy, CombinationFemaleHumansMaleMemantineTimeTreatment OutcomeCholinesterase InhibitorsDopamine AgentsMemantine

Identifiers

PMID18580597
PMCPMC2718545
OpenAlexW2133239607

What OpenQuestion holds

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Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.