Memantine showed no benefit in patients with frontotemporal lobar degeneration


Memantine ( Ebixa, Namenda ) has been used off-label to treat frontotemporal lobar degeneration ( FTD ). A previous 26-week open-label study suggested a transient, modest benefit on neuropsychiatric symptoms as measured by the neuropsychiatric inventory ( NPI ).

The aim of a study was to determine whether Memantine is an effective treatment for frontotemporal lobar degeneration.

Researchers did a randomised, parallel group, double-blind, placebo-controlled trial of 20 mg Memantine taken orally daily for 26 weeks in patients with FTD.
Participants met neary criteria for behavioural variant FTD ( bvFTD ) or semantic dementia and had characteristic brain atrophy.
Use of acetylcholinesterase inhibitors was prohibited.

Patients were randomly assigned to receive either Memantine or matched placebo tablets ( 1:1 ) in blocks of two and four patients.
All patients and study personnel were masked to treatment assignment.

Primary endpoints were the change in total NPI score and clinical global impression of change ( CGIC ) score after 26 weeks and were analysed by intention to treat.

Of 100 patients screened, 81 were randomly assigned to receive Memantine ( n=39 ) or placebo ( n=42 ). Five ( 6% ) patients discontinued, and 76 completed the 26-week treatment.
Enrolment numbers were lower than planned because of many patients’ preference to take Memantine or cholinesterase inhibitors off-label rather than participate in a clinical trial.

Memantine treatment had no effect on either the NPI ( mean difference 2.2; p=0.47 ) or CGIC ( mean difference 0.0: p=0.90 ) after 26 weeks of treatment.

Memantine was generally well tolerated; however, patients in the Memantine group had more frequent cognitive adverse events ( n=6 ) than those in the placebo group ( n=1 ).

In conclusion, Memantine treatment showed no benefit in patients with FTD. These data do not support Memantine use in frontotemporal lobar degeneration. ( Xagena )

Boxer AL et al, The Lancet Neurology 2013; 12; 149-156

XagenaMedicine_2013



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