Trial Outcomes & Findings for Safety and Tolerability of Memantine in Moderate to Severe Alzheimer's Disease (NCT NCT00857233)

NCT ID: NCT00857233

Last Updated: 2012-08-29

Results Overview

Overview of AEs

Recruitment status

TERMINATED

Study phase

PHASE3

Target enrollment

297 participants

Primary outcome timeframe

Baseline to Week 24

Results posted on

2012-08-29

Participant Flow

This was an interventional, multi-centre, open-label, fixed-dose extension study to Study 10158. The Baseline visit in Study 10252 was scheduled to occur at the same time as the Week 24 Visit in Study 10158.

Placebo patients from Study 10158 were uptitrated in weekly increments of 5 mg over a 4-week, double-blind period. Target dose of 20 mg/day was reached at the start of the 4th week and maintained for the rest of the study. Memantine patients in Study 10158 continued on 20 mg/day. From the end of Week 4, the study was open-label.

Participant milestones

Participant milestones
Measure
Memantine
20 mg Oral Tablets Once Daily
Overall Study
STARTED
297
Overall Study
COMPLETED
242
Overall Study
NOT COMPLETED
55

Reasons for withdrawal

Reasons for withdrawal
Measure
Memantine
20 mg Oral Tablets Once Daily
Overall Study
Adverse Event
24
Overall Study
Lack of Efficacy
1
Overall Study
Non-compliance
1
Overall Study
Withdrawal of Consent
9
Overall Study
Lost to Follow-up
4
Overall Study
Nursing Home Placement
14
Overall Study
Other Reasons
2

Baseline Characteristics

Safety and Tolerability of Memantine in Moderate to Severe Alzheimer's Disease

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Memantine
n=297 Participants
20 mg Oral Tablets Once Daily
Age Continuous
75 years
STANDARD_DEVIATION 7.3 • n=5 Participants
Sex: Female, Male
Female
172 Participants
n=5 Participants
Sex: Female, Male
Male
125 Participants
n=5 Participants
NPI: Baseline Total Score
22.32 Scores on a scale
STANDARD_DEVIATION 15.41 • n=5 Participants
SIB: Baseline Total Score
79.99 Scores on a Scale
STANDARD_DEVIATION 16.36 • n=5 Participants
CIBIC-plus: Baseline Severity Score
4.52 Scores on a scale
STANDARD_DEVIATION 0.85 • n=5 Participants
ADCS-ADL - 19 items: Baseline Total Score
33.43 Scores on a scale
STANDARD_DEVIATION 10.06 • n=5 Participants

PRIMARY outcome

Timeframe: Baseline to Week 24

Population: Completers from lead-in study 10158 were eligible for this open-label extension study. We analysed the All-patients-treated Set (APTS) - all patients who took at least one dose of investigational medicinal product (IMP)

Overview of AEs

Outcome measures

Outcome measures
Measure
Memantine
n=297 Participants
20 mg Oral Tablets Once Daily
Number of Patients With Adverse Events (AEs)
Patients with AEs
191 participants
Number of Patients With Adverse Events (AEs)
Patients with serious AEs (SAEs)
27 participants
Number of Patients With Adverse Events (AEs)
Patients with AEs Leading to Withdrawal
24 participants
Number of Patients With Adverse Events (AEs)
Patients with Baseline Events
1 participants

PRIMARY outcome

Timeframe: Baseline to Week 24

Population: APTS

Outcome measures

Outcome measures
Measure
Memantine
n=297 Participants
20 mg Oral Tablets Once Daily
Percentage of Patients Who Withdrew Due to Intolerance to Treatment
8.1 percentage of participants

SECONDARY outcome

Timeframe: Baseline and Week 24

Population: APTS; Observed cases (OC)

Change from Baseline in the NPI total score. Analysed by descriptive methods only. NPI is a validated scale that assesses behavioural disturbances in patients with dementia. The 12 item version consists of 10 behavioural and 2 neurovegetative areas. It provides both a total score as well as scores for a number of sub-scales. The frequency, severity and caregiver distress for each domain are measured. The NPI is based upon responses obtained from the caregiver. The total score is from 0 to 144. A higher score reflects more frequency and severity of the disturbances.

Outcome measures

Outcome measures
Measure
Memantine
n=247 Participants
20 mg Oral Tablets Once Daily
Long-term Efficacy of Memantine on Behavioural Symptoms Using the Neuropsychiatric Inventory (NPI) - 12 Items Version Total Score.
2.11 Scores on a scale
Standard Deviation 16.12

SECONDARY outcome

Timeframe: Baseline and Week 24

Population: APTS; OC

Change from Baseline in the SIB total score. Analysed by descriptive methods only. SIB is a validated scale used to assess cognitive function in patients with moderate to severe dementia. Items are single words or one-step commands combined with gestures. Nine domains are assessed, and the total score is between 0 and 100. A lower total score reflects the loss of cognitive function.

Outcome measures

Outcome measures
Measure
Memantine
n=244 Participants
20 mg Oral Tablets Once Daily
Long-term Efficacy of Memantine on Cognition Using the Severe Impairment Battery (SIB) Total Score.
-5.60 Scores on a scale
Standard Deviation 9.81

SECONDARY outcome

Timeframe: Week 24

Population: APTS; OC

CIBIC-plus. Improvement evaluated with reference to Baseline. Analysed by descriptive methods only. CIBIC-plus is a global rating that is derived through an independent, comprehensive interview with the patient and caregiver by a rater who is barred from knowledge of all other psychometric test scores conducted as part of this protocol as well as from reported safety data. The rating is made on a 7-point scale ranging from "1 = marked improvement" to "7 = marked worsening". A score of "4" indicates no change.

Outcome measures

Outcome measures
Measure
Memantine
n=243 Participants
20 mg Oral Tablets Once Daily
Long-term Efficacy of Memantine on Global Condition Using the Clinician's Interview-Based Impression of Change-Plus Version (CIBIC-plus).
4.75 Scores on a scale
Standard Deviation 1.14

SECONDARY outcome

Timeframe: Baseline and Week 24

Population: APTS; OC

Change from Baseline on the ADCS-ADL 19-item version total score. Analysed by descriptive methods only. ADCS-ADL- 19 items version for moderate to severe AD will measure patient's functioning. This battery of ADL questions is used here to measure the functional capabilities of patients with dementia. The inventory is done by interviewing a person in close contact with the patient and covers the most usual and consistent performance of the patient over the preceding 4 weeks. Total score is from 0 to 54. The higher score, the lower impairment.

Outcome measures

Outcome measures
Measure
Memantine
n=247 Participants
20 mg Oral Tablets Once Daily
Long-term Efficacy of Memantine on Functioning Using the Alzheimer's Disease Cooperative Study - Activities of Daily Living Inventory (ADCS-ADL) 19-item Version Total Score
-4.16 Scores on a scale
Standard Deviation 6.45

Adverse Events

Memantine

Serious events: 27 serious events
Other events: 85 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
Memantine
n=297 participants at risk
20 mg Oral Tablets Once Daily
Blood and lymphatic system disorders
Anaemia
0.34%
1/297 • 24 weeks plus 30 days safety follow-up period
Cardiac disorders
Acute myocardial infarction
0.34%
1/297 • 24 weeks plus 30 days safety follow-up period
Cardiac disorders
Bradycardia
0.34%
1/297 • 24 weeks plus 30 days safety follow-up period
Cardiac disorders
Cardiac failure
0.34%
1/297 • 24 weeks plus 30 days safety follow-up period
Cardiac disorders
Supraventricular tachycardia
0.34%
1/297 • 24 weeks plus 30 days safety follow-up period
General disorders
Asthenia
0.34%
1/297 • 24 weeks plus 30 days safety follow-up period
Hepatobiliary disorders
Bile duct stone
0.34%
1/297 • 24 weeks plus 30 days safety follow-up period
Infections and infestations
Gastroenteritis
0.34%
1/297 • 24 weeks plus 30 days safety follow-up period
Infections and infestations
Pneumonia
0.34%
1/297 • 24 weeks plus 30 days safety follow-up period
Infections and infestations
Scrotal infection
0.34%
1/297 • 24 weeks plus 30 days safety follow-up period
Infections and infestations
Urinary tract infection bacterial
0.34%
1/297 • 24 weeks plus 30 days safety follow-up period
Injury, poisoning and procedural complications
Acetabulum fracture
0.34%
1/297 • 24 weeks plus 30 days safety follow-up period
Injury, poisoning and procedural complications
Fall
1.7%
5/297 • 24 weeks plus 30 days safety follow-up period
Injury, poisoning and procedural complications
Hip fracture
0.67%
2/297 • 24 weeks plus 30 days safety follow-up period
Injury, poisoning and procedural complications
Lumbar vertebral fracture
0.34%
1/297 • 24 weeks plus 30 days safety follow-up period
Injury, poisoning and procedural complications
Upper limb fracture
0.34%
1/297 • 24 weeks plus 30 days safety follow-up period
Musculoskeletal and connective tissue disorders
Muscular weakness
0.34%
1/297 • 24 weeks plus 30 days safety follow-up period
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
Oesophageal carcinoma
0.34%
1/297 • 24 weeks plus 30 days safety follow-up period
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
Prostate cancer
0.34%
1/297 • 24 weeks plus 30 days safety follow-up period
Nervous system disorders
Dementia Alzheimer's type
0.67%
2/297 • 24 weeks plus 30 days safety follow-up period
Nervous system disorders
Dizziness
0.67%
2/297 • 24 weeks plus 30 days safety follow-up period
Nervous system disorders
Syncope
0.34%
1/297 • 24 weeks plus 30 days safety follow-up period
Psychiatric disorders
Abnormal behaviour
0.34%
1/297 • 24 weeks plus 30 days safety follow-up period
Psychiatric disorders
Aggression
0.34%
1/297 • 24 weeks plus 30 days safety follow-up period
Psychiatric disorders
Hallucination
0.34%
1/297 • 24 weeks plus 30 days safety follow-up period
Psychiatric disorders
Restlessness
0.34%
1/297 • 24 weeks plus 30 days safety follow-up period
Respiratory, thoracic and mediastinal disorders
Pneumonia aspiration
0.34%
1/297 • 24 weeks plus 30 days safety follow-up period
Respiratory, thoracic and mediastinal disorders
Pulmonary embolism
0.34%
1/297 • 24 weeks plus 30 days safety follow-up period
Social circumstances
Social stay hospitalisation
1.0%
3/297 • 24 weeks plus 30 days safety follow-up period

Other adverse events

Other adverse events
Measure
Memantine
n=297 participants at risk
20 mg Oral Tablets Once Daily
Gastrointestinal disorders
Constipation
3.0%
9/297 • 24 weeks plus 30 days safety follow-up period
Gastrointestinal disorders
Diarrhoea
4.0%
12/297 • 24 weeks plus 30 days safety follow-up period
Gastrointestinal disorders
Nausea
3.4%
10/297 • 24 weeks plus 30 days safety follow-up period
General disorders
Gait disturbance
3.0%
9/297 • 24 weeks plus 30 days safety follow-up period
Injury, poisoning and procedural complications
Fall
5.1%
15/297 • 24 weeks plus 30 days safety follow-up period
Nervous system disorders
Dizziness
5.1%
15/297 • 24 weeks plus 30 days safety follow-up period
Nervous system disorders
Headache
3.4%
10/297 • 24 weeks plus 30 days safety follow-up period
Psychiatric disorders
Agitation
6.1%
18/297 • 24 weeks plus 30 days safety follow-up period
Psychiatric disorders
Confusional state
3.4%
10/297 • 24 weeks plus 30 days safety follow-up period

Additional Information

H. Lundbeck A/S

H. Lundbeck A/S

Phone: +45 3630 1311

Results disclosure agreements

  • Principal investigator is a sponsor employee The main publication has to be published before any sub-publications. Order of authors has to be established. Publication of the results by the investigator will be subject to mutual agreement between the investigator and H. Lundbeck A/S. Manuscripts and abstracts must be sent to H. Lundbeck A/S at least one month prior to submission for publication or presentation.
  • Publication restrictions are in place

Restriction type: OTHER