New approaches to clinical trials in vascular dementia: memantine in small vessel disease.

Mobius HJ, Stoffler A.

Merz & Co.
Frankfurt, Germany. 
hj.moebius@merz.de
Cerebrovasc Dis 2002;13 Suppl 2:61-6

Abstract

Although criteria for the diagnosis of vascular dementia (VaD) are established, the diagnostic concept is still controversial and there is no regulatory guidance for clinical drug development. Clinical trials in VaD present a number of pitfalls and challenges and, so far, no compound has received regulatory approval for this indication. The methodological issues of clinical VaD trials are discussed using the development of memantine for this indication as an example.  In a pooled analysis of two placebo-controlled trials with the NMDA-antagonist memantine in VaD, the cognitive benefit by memantine treatment was more pronounced for patients with 'small vessel disease' than for those with other neuroradiological findings at baseline.  In a subgroup of patients with 'large vessel disease' or macrolesions, there was less cognitive decline among the placebo patients.  It may therefore be helpful to use predefined diagnostic subcategories in clinical studies in this indication.  The findings further suggest that stroke or multiple infarctions may not be the primary reason for cognitive decline in VaD patients. 

 | order  |
  
www.AlzheimersTreatments.com


Galantamine Alzheimer's articles         www.AlzheimersTreatments.com

Galantamine  fights Alzheimer's
   In the 1950s, a Bulgarian pharmacologist noticed that local villagers rubbed their foreheads with the snowdrop plant to ease nerve pain. Further investigation led to the isolation of the snowdrop extract galantamine  continue

Galantamine
: why galantamine is the best agent for restoring memory
   Galantamine has several advantages over donepezil (Aricept®) and rivastigmine (Exelon®)    continue

Galantamine: can sharpen your mental edge
  
Galantamine's positive results in slowing the progression of Alzheimer's disease may be due  continue

Galantamine
: helps save Memory
  
Galantamine is used in treating Alzheimer's disease, because of its ability   continue

Galantamine: beats Prescription Drugs for combating Mental Decline
 
Galantamine is different from donepezil (Aricept®) and rivastigmine (Exelon®) in one very important way, galantamine has the unique ability to increase the receptiveness of nicotinic receptors to acetylcholine  continue

Galantamine: opens the channels of your Memory
   The secret of galantamine's success lies in your brain's nicotinic receptors. 
continue

GalantamineProtect Brain Function by Enhancing Neurotransmission
  
Galantamine has been found to be effective in treating  Alzheimer's disease  
continue

Galantamine
: Boost Memory
  
Galantamine achieves the same effect as drugs such as Aricept or tacrine, but has additional benefits   continue

Galantamine protects Brain funtion
  
The primary objective
with Alzheimer's is to enhance neurotransmission so as to retain memory  continue
    
Galantamine: food for Mind & Body
  
Galantamine is a
flower extract that improves memory and perhaps even helps with impotence  continue

Galantamine  may help stave off Dementia
   Dementia is a progressive loss of memory accompanied by significant 
continue

Galantamine: Memory Enhancement
  
Alzheimer's patients  suffer sharp declines in their brain levels of acetylcholine. Galantamine    continue

Galantamine rescues Brain Cells
   According to a study of 653 Alzheimer's disease patients published in the British Medical Journal, the herbal supplement galantamine "appears to slow the progression of the neurodegenerative condition"  continue

Galantamine: the Old Become Young
  
As we age, it becomes harder to learn new things. One explanation is the deterioration of the brain's continue

Galantamine: What's Old with Acetylcholine is New to Us
  
Acetylcholine deficiency is characteristic of Alzheimer's disease. The primary treatment is administration of agents like galantaminean extract from the snowdrop and daffodil plants  continue