Combination Drug Therapy for the Management of Alzheimer’s Disease
https://doi.org/10.37586/2686-8636-2-2024-140-144
Abstract
Alzheimer's disease (AD) is one of the most prevalent neurodegenerative diseases worldwide. It is the leading cause of dementia in both older and oldest old population. The standard treatment for AD dementia is based on two groups of drugs: cholinesterase inhibitors (donepezil, rivastigmine, galantamine) and NMDA glutamate receptor modulator memantine. At moderate and severe stages of dementia, it is often necessary to use both a cholinergic inhibitor and memantine simultaneously. This review discusses current capabilities, efficacy and safety of combined therapy for Alzheimer's. It also covers details the features of using fixed combinations of donepezil and memantine in clinical practice.
About the Authors
N. G. Dudchenko
Russian Gerontology Research and Clinical Centre, Pirogov Russian National Research Medical University of the Ministry of Health of the Russian Federation
Russian Federation
Russian Federation
Dudchenko Nadezhda G., MD, PhD, Age-Related Diseases Department
Moscow
E. A. Mkhitaryan
Russian Gerontology Research and Clinical Centre, Pirogov Russian National Research Medical University of the Ministry of Health of the Russian Federation
Russian Federation
Russian Federation
Mkhitaryan Elen A., MD, PhD, Age-Related Diseases Department
Moscow
References
1. DeTure M. A., Dickson D. W. The neuropathological diagnosis of Alzheimer’s disease //Molecular neurodegeneration. — 2019. — Т. 14. — №. 1. — С. 1-18.
2. Alzheimer's Association. 2019 Alzheimer's disease facts and figures //Alzheimer's & dementia. — 2019. — Т. 15. — № 3. — С. 321–387.
3. Васенина Е.Е., Верюгина Н.И., Левин О.С. Возможности комбинированной терапии болезни Альцгеймера. Журнал неврологии и психиатрии им. С.С. Корсакова. 2022; 122 (11 вып. 2):45–50 https://doi.org/10.17116/jnevro202212211245
4. Parsons CG, Danysz W, Dekundy A, Pulte I. Memantine and cholinesterase inhibitors: complementary mechanisms in the treatment of Alzheimer’s disease. Neurotox Res. 2013; 24(3):358369.https://doi.org/10.1007/s12640-013-9398
5. Luo JJ, Wallace W, Kusiak JW. A tough trek in the development of an anti-amyloid therapy for Alzheimer’s disease: Do we see hope in the distance?J Neurol Sci. 2022; 438(6);134-139. https://doi.org/10.1016/j.jns.2022.120294
6. Shi M. Chu F, Zhu F, Zhu J. Impact of Anti-amyloid- β Monoclonal Antibodies on the Pathology and Clinical Profile of Alzheimer’s Disease: A Focus on Aducanumab and Lecanemab. Frontiers in Aging Neuroscience. 2022; 14:1-11. https://doi.org/10.3389/fnagi.2022.870517
7. Захаров В. В., Локшина А. Б., Вахнина Н. В. Комбинированная терапия болезни Альцгеймера //Неврология, нейропсихиатрия, психосоматика. — 2022. — Т. 14. — № 3. — С. 74– 80.
8. Birks J. S., Cochrane Dementia and Cognitive Improvement Group. Cholinesterase inhibitors for Alzheimer's disease //Cochrane database of systematic reviews. — 1996. — Т. 2016. — № 3. Birks J. S., Harvey R. J. Donepezil for dementia due to Alzheimer's disease //Cochrane Database of systematic reviews. — 2018. — № 6.
9. Kobayashi H. et al. The comparative efficacy and safety of cholinesterase inhibitors in patients with mild‐to‐moderate Alzheimer's disease: a Bayesian network meta‐analysis // International journal of geriatric psychiatry. — 2016. — Т. 31. — № 8. — С. 892-904.
10. Campbell N. et al. Impact of cholinesterase inhibitors on behavioral and psychological symptoms of Alzheimer’s disease: a meta-analysis //Clinical Interventions in Aging. — 2008. — Т. 3. — № 4. — С. 719–728.
11. Blanco-Silvente L, Castells X, Saez M, et al. Discontinuation, efficacy, and safety of cholinesterase inhibitors for Alzheimer’s disease: A meta-analysis and meta-regression of 43 randomized clinical trials enrolling 16 106 patients. Int J Neuropsychopharmacol. 2017; 20(7):519-528. https://doi.org/10.1093/ijnp/pyx012
12. Hansen RA, Gartlehner G, Webb AP, et al. Efficacy and safety of donepezil, galantamine, and rivastigmine for the treatment of Alzheimer’s disease:a systematic review and meta-analysis. Clin Interv Aging. 2008;3(2):211-225.
13. Dubois B. et al. Donepezil decreases annual rate of hippocampal atrophy in suspected prodromal Alzheimer's disease //Alzheimer's & Dementia. — 2015. — Т. 11. — № 9. — С. 1041–1049.
14. Birks J, Harvey RJ. Donepezil for dementia due to Alzheimer’s disease.Cochrane Database Syst Rev. 2018;6:1-245. https://doi.org/10.1002/14651858.CD001190.pub3
15. Birks J, Harvey RJ. Donepezil for dementia due to Alzheimer’s disease.Cochrane Database Syst Rev. 2018;6:1-245. https://doi.org/10.1002/14651858.CD001190.pub3
16. McShane R. et al. Memantine for dementia //Cochrane database of systematic reviews. — 2019. — № 3.
17. Tariot P. N. et al. Memantine treatment in patients with moderate to severe Alzheimer disease already receiving donepezil: a randomized controlled trial //Jama. — 2004. — Т. 291. — № 3. — С. 317–324.
18. Araki T. et al. The effects of combine treatment of memantine and donepezil on Alzheimer's disease patients and its relationship with cerebral blood flow in the prefrontal area //International journal of geriatric psychiatry. — 2014. — Т. 29. — № 9. — С. 881–889.
19. Howard R, McShane R, Lindesay J, et al. Donepezil and memantine for moderate-to-severe Alzheimer’s disease. N Engl J Med. 2012; 366:893-903. https://doi.org/10.1056/NEJMoa1106668
20. Hendrix S. et al. Post hoc evidence for an additive effect of memantine and donepezil: consistent findings from DOMINOAD study and memantine clinical trial program //J Prev Alzheimers Dis. — 2015. — Т. 2. — № 3. — С. 165–171.
21. Howard R. et al. Nursing home placement in the Donepezil and Memantine in Moderate to Severe Alzheimer's Disease (DOMINO-AD) trial: secondary and post-hoc analyses //The Lancet Neurology. — 2015. — Т. 14. — № 12. — С. 1171–1181.
22. Guo J, Wang Z, Liu R, et al. Memantine,Donepezil, or Combination Therapy-What is the best therapy for Alzheimer's Disease? A Network Meta-Analysis. Brain Behav. 2020 Nov; 10(11):e01831. doi: 10.1002/brb3.1831.Epub 2020 Sep 10
23. Knorz A. L., Quante A. Alzheimer’s disease: Efficacy of mono-and combination therapy. A sytic review //Journal of Geriatric Psychiatry and Neurology. — 2022. — Т. 35. — № 4. — С. 475– 486.
24. Ткачева О.Н., Рунихина Н.К., Мхитарян Э.А., Коберская Н.Н., Маневич Т.М. Сравнительный анализ эффективности применения монотерапии донепезилом и комбинированной терапии донепезилом и акатинолом мемантином у больных с болезнью Альцгеймера на стадии легкой деменции. Российский неврологический журнал. 2019; 24(5):54-60.
25. Atri A, Shaughnessy LW, Locasco JJ, Growdon JH. Long-term course and effectiveness of combination therapy in Alzheimer disease. Alzheimer Dis Assoc Disord. 2008; 22(3):209-221. https://doi.org/10.1097/WAD.0b013e31816653bc
26. Calhoun, Amanda, et al. «An evaluation of memantine ER+ donepezil for the treatment of Alzheimer’s disease.» Expert opinion on pharmacotherapy 19.15 (2018): 1711-1717.
27. Смолярчук Е.А, Лейкин З.Н. Сравнительное клини-ческое исследование фармакокинетики и биоэквивалентности комбинированного лекарственного препарата Миореол и совместного применения монопрепаратов, содержащих донепезил и мемантин. Журнал неврологии и психиатрии им. С.С. Корсакова. 2022; 122(3):85-91.Smolyarchuk EA, Leykin ZN. Comparatative clinical study of the pharmacokinetics and bioequivalence of the combined drug Mioreol and combined use of mono-drugs containing Donepezil and Memantine. S.S. Korsakov Journal of Neurology and Psychiatry. 2022; 122(3):85-91. (In Russ.). https://doi.org/10.17116/jnevro202212203185
28. Колыхалов И.В., Мхитарян Э.А., Федорова Я.Б., Пономарева Е.В., Селезнева Н.Д., Чердак М.А., Дудченко Н.Г., Сейфединова А.Б., Исаев Р.И., Гаврилова С.И., Ткачева О.Н. Российский опыт применения комбинации фиксированных доз донепезила и мемантина в терапии болезни Альцгеймера в рамках наблюдательной неинтервенционной многоцентровой программы. Журнал неврологии и психиатрии им. С.С. Корсакова. 2023; 123(12):69-75.
Review
For citations:
Dudchenko N.G., Mkhitaryan E.A. Combination Drug Therapy for the Management of Alzheimer’s Disease. Russian Journal of Geriatric Medicine. 2024;(2):140-144. (In Russ.) https://doi.org/10.37586/2686-8636-2-2024-140-144
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