Memantine in Korean Alzheimer's disease: A prospective real-world REMIND study.

OBJECTIVES

Prospective real-world evidence on memantine in Korean patients with Alzheimer's disease remains limited. This study evaluated its real-world effectiveness and tolerability over 24 weeks of routine clinical practice.

DESIGN &

SETTING

Multicenter, prospective, single-arm observational study conducted at twelve university-affiliated tertiary hospitals in Korea.

PARTICIPANTS

Patients aged ≥ 50 years with Alzheimer's disease (Mini-Mental State Examination score of 5-20 and either a Clinical Dementia Rating of 2-3 or a Global Deterioration Scale score of 4-7) initiated on memantine (Ebixa®) 10-20 mg/day. The safety set comprised 401 patients and the effectiveness set 339.

MEASUREMENTS: The primary outcome was change in the Clinical Dementia Rating global score at Week 24. Secondary outcomes were changes in the Clinical Dementia Rating Sum of Boxes, Mini-Mental State Examination, Neuropsychiatric Inventory, and Zarit Burden Interview at Weeks 12 and 24, together with treatment persistence and adverse events.

RESULTS

At Week 24, 86.6% of 339 effectiveness-set patients remained within their baseline Clinical Dementia Rating category, 10.5% worsened, and 2.9% improved. Mini-Mental State Examination scores increased and Neuropsychiatric Inventory total scores decreased at both visits (all p < 0.05), with small standardized effect sizes (absolute d 0.08-0.17). Zarit Burden Interview scores increased at both visits. Treatment persistence was 89.5% at Week 24, and drug-related adverse events occurred in 17.7%.

CONCLUSION

Over 24 weeks of memantine treatment, most patients remained within their baseline Clinical Dementia Rating category, cognitive and neuropsychiatric scores showed small within-patient changes, caregiver burden increased, and tolerability was acceptable.