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Memantine combinations and use

a technology of memantine and combination, applied in the field of brain hypocholinergic disorder treatment of patients, can solve the problem of not being able to achieve the general accepted rationale for any symptomatic benefit gained by combining these drugs

Inactive Publication Date: 2019-09-05
CHASE PHARMA CORP
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  • Summary
  • Abstract
  • Description
  • Claims
  • Application Information

AI Technical Summary

Benefits of technology

This combination therapy significantly improves cognitive symptoms in patients with moderate to severe Alzheimer's disease by allowing higher donepezil doses without cholinergic side effects, demonstrating a synergistic effect greater than additive improvements.

Problems solved by technology

However, results from some randomized controlled trials in patients with moderate to severe AD have failed to show that the combination of donepezil plus memantine confers significant efficacy advantages over donepezil alone, regardless of whether donepezil was given at the standard 10 mg / day or the 23 mg / day dose (Porsteinsson A P, Grossberg G T, Mintzer J, Olin J T; Memantine MEM-MD-12 Study Group, “Memantine treatment in patients with mild to moderate Alzheimer's disease already receiving a cholinesterase inhibitor: a randomized, double-blind, placebo-controlled trial”, Curr Alzheimer Res. 2008 February; 5(1):83-9; Doody R S, Geldmacher D S, Farlow M R, Sun Y, Moline M, Mackell J, “Efficacy and safety of donepezil 23 mg versus donepezil 10 mg for moderate-to-severe Alzheimer's disease: a subgroup analysis in patients already taking or not taking memantine”, Dement Geriatr Cogn Disord.
Moreover, there is no generally accepted rationale for any symptomatic benefit gained by combining these drugs.
Thus, to date, there is scant experimental support for this view and thus no basis to expect a synergistic or additive effect of memantine on cholinergic function.

Method used

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Examples

Experimental program
Comparison scheme
Effect test

example 1

[0785]Patients with moderate Alzheimer's disease were enrolled in a clinical trial to examine the efficacy of high doses of donepezil (enabled by the concomitant administration of solifenacin) with or without memantine. The dose of solifenacin was fixed throughout the trial at 15 mg / day. The dose of donepezil was titrated up to 40 mg per day, or to highest tolerated dose, whichever came first. To be enrolled, patients had to have been treated with donepezil 10 mg per day for at least 12 weeks. Concomitant use of memantine was allowed, provided patients were treated with a stable dose of memantine for at least 8 weeks prior to enrollment, and providing the dose of memantine remained stable throughout the trial.

[0786]A total of 26 evaluable patients were enrolled in the study, 11 males and 15 females, mean age 74+8 years, and mean weight 74+18 kg. A total of 15 patients were on concomitant memantine upon study entry and remained on the same dose of memantine throughout the study.

[0787...

example 2

[0791]As a further approach to the result of the clinical trial of Example 1, after discarding the two best and the two worst responses to treatment of the patients with and without memantine, it was observed as follows.

No Memantine Co-Treatment:

[0792]Case 1. An 88 year old woman with a baseline MMSE score of 20 declined cognitively by 1.33 ADAS-cog points.

Case 2. An 80 year old woman with a baseline MMSE score of 18 declined by 3.65 points.

Case 3. A 57 year old man with a baseline MMSE score of 20 declined by 4.33 points.

Case 4. A 74 year old woman with a baseline MMSE score of 19 declined by 3.67 points

Memantine Co-Treated:

[0793]Case 1. A 63 year old man with a baseline MMSE score of 12 improved by −5.66 points.

case 2

woman with a baseline MMSE score of 16 improved by −7.33 points at her maximum tolerated dose of 25 mg / day donepezil.

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Abstract

A pharmaceutical combination of memantine and a non-anticholinergic antiemetic agent for the treatment of hypocholinergic disorders in further combination with high doses of donepezil and with solifenacin, and kits comprising said combination. A pharmaceutical combination of memantine and solifenacin for the treatment of hypocholinergic disorders, including Alzheimer type dementia, in further combination with high doses of donepezil, and kits comprising said combination.

Description

CROSS-REFERENCE TO RELATED APPLICATIONS[0001]This application claims priority benefit of U.S. Provisional Patent Application Ser. No. 62 / 414,359 filed Oct. 28, 2016, U.S. Provisional Patent Application Ser. No. 62 / 424,085 filed Nov. 18, 2016, and U.S. Provisional Patent Application Ser. No. 62 / 423,999 filed Nov. 18, 2016; the disclosures of which are herein incorporated by reference in their entirety.FIELD OF THE INVENTION[0002]This invention pertains to the field of the treatment of patients suffering from a hypocholinergic disorder in the brain such as Alzheimer disease, Lewy body disease, Parkinson's disease, and related disorders in humans. The invention provides a combination of memantine with a non-anticholinergic antiemetic agent (naAEA) to be safely administered to a patient suffering from a hypocholinergic disorder in further combination with donepezil high doses and solifenacin, thus inducing neuroprotection in said patient. The invention also provides a combination of mem...

Claims

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Application Information

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Patent Type & Authority Applications(United States)
IPC IPC(8): A61K31/13A61K31/473A61K31/496A61K31/445A61P25/28
CPCA61K31/473A61K9/0053A61K31/445A61P25/28A61K31/496A61K31/13A61K45/06A61K31/4178A61K2300/00A61K31/4725
Inventor CLARENCE-SMITH, KATHLEEN E.CHASE, THOMAS N.
Owner CHASE PHARMA CORP
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