Combining Donepezil & Memantine Extends Lives in Alzheimer’s

Alzheimer’s disease is the most prevalent neurological illness, affecting about 50 million individuals worldwide. Alzheimer’s disease is also one of the most deadly, being among the top five causes of mortality in the world. However, most current treatments are confined to relieving the disease’s symptoms.

A new study led by Chapman University researchers investigated the efficacy of combining two existing Alzheimer’s disease medications to minimize mortality. It is one of the largest and most comprehensive Alzheimer’s treatment trials to date.

The study, “Combine use of Donepezil and Memantine increases the probability of five-year survival of Alzheimer’s disease patients”, was released this month in Communications Medicine, finds that combining the use of the two most common Alzheimer’s disease drugs, Donepezil and Memantine, could extend the lives of approximately 303,000 people with Alzheimer’s Disease living in the USA beyond five years from diagnosis. The senior author is Cyril Rakovski, Professor and Program Director for the Faculty of Computational and Data Sciences.

The researchers analyzed anonymized medical data from 12,744 Alzheimer’s disease patients, focusing on those who received the three most common treatments: the acetylcholinesterase inhibitor Donepezil (28.94%), the NMDA receptor antagonist Memantine (10.7%), and the combination of Donepezil and Memantine (9.11%). Approximately half of the patients (45.54%) did not get any drug treatment, and this group served as the control. The researchers followed the patients’ progress five years later. They discovered that the mortality rates for patients who received no medication treatment, only Memantine, or alone Donepezil were 36%, 32%, and 42% higher than combined use, respectively.

The authors then used advanced statistical approaches to obtain unbiased estimates of treatment effects and assure the reliability of the data. With these analyses in place, they confirmed a significant, beneficial drug-drug interaction, indicating that combining Donepezil and Memantine significantly increased the probability of five-year survival of Alzheimer’s disease patients compared to no drug use and Memantine and Donepezil alone. In specifically, compared to no medication use, taking Memantine and Donepezil together raised the likelihood of five-year survival by 0.05 (6.4%).

The research underscores the importance of the combined treatment, suggesting it can extend patients’ lives and reduce medical costs. This comprehensive causal inference study, using a large, high-quality medical database, provides strong evidence for adopting the combined treatment approach to improve patient outcomes and healthcare efficiency.”

Dr. Ehsan Yaghmaei, lead author

Dr. Yaghmaei and colleagues at Chapman University worked with researchers from UNC Chapel Hill’s School of Medicine, the Children’s Hospital of Orange County (CHOC), and UC Irvine’s School of Medicine.

The findings highlight the significance of reevaluating present Alzheimer’s disease treatment methods, and they offer optimism that this new standard of care will benefit the millions of people impacted by this awful disease.