Robert Howard, Rupert McShane, James Lindesay, Craig Ritchie, Ashley Baldwin, Robert Barber, Alistair Burns, Tom Dening, David Findlay, Clive Holmes, Robert Jones, Roy Jones, Ian McKeith, Ajay Macharouthu, John O'Brien, Bart Sheehan, Edmund Juszczak, Cornelius Katona, Robert Hills, Martin Knapp, Clive Ballard, Richard G Brown, Sube Banerjee, Jessica Adams, Tony Johnson, Peter Bentham, Patrick P J Phillips
BACKGROUND: Findings from observational studies have suggested a delay in nursing home placement with dementia drug treatment, but findings from a previous randomised trial of patients with mild-to-moderate Alzheimer's disease showed no effect. We investigated the effects of continuation or discontinuation of donepezil and starting of memantine on subsequent nursing home placement in patients with moderate-to-severe Alzheimer's disease. METHODS: In the randomised, double-blind, placebo-controlled Donepezil and Memantine in Moderate to Severe Alzheimer's Disease (DOMINO-AD) trial, community-living patients with moderate-to-severe Alzheimer's disease (who had been prescribed donepezil continuously for at least 3 months at a dose of 10 mg for at least the previous 6 weeks and had a score of between 5 and 13 on the Standardised Mini-Mental State Examination) were recruited from 15 secondary care memory centres in England and Scotland and randomly allocated to continue donepezil 10 mg per day without memantine, discontinue donepezil without memantine, discontinue donepezil and start memantine 20 mg per day, or continue donepezil 10 mg per day and start memantine 20 mg per day, for 52 weeks...
December 2015: Lancet Neurology