scott,
I've certainly never claimed that memantine is a groundbreaking advance. Likely all we can expect from it is that it substantially slows decline in AD, and we don't yet know the longevity of any gains.
However, it seems to me that memantine is showing good enough results to make it an approvable drug:
Efficacy endpoints included the Clinician's Interview-Based Impression of Change (NYU CIBIC-plus), Activities of Daily Living (modified ADCS-ADL Inventory), and cognitive performance (Severe Impairment Battery, SIB). For CIBIC-plus, a mean difference of 0.36 points (p = 0.025; N = 181) was found. For the ADL total score, the mean difference between treatment groups was 3.37 points (p = 0.003; N = 181). This was consistent with Memantine's effect on cognitive performance: for SIB total scores, a 5.70-point mean difference (p = 0.002; N = 179) was shown.
Can any of the claimed AD advances involving other neurotransmitter systems that you mention show comparable or better data? Not that I'm aware of.
Do you consider Aricept to be a groundbreaking drug? I'd say it was an advance, but certainly not a dramatic advance. It currently has annualized sales of some $800 million.
Basically I'm looking at the memantine results from an investment perspective. If their AIDS dementia study show similar results to the AD studies, then I believe NTII will do well. (And of course they will do even better if diabetic neuropathy results hold up).
Peter |
