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Roshini Claire Anthony, 20 Aug 2019

The combination of emtricitabine and dolutegravir with either a tenofovir alafenamide fumarate (TAF) or tenofovir disoproxil fumarate (TDF)-based regimen fared similarly to a TDF-emtricitabine-efavirenz regimen in reducing HIV-1 RNA levels, according to results of the phase III ADVANCE* study presented at IAS 2019.

Memantine of no benefit in glaucoma treatment

13 Sep 2018

Long-term treatment with memantine is well tolerated but does not effectively prevent glaucomatous progression in patients with open-angle glaucoma (OAG), according to the results of two phase III trials.

The overall population comprised 2,298 bilateral OAG patients with glaucomatous optic disc damage and visual field loss in one eye, intraocular pressure (IOP) 21 mm Hg, and high-risk of progression. The two trials followed the same protocol, wherein patients were randomized to receive memantine 20 mg (n=974) or 10 mg (n=664) or placebo (n=660) tablets daily for 48 months.

The predefined primary efficacy measure was glaucomatous visual field progression, as assessed using full-threshold standard automated perimetry (SAP). Other efficacy measures were glaucomatous progression of visual field (measured using frequency doubling technology [FDT]) and optic nerve damage (evaluated using stereoscopic optic disc photographs). Safety evaluations included adverse events (AEs), best-corrected visual acuity (BVCA), biomicroscopy, IOP and ophthalmoscopy.

Compared with placebo, use of memantine for 48 months did not delay glaucomatous progression significantly in the individual studies and pooled analyses. The pooled risk reduction ratio for SAP-assessed progression was −0.13 (95 percent CI, −0.40 to 0.09) with the 10-mg dose and −0.17 (−0.46 to 0.07) with the 20-mg dose. Similar results were obtained per FDT and stereoscopic optic disc photographs.

Memantine was well tolerated, and dizziness was the most frequently reported AE. Changes in biomicroscopy and ophthalmoscopy findings with ≥1 severity grade increase, BVCA, mean IOP, and average central corneal thickness were comparable among the three treatment groups.

An uncompetitive N-methyl-D-aspartate (NMDA) receptor antagonist, memantine is currently approved in several countries for the treatment of moderate to severe Alzheimer’s and Parkinson’s diseases. The drug can inhibit overstimulation of the NMDA receptor and potentially provide neuroprotection by preventing excessive calcium influx, the investigators said.

However, pooled results of visual field and optic disc analyses from the two trials revealed no consistent or beneficial effects of memantine in OAG based on ophthalmic assessments from the two trials, they added.

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Most Read Articles
21 Aug 2019
Daily use of the selective oral Bruton’s tyrosine kinase inhibitor evobrutinib in the treatment of patients with relapsing multiple sclerosis helps reduce the number of gadolinium-enhancing lesions, according to the results of a phase II trial.
20 Aug 2019
The combination of pravastatin and sorafenib does not appear to improve survival in patients with hepatocellular carcinoma (HCC), a recent study has shown.
08 Jul 2017
Entecavir and lamivudine demonstrate comparable effects on the mortality rate of patients with chronic hepatitis B virus (HBV)-related acute exacerbation with or without acute-on-chronic liver failure (ACLF), reports a study. In patients with ACLF, however, entecavir delivers a more favourable long-term outcome and is associated with greater clinical improvements.
Roshini Claire Anthony, 20 Aug 2019

The combination of emtricitabine and dolutegravir with either a tenofovir alafenamide fumarate (TAF) or tenofovir disoproxil fumarate (TDF)-based regimen fared similarly to a TDF-emtricitabine-efavirenz regimen in reducing HIV-1 RNA levels, according to results of the phase III ADVANCE* study presented at IAS 2019.