Study Compares Risk for Pneumonia with Various Antidementia Drugs

The rivastigmine patch and memantine are associated with an increased risk of pneumonia in patients with Alzheimer disease, according to a new analysis.

Although it is well known that patients with Alzheimer disease are highly susceptible to pneumonia, it is unclear whether antidementia treatments increase the risk.
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This is the first study to compare the risk of pneumonia associated with different antidementia drugs and drug forms.

To conduct their study, the researchers examined 65,481 patients from Finland who were diagnosed with Alzheimer disease from 2005 to 2011 and started monotherapy with an acetylcholinesterase inhibitor or memantine.

Cox analysis showed that patients using the rivastigmine patch (n=9709) and taking memantine (n=11,024) had a higher risk of pneumonia compared with those taking donepezil (n=26,416).

However, patients taking oral rivastigmine (n=7384) and galantamine (n=10,948) did not have an increased risk.

Results were consistent after adjusting for comorbid conditions and use of psychotropic drugs, and with inverse probability of treatment weighting.

“The increased risk of pneumonia in this fragile group of aged persons should be taken into account,” the researchers concluded. “Memantine is associated with the highest risk in the comparison of antidementia drugs.”

—Amanda Balbi

Reference:

Lampela P, Tolppanen A-M, Tanskanen A, et al. Use of antidementia drugs and risk of pneumonia in older persons with Alzheimer’s disease [published online October 27, 2016]. Ann Med. http://dx.doi.org/10.1080/07853890.2016.1254349.