Compared to other anti-dementia medications, memantine was associated with the highest risk of pneumonia, according to a recent study conducted by University of Finland researchers. Findings from the study are published in the Annals of Medicine.

Alzheimer’s disease patients have a higher risk of pneumonia but the specific risks associated with anti-dementia treatments are unknown. A group of researchers aimed to compare the risk of pneumonia with the use of donepezil, oral rivastigmine, transdermal rivastigmine, galantamine, and memantine.

Data from a nationwide cohort of community-dwelling individuals with Alzheimer’s disease in Finland during 2005–2011 who started monotherapy with acetylcholinesterase inhibitor or memantine (n=65,481) were included in the study. Using Cox proportional hazard models, study authors calculated the risk of hospitalization or death due to pneumonia.

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They found that patients using the rivastigmine patch (adjusted hazard ratio [HR] 1.15, 95% CI: 1.04–1.27) and memantine (HR 1.59, 95% CI: 1.48–1.71) had a greater risk of pneumonia compared to patients using donepezil. Use of oral rivastigmine (HR 1.08, 95% CI: 0.98–1.19) and galantamine (HR 0.91, 95% CI: 0.83–1.00) were not associated with an increased risk of pneumonia

Even after adjusting for comorbidities, use of psychotropic medications, or inverse probability of treatment weighting, the results did not change. 

The authors concluded that for this patient population, the increased risk of pneumonia should be considered when deciding on therapy. 

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