Page 11 - Drug Class Review

Final Report Update 1 Drug Effectiveness Review Project

patients, in reality, may not be significantly better than they were when they started treatment, but have
demonstrated slower deterioration than patients in the other study groups.

As equipotency among the reviewed antidementia drugs is not well established, we assume that dose
comparisons made within the recommended daily dosing range are comparable (Table 1). Dose

comparisons made outside the recommended daily dosing range are acknowledged in our report, but we
do not use them to determine the quality of the evidence. Furthermore, we evaluate studies that assess

only initial treatment with these drugs as independent agents; we do not consider the issue of switching
from a ChEI to memantine or vice versa. Although some clinicians may use a combination of drugs in
clinical practice, we do not specifically consider combination therapy in this report. However, because

combination therapy has been addressed by at least one clinical trial, we contrast this trial with other
available evidence.

Considerations governing our work on key question 1 and 2 (i.e., dose equivalency, operational
definitions) pertain as well (as appropriate) to key questions 3 and 4.

Alzheimer's Drugs Page 11 of 205