Improvement in neuropsychological function with memantine treatment among patients with systemic lupus erythematosus: a phase 2 randomised placebo-controlled clinical trial.
Jillian P Rhoads, Lillian N Ahmad, Jonathan Williams et al.
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In 30 seconds
ClearMEMory was a multisite, phase 2 randomised, placebo-controlled trial assessing memantine for objective neuropsychological dysfunction in adults with systemic lupus erythematosus (SLE). Of 56 randomised participants, 43 completed the primary outcome assessment and were analysed. At 12 weeks, median improvement in the RBANS total score was +8 with memantine versus +5 with placebo (P = .032). The authors concluded that memantine improved objective neuropsychological function over the trial period.
Key findings
- Median RBANS total-score change at week 12 was +8 with memantine and +5 with placebo (P = .032).
- An RBANS increase ≥8 occurred in 12 (66.7%) memantine participants and 9 (36.0%) placebo participants (P = .047; number-needed-to-treat = 3.3).
- Self-reported improvement on the PGI-C was 61% with memantine and 36% with placebo (P = .19).
- Discontinuation due to adverse events occurred in 5 (19%) memantine participants and 5 (17%) placebo participants.
Why it matters
Neuropsychological dysfunction in SLE can persist despite immunomodulatory treatment and may be disabling. This trial provides controlled evidence that memantine was associated with greater short-term improvement on an objective cognitive measure than placebo, while also reporting patient-perceived change and adverse-event discontinuations. These outcomes help frame the potential benefit and tolerability of further evaluation.
What to keep in mind
The primary outcome analysis included 43 participants, fewer than the 56 randomised, and follow-up was limited to 12 weeks.