Effectiveness and tolerability of transdermal rivastigmine in the treatment of Alzheimer’s disease in daily practice Full Text
Neuropsychiatric Disease and Treatment, 04/24/2012
Seibert J et al. – Results were in line with data from controlled clinical trials. Switching from any other oral acetylcholinesterase inhibitor to transdermal rivastigmine may improve cognition.Methods
- This was a prospective, multicenter, observational study on transdermal rivastigmine in Germany.
- Eligible patients were those with AD who had not yet been treated with rivastigmine.
- Outcome measures were changes in clock-drawing test, Mini-Mental State Examination (MMSE), Caregiver Burden Scale, Clinical Global Impression (CGI), physicians’ assessments of tolerability, and the incidence of adverse events (AEs) over 4 months of treatment.
- In 257 centers 1113 patients were enrolled; 614 women and 499 men, mean age 76.5 years.
- In 58% of patients AD was treated for the first time and in 42% therapy was switched to transdermal rivastigmine, mostly due to lack of tolerability (13.6%) or effectiveness (26.9%).
- After 4 months, 67.4% of patients were on the target dose of 9.5 mg/day and 21.8% were still on 4.6 mg/day.
- MMSE significantly improved in patients with and without pretreatment (ΔMMSE, 0.9 ± 3.4 and 0.8 ± 3.4, respectively, both P < 0.001); the CGI score improved in 60.9% and 61.3% of patients, respectively.
- Overall 11.7% of patients had AEs, mainly affecting the skin or the gastrointestinal tract; in 1.1% of cases AEs were serious; 14.7% of patients discontinued therapy, 6.0% due to AEs.
- With rivastigmine treatment the percentage of patients taking psychotropic comedication decreased, particularly in first-time treated rivastigmine patients (from 27.1% to 22.6%; P < 0.001).