PMID- 15027039
OWN - NLM
STAT- MEDLINE
DCOM- 20040413
LR  - 20151119
IS  - 0885-6230 (Print)
IS  - 0885-6230 (Linking)
VI  - 19
IP  - 3
DP  - 2004 Mar
TI  - Efficacy of rivastigmine in subjects with moderately severe Alzheimer's disease.
PG  - 243-9
AB  - BACKGROUND: Cholinesterase (ChE) inhibitors are primarily used in the treatment 
      of mild to moderate Alzheimer's disease (AD), but may also be effective in more 
      severe disease. OBJECTIVE: To evaluate the dual ChE inhibitor, rivastigmine, in 
      more severe dementia. METHODS: We retrospectively analysed pooled data from three 
      randomised, placebo-controlled, double-blind, 6-month trials, involving 2126 AD 
      subjects. Subjects were selected according to baseline Mini-Mental State 
      Examination (MMSE) score to identify subjects with more severe cognitive 
      impairment (10-12 MMSE points). One-hundred-and-seventeen subjects were included 
      who had been treated with rivastigmine 6-12 mg/day or placebo. The AD Assessment 
      Scale-Cognitive Subscale (ADAS-Cog), the MMSE, a six-item subscore of the 
      Progressive Deterioration Scale (PDS) and the BEHAVE-AD assessed efficacy. 
      Tolerability was assessed by recording adverse events (AEs) and the relative risk 
      (RR) of discontinuation. RESULTS: This group of subjects responded well to 
      rivastigmine. After 6 months, the mean ADAS-Cog score declined by 6.3 points in 
      the placebo group and increased by 0.2 points in the rivastigmine group (observed 
      cases; p<0.001). Clinical benefits were also observed with the MMSE, the six-item 
      PDS score and items of the BEHAVE-AD. Rivastigmine showed the same pattern of AEs 
      as in other studies, but the RR of dropping out due to AEs was lower than in 
      subjects with milder AD. CONCLUSION: Current treatment guidelines do not 
      recommend treating individuals with severe AD with ChE inhibitors. However, this 
      retrospective analysis suggests that rivastigmine 6-12 mg/day may benefit 
      subjects with more severe disease, as well as subjects with mild to moderate 
      impairment.
CI  - Copyright 2004 John Wiley & Sons, Ltd.
FAU - Burns, A
AU  - Burns A
AD  - University of Manchester, Wythenshawe Hospital, Manchester, UK.
FAU - Spiegel, R
AU  - Spiegel R
FAU - Quarg, P
AU  - Quarg P
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - England
TA  - Int J Geriatr Psychiatry
JT  - International journal of geriatric psychiatry
JID - 8710629
RN  - 0 (Carbamates)
RN  - 0 (Cholinesterase Inhibitors)
RN  - 0 (Phenylcarbamates)
RN  - PKI06M3IW0 (Rivastigmine)
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Alzheimer Disease/*drug therapy
MH  - Carbamates/*administration & dosage/adverse effects
MH  - Cholinesterase Inhibitors/*administration & dosage/adverse effects
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Models, Statistical
MH  - Multicenter Studies as Topic
MH  - *Phenylcarbamates
MH  - Randomized Controlled Trials as Topic
MH  - Retrospective Studies
MH  - Rivastigmine
MH  - Treatment Outcome
EDAT- 2004/03/18 05:00
MHDA- 2004/04/14 05:00
CRDT- 2004/03/18 05:00
PHST- 2004/03/18 05:00 [pubmed]
PHST- 2004/04/14 05:00 [medline]
PHST- 2004/03/18 05:00 [entrez]
AID - 10.1002/gps.1058 [doi]
PST - ppublish
SO  - Int J Geriatr Psychiatry. 2004 Mar;19(3):243-9. doi: 10.1002/gps.1058.