PMID- 22536070
OWN - NLM
STAT- PubMed-not-MEDLINE
DCOM- 20120823
LR  - 20211021
IS  - 1178-2021 (Electronic)
IS  - 1176-6328 (Print)
IS  - 1176-6328 (Linking)
VI  - 8
DP  - 2012
TI  - Effectiveness and tolerability of transdermal rivastigmine in the treatment of 
      Alzheimer's disease in daily practice.
PG  - 141-7
LID - 10.2147/NDT.S29116 [doi]
AB  - BACKGROUND: Oral cholinesterase inhibitors at doses efficacious for the treatment 
      of Alzheimer's disease (AD) are often prematurely discontinued due to 
      gastrointestinal side effects. In controlled clinical trials, transdermal 
      rivastigmine demonstrated less such effects at similar efficacy. The current 
      study aimed to verify the validity of this data in daily practice. 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. RESULTS: 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 (DeltaMMSE, 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). 
      CONCLUSION: Results were in line with data from controlled clinical trials. 
      Switching from any other oral acetylcholinesterase inhibitor to transdermal 
      rivastigmine may improve cognition.
FAU - Seibert, Johannes
AU  - Seibert J
AD  - Outpatient Clinic, Heidelberg, Germany.
FAU - Tracik, Ferenc
AU  - Tracik F
FAU - Articus, Konstantin
AU  - Articus K
FAU - Spittler, Stefan
AU  - Spittler S
LA  - eng
PT  - Journal Article
DEP - 20120405
PL  - New Zealand
TA  - Neuropsychiatr Dis Treat
JT  - Neuropsychiatric disease and treatment
JID - 101240304
PMC - PMC3333784
OTO - NOTNLM
OT  - Alzheimer's disease
OT  - rivastigmine patch
OT  - treatment practice
EDAT- 2012/04/27 06:00
MHDA- 2012/04/27 06:01
PMCR- 2012/04/05
CRDT- 2012/04/27 06:00
PHST- 2012/04/27 06:00 [entrez]
PHST- 2012/04/27 06:00 [pubmed]
PHST- 2012/04/27 06:01 [medline]
PHST- 2012/04/05 00:00 [pmc-release]
AID - ndt-8-141 [pii]
AID - 10.2147/NDT.S29116 [doi]
PST - ppublish
SO  - Neuropsychiatr Dis Treat. 2012;8:141-7. doi: 10.2147/NDT.S29116. Epub 2012 Apr 5.