PMID- 25394739
OWN - NLM
STAT- MEDLINE
DCOM- 20160115
LR  - 20181113
IS  - 1590-3478 (Electronic)
IS  - 1590-1874 (Linking)
VI  - 36
IP  - 3
DP  - 2015 Mar
TI  - Effectiveness of switching to the rivastigmine transdermal patch from oral 
      cholinesterase inhibitors: a naturalistic prospective study in Alzheimer's 
      disease.
PG  - 457-63
LID - 10.1007/s10072-014-2002-3 [doi]
AB  - Oral donepezil and rivastigmine are two commonly used cholinesterase inhibitors 
      (ChEIs) used in Alzheimer's disease (AD). The rivastigmine transdermal patch 
      formulation has high tolerability profile, allowing patients to achieve optimal 
      therapeutic doses and providing potential advantages over oral ChEIs. This is a 
      6-month, multicentre, observational efficacy and tolerability study of switching 
      from oral ChEIs to rivastigmine patch in AD patients who failed to show benefit 
      from previous treatment. The reasons of the switch were: (1) lack/loss of benefit 
      from previous oral ChEI treatment; (2) tolerability problems. The primary outcome 
      was cognitive changes measured with the mini-mental state examination (MMSE) 
      test. Secondary outcomes were modifications of functional independence and 
      behavioral disturbances and occurrence of adverse events (AEs) after switching. 
      174 patients, over 180 patients screened, entered the study (lack/loss of 
      efficacy: 57 %, tolerability problems: 33 %, both reasons: 10 %). 6 months after 
      switching 56 % of patients stabilized or increased the MMSE score respect to 
      baseline. The only predictor of this outcome was the response at 3 months. In the 
      group with lack/loss of response to oral ChEI, the decline of the MMSE score 
      changed from -3.4 +/- 2.5 points in the 6 months before switching to -0.5 +/- 3.2 in 
      the 6 months after the switch (p < 0.001). There were no significant changes in 
      the IADL or NPI scores. Drug discontinuation rate was 20 %, due to AEs (18 %) and 
      lack of compliance (2 %). Switching from an unsuccessful oral ChEI therapy to 
      rivastigmine patch is effective and safe in more than half of the switched 
      patients after a 6-month period.
FAU - Cagnin, Annachiara
AU  - Cagnin A
AD  - Department of Neurosciences SNPSRR, University of Padova Medical School, Via 
      Giustiniani 5, 35128, Padova, Italy, annachiara.cagnin@unipd.it.
FAU - Cester, Alberto
AU  - Cester A
FAU - Costa, Bruno
AU  - Costa B
FAU - Ermani, Mario
AU  - Ermani M
FAU - Gabelli, Carlo
AU  - Gabelli C
FAU - Gambina, Giuseppe
AU  - Gambina G
CN  - SWITCH study working group
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PT  - Observational Study
PT  - Research Support, Non-U.S. Gov't
DEP - 20141114
PL  - Italy
TA  - Neurol Sci
JT  - Neurological sciences : official journal of the Italian Neurological Society and 
      of the Italian Society of Clinical Neurophysiology
JID - 100959175
RN  - 0 (Cholinesterase Inhibitors)
RN  - PKI06M3IW0 (Rivastigmine)
SB  - IM
MH  - Administration, Cutaneous
MH  - Administration, Oral
MH  - Aged
MH  - Aged, 80 and over
MH  - Alzheimer Disease/*drug therapy
MH  - Cholinesterase Inhibitors/administration & dosage/adverse effects/*therapeutic 
      use
MH  - Female
MH  - Humans
MH  - Male
MH  - Neuropsychological Tests
MH  - Rivastigmine/administration & dosage/adverse effects/*therapeutic use
MH  - Transdermal Patch
MH  - Treatment Outcome
EDAT- 2014/11/15 06:00
MHDA- 2016/01/16 06:00
CRDT- 2014/11/15 06:00
PHST- 2014/08/13 00:00 [received]
PHST- 2014/11/01 00:00 [accepted]
PHST- 2014/11/15 06:00 [entrez]
PHST- 2014/11/15 06:00 [pubmed]
PHST- 2016/01/16 06:00 [medline]
AID - 10.1007/s10072-014-2002-3 [doi]
PST - ppublish
SO  - Neurol Sci. 2015 Mar;36(3):457-63. doi: 10.1007/s10072-014-2002-3. Epub 2014 Nov 
      14.