Abstract
Alzheimer’s disease (AD) patients treated with rivastigmine transdermal patch have shown statistically significant differences versus placebo on the AD Assessment scale-cognitive subscale (ADAS-cog). In this retrospective analysis of a double-blind, placebo- and active-controlled, 24-week clinical trial, the specific effects of rivastigmine patch on individual ADAS-cog items and cognitive domains (memory, language, and praxis) were explored. The mean baseline to week 24 changes were calculated for each ADAS-cog item and domain in this exploratory, hypothesis-generating analysis. Patients on 9.5 mg/24 h rivastigmine patch, 17.4 mg/24 h rivastigmine patch, and 3 to 12 mg/d rivastigmine capsules showed improvements over placebo on the memory and praxis ADAS-cog subscales. The rivastigmine patch groups also showed improvements on the language subscale. Significant differences versus placebo were seen on several individual item scores in the rivastigmine-treated groups. Rivastigmine patch was associated with improvements on the memory, praxis, and language domains of cognition in patients with mild-to-moderate AD.
Keywords: Alzheimer’s disease, cognition, rivastigmine, transdermal patch
Full Text
The Full Text of this article is available as a PDF (230.3 KB).
Contributor Information
George T. Grossberg, St Louis University School of Medicine, St Louis, MO, USA, Grossbgt@slu.edu .
Frederick A. Schmitt, Sanders-Brown Center on Aging, Lexington, KY, USA.
Xiangyi Meng, Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA.
Sibel Tekin, Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA.
Jason Olin, Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA.
References
- Rosen WG, Mohs RC, Davis KL A new rating scale for Alzheimer’s disease. Am J Psychiatry . 1984;141(11):1356-1364. [DOI] [PubMed] [Google Scholar]
- Winblad B., Brodaty H., Gauthier S., et al. Pharmacotherapy of Alzheimer’s disease: is there a need to redefine treatment success? Int J Geriatr Psychiatry. 2001;16(7):653-666. [DOI] [PubMed] [Google Scholar]
- Olin JT, Schneider LS Assessing response to tacrine using the factor analytic structure of the Alzheimer’s Disease Assessment Scale (ADAS)-cognitive subscale. Int J Geriatr Psychiatry. 1995;10(9):753-756. [Google Scholar]
- Weyer G., Erzigkeit H., Kanowski S., Ihl R., Hadler D. Alzheimer’s Disease Assessment Scale: reliability and validity in a multicenter clinical trial. Int Psychogeriatr. 1997;9(2):123-138. [DOI] [PubMed] [Google Scholar]
- Winblad B., Cummings J., Andreasen N., et al. A six-month double-blind, randomized, placebo-controlled study of a transdermal patch in Alzheimer’s disease-rivastigmine patch versus capsule. Int J Geriatr Psychiatry. 2007;22(5):456-467. [DOI] [PubMed] [Google Scholar]
- Rösler M. , Anand R., Cicin-Sain A., et al. Efficacy and safety of rivastigmine in patients with Alzheimer’s disease: international randomised controlled trial. BMJ. 1999;318(7184): 633-638. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Corey-Bloom J. , Anand R., Veach J. A randomized trial evaluating the efficacy and safety of ENA 713 (rivastigmine tartrate), a new acetylcholinesterase inhibitor, in patients with mild to moderately severe Alzheimer’s disease . Int J Geriatr Psychopharmacol. 1998;1(5):55-65. [Google Scholar]
- Schneider LS , Anand R., Farlow MR Systematic review of the efficacy of rivastigmine for patients with Alzheimer’s disease. Int J Geriatr Psychopharmacol. 1998;1(1):S26-S34. [Google Scholar]
- Poirier J. Evidence that the clinical effects of cholinesterase inhibitors are related to potency and targeting of action. Int J Clin Pract. 2002;127(1):6-19. [PubMed] [Google Scholar]
- Venneri A., Shanks MF, Staff RT, et al. Cerebral blood flow and cognitive responses to rivastigmine treatment in Alzheimer’s disease. Neuroreport. 2002;13(1):83-87. [DOI] [PubMed] [Google Scholar]
- Adler G., Brassen S. Short-term rivastigmine treatment reduces EEG slow-wave power in Alzheimer patients. Neuropsychobiology. 2001;43(4):273-276. [DOI] [PubMed] [Google Scholar]
- Nordberg A. , Darreh-Shori T., Svensson A., Guan Z. Acetylcholinesterase (AChE) and butyrylcholinesterase (BuChE) activities in CSF of mild AD patients following 12 months of rivastigmine treatment. J Neurol Sci. 2001;187(1):P0144. [Google Scholar]
- Bullock R., Lane R. Executive dyscontrol in dementia, with emphasis on subcortical pathology and the role of butyrylcholinesterase. Curr Alzheimer Res. 2007;4(3):277-293. [DOI] [PubMed] [Google Scholar]
- American Psychiatric Association. 1994. Diagnostic and Statistical Manual of Mental Disorders, 4th edition. American Psychiatric Association: Washington, DC. [Google Scholar]
- McKhann G., Drachman D., Folstein M., Katzman R., Price D., Stadlan EM Clinical diagnosis of Alzheimer’s disease: report of the NINCDS-ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer’s disease. Neurology. 1984;34(7):939-944. [DOI] [PubMed] [Google Scholar]
- Folstein MF , Folstein SE, McHugh PR ‘‘Mini-mental state’’. A practical method for grading the cognitive state of patients for the clinician . J Psychiatr Res. 1975;12(3):189-198. [DOI] [PubMed] [Google Scholar]
- Farlow M., Cummings JL, Olin JT, Meng X. Effects of oral rivastigmine on cognitive domains in mild to moderate Alzheimer’s disease. Am J Alzheimers Dis Other Demen. 2010. April 14 [Epub ahead of print]. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Kurz A., Farlow M., Lefevre G. Pharmacokinetics of a novel transdermal rivastigmine patch for the treatment of Alzheimer’s disease: a review. Int J Clin Pract. 2009;63(5):799-805. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Small G., Dubois B. A review of compliance to treatment in Alzheimer’s disease: potential benefits of a transdermal patch. Curr Med Res Opin. 2007;23(11):2705-2713. [DOI] [PubMed] [Google Scholar]