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. 2011 Sep;7(3):137-42.
doi: 10.3988/jcn.2011.7.3.137. Epub 2011 Sep 29.

Efficacy and safety of switching from oral cholinesterase inhibitors to the rivastigmine transdermal patch in patients with probable Alzheimer's disease

Hyun Jeong Han  1 , Jeong Ju Lee, Sun A Park, Hyun Young Park, Jeong Eun Kim, Young Soo Shim, Dong-Seok Shim, Eun-Joo Kim, Soo Jin Yoon, Seong Hye Choi
Affiliations

Efficacy and safety of switching from oral cholinesterase inhibitors to the rivastigmine transdermal patch in patients with probable Alzheimer's disease

Hyun Jeong Han et al. J Clin Neurol. 2011 Sep.

Abstract

Background and purpose: The goal of this study was to estimate the efficacy and safety of the rivastigmine transdermal patch in patients with probable Alzheimer's disease (AD) who cannot tolerate or do not respond to oral cholinesterase inhibitors (ChEIs).

Methods: A 24-week, prospective, open-label, single-arm, multicenter study was conducted from June 2009 to June 2010 in patients with probable AD. The enrolled patients had either a poor response or a decline in global function after treatment with oral ChEIs, or they were not able to tolerate treatment with oral ChEIs due to adverse events such as nausea or vomiting. A poor response was defined as a decrease of at least 2 points on the Korean version of the Mini-Mental State Examination (K-MMSE) within the previous 6 months (the decline in global function was determined by the investigator or caregiver). The efficacy of treatment was assessed using a follow-up Clinical Global Impression of Change (CGIC) assessment and K-MMSE conducted after 24 weeks, and safety was measured by the occurrence of adverse events and patient disposition.

Results: In total, 164 patients aged 74.7±7.52 years (mean±SD) and with 5.12±3.64 years of education were included. The study was completed by 70% of the patients (n=116), with 12.2% discontinuing due to adverse events. The most frequently reported adverse events (11%) were skin lesions, such as erythema or itching, followed by gastrointestinal problems (1.2%). Either an improvement or no decline in CGIC scores was reported for 82% of the patients.

Conclusions: The immediate switching of patients from an oral ChEI to the rivastigmine transdermal patch without a washout period was safe and well tolerated by the probable-AD patients in this study.

Keywords: Alzheimer's disease; cholinesterase inhibitors; efficacy; rivastigmine transdermal patch; safety.

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Conflict of interest statement

The authors have no financial conflicts of interest.

Figures

Fig. 1
Fig. 1
Study flowchart for patients with probable Alzheimer's disease.
Fig. 2
Fig. 2
Clinical Global Impression of Change (CGIC) scores at week 24 (n=116). 1: very much improved, 2: much improved, 3: slightly improved, 4: no change, 5: slightly worse, 6: much worse, 7: very much worse.
Fig. 3
Fig. 3
CGIC scores in the poor-responder (n=75) and adverse-events (n=41) groups at week 24. CGIC: Clinical Global Impression of Change.
See this image and copyright information in PMC

References

    1. Doody RS, Stevens JC, Beck C, Dubinsky RM, Kaye JA, Gwyther L, et al. Practice parameter: management of dementia (an evidence-based review). Report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology. 2001;56:1154–1166. - PubMed
    1. Ritchie CW, Ames D, Clayton T, Lai R. Metaanalysis of randomized trials of the efficacy and safety of donepezil, galantamine, and rivastigmine for the treatment of Alzheimer disease. Am J Geriatr Psychiatry. 2004;12:358–369. - PubMed
    1. Kaduszkiewicz H, Zimmermann T, Beck-Bornholdt HP, van den Bussche H. Cholinesterase inhibitors for patients with Alzheimer's disease: systematic review of randomised clinical trials. BMJ. 2005;331:321–327. - PMC - PubMed
    1. Imbimbo BP. Pharmacodynamic-tolerability relationships of cholinesterase inhibitors for Alzheimer's disease. CNS Drugs. 2001;15:375–390. - PubMed
    1. Inglis F. The tolerability and safety of cholinesterase inhibitors in the treatment of dementia. Int J Clin Pract Suppl. 2002:45–63. - PubMed