Browsing by Subject "Rivastigmine"

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    Comparing Clinical Profiles in Alzheimer's Disease and Parkinson's Disease Dementia
    (Karger, 2013-09-11) Farlow, Martin R.; Schmitt, Frederick; Aarsland, Dag; Grossberg, George T.; Somogyi, Monique; Meng, Xiangyi; Neurology, School of Medicine
    Background: Greater understanding of differences in baseline impairment and disease progression in patients with Alzheimer's disease (AD) and Parkinson's disease dementia (PDD) may improve the interpretation of drug effects and the design of future studies. Methods: This was a retrospective analysis of three randomized, double-blind rivastigmine databases (one in PDD, two in AD). Impairment on the Alzheimer's Disease Assessment Scale-cognitive subscale (ADAS-cog), Alzheimer's Disease Cooperative Study-Activities of Daily Living (ADCS-ADL) scale, 10-item Neuropsychiatric Inventory (NPI-10) and the ADCS-Clinical Global Impression of Change (CGIC) was compared [standardized difference (Cohen's d), similar if <0.1]. Results: Patients with AD or PDD had similar levels of impairment on the ADAS-cog and NPI-10. Scores on the ADCS-ADL scale (standardized difference = 0.47) and the ADAS-cog memory domain (total, 0.33; items, 0.10-0.58) were higher in AD; PDD patients were more impaired in the language (0.23) and praxis (0.34) domains. AD patients receiving placebo showed greater deterioration on the ADAS-cog (0.14) and improvement on the NPI-10 (0.11) compared with patients with PDD. Conclusion: Differing patterns of impairment occur in AD and PDD.
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    Effects of Oral Rivastigmine on Cognitive Domains in Mild-to-Moderate Alzheimer’s Disease
    (Sage, 2010) Farlow, Martin R.; Cummings, Jeffrey L.; Olin, Jason T.; Meng, Xiangyi; Neurology, School of Medicine
    Rivastigmine has beneficial effects on cognitive functioning in Alzheimer's disease (AD). Effects of cholinesterase inhibitors, particularly rivastigmine, on AD Assessment Scale-cognitive subscale (ADAS-cog) domains and individual items have rarely been analyzed. Results from 4 randomized, double-blind, placebo-controlled, 26-week rivastigmine capsule trials in patients with mild-to-moderate AD were pooled and ADAS-cog domains and individual items were evaluated. Data were available from 878, 1053, and 863 patients in the 1 to 4 mg/d, 6 to 12 mg/d, and placebo groups, respectively. Rivastigmine-treated groups were superior to placebo on total ADAS-cog and memory domain scores (P < or = .0001). Rivastigmine 6 to 12 mg/d was also significantly better versus placebo on language (P < .001) and praxis (P < .001); greatest treatment responses were seen on memory items (P < .0001). Although rivastigmine was associated with dose-dependent improvements in all cognitive domains, largest effects were on memory items. Evaluation of ADAS-cog domain scores provides insight into test items most likely to respond to treatment.
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    Evaluating Response to High-Dose 13.3 mg/24 h Rivastigmine Patch in Patients with Severe Alzheimer's Disease
    (Wiley, 2015-06) Farlow, Martin R.; Sadowsky, Carl H.; Velting, Drew M.; Meng, Xiangyi; Islam, M. Zahur; Neurology, School of Medicine
    AIMS: To identify factors predicting improvement/stabilization on the Alzheimer's Disease Cooperative Study-Clinical Global Impression of Change (ADCS-CGIC) and investigate whether early treatment responses can predict long-term outcomes, during a trial of 13.3 mg/24 h versus 4.6 mg/24 h rivastigmine patch in patients with severe Alzheimer's disease (AD). METHODS: Logistic regression was used to relate Week 24 ADCS-CGIC score to potential baseline predictors. Additional analyses based on receiver-operating characteristic curves were performed using Week 8/16 ADCS-CGIC scores to predict response (13.3 mg/24 h patch) at Week 24. ADCS-CGIC score of (1) 1-3 = "improvement," (2) 1-4 = "improvement or no change". RESULTS: "Treatment" (13.3 mg/24 h patch) and increased age were significant predictors of "improvement" (P = 0.01 and P = 0.003, respectively), and "treatment" (P = 0.001), increased age (P = 0.002), and prior AD treatment (P = 0.03) for "improvement or no change". At Week 8 and 16, ADCS-CGIC scores of 4 and 5 were optimal thresholds in predicting "improvement," and "improvement or no change," respectively, at Week 24. CONCLUSIONS: A significant therapeutic effect of high-dose rivastigmine patch on ADCS-CGIC response was observed. The 13.3 mg/24 h patch was identified as a predictor of "improvement" or "improvement or no change". Patients with minimal worsening/improvement/no change after treatment initiation may be more likely to respond following long-term therapy.