Abstract | BACKGROUND: OBJECTIVE: METHODS: We retrospectively analysed pooled data from three randomised, placebo-controlled, double-blind, 6-month trials, involving 2126 AD subjects. Subjects were selected according to baseline Mini-Mental State Examination (MMSE) score to identify subjects with more severe cognitive impairment (10-12 MMSE points). One-hundred-and-seventeen subjects were included who had been treated with rivastigmine 6-12 mg/day or placebo. The AD Assessment Scale-Cognitive Subscale (ADAS-Cog), the MMSE, a six-item subscore of the Progressive Deterioration Scale (PDS) and the BEHAVE-AD assessed efficacy. Tolerability was assessed by recording adverse events (AEs) and the relative risk (RR) of discontinuation. RESULTS: This group of subjects responded well to rivastigmine. After 6 months, the mean ADAS-Cog score declined by 6.3 points in the placebo group and increased by 0.2 points in the rivastigmine group (observed cases; p<0.001). Clinical benefits were also observed with the MMSE, the six-item PDS score and items of the BEHAVE-AD. Rivastigmine showed the same pattern of AEs as in other studies, but the RR of dropping out due to AEs was lower than in subjects with milder AD. CONCLUSION: Current treatment guidelines do not recommend treating individuals with severe AD with ChE inhibitors. However, this retrospective analysis suggests that rivastigmine 6-12 mg/day may benefit subjects with more severe disease, as well as subjects with mild to moderate impairment.
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Authors | A Burns, R Spiegel, P Quarg |
Journal | International journal of geriatric psychiatry
(Int J Geriatr Psychiatry)
Vol. 19
Issue 3
Pg. 243-9
(Mar 2004)
ISSN: 0885-6230 [Print] England |
PMID | 15027039
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Copyright | Copyright 2004 John Wiley & Sons, Ltd. |
Chemical References |
- Carbamates
- Cholinesterase Inhibitors
- Phenylcarbamates
- Rivastigmine
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Topics |
- Aged
- Aged, 80 and over
- Alzheimer Disease
(drug therapy)
- Carbamates
(administration & dosage, adverse effects)
- Cholinesterase Inhibitors
(administration & dosage, adverse effects)
- Female
- Humans
- Male
- Middle Aged
- Models, Statistical
- Multicenter Studies as Topic
- Phenylcarbamates
- Randomized Controlled Trials as Topic
- Retrospective Studies
- Rivastigmine
- Treatment Outcome
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