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Efficacy of rivastigmine transdermal patch on activities of daily living: item responder analyses

Authors

Alva, Gustavo, Grossberg, George T., Schmitt, Frederick A., Meng, Xiangyi, Olin, Jason T.

Journal

International Journal Of Geriatric Psychiatry, Volume: 26, No.: 4, Pages.: 356-363

Year of Publication

2011

Abstract

Objective: In Alzheimer’s disease (AD), rivastigmine has demonstrated statistically significant efficacy versus placebo on cognition and activities of daily living (ADL). The aim of this retrospective analysis was to further evaluate the treatment effects of rivastigmine on individual ADL items.; Methods: This exploratory analysis focused on the Alzheimer’s Disease Cooperative Study Activities of Daily Living (ADCS-ADL) outcome from a large, international, 24-week, controlled trial of rivastigmine once-daily transdermal patch and twice-daily capsules in AD (CENA713D2320, NCT00099242). Percentages of patients “improving” or “not worsening” on individual ADL items were calculated and changes from baseline with rivastigmine versus placebo were evaluated.; Results: Patients received rivastigmine patch (9.5 mg/24 h; n = 247), capsule (12 mg/day; n = 254), and placebo (n = 281). Statistically significant changes from baseline in composite ADCS-ADL scores in both rivastigmine treatment groups versus placebo (p < 0.05) had previously been reported. In this responder analysis of the subset of patients who showed baseline functional impairments on each item, statistically significant differences favoring rivastigmine were seen on the following functions: bathing, clearing dishes, obtaining a beverage, garbage disposal, traveling, shopping, writing, using household appliances, and talking about current events. A responder analysis of emergence of ADL impairment was not as sensitive to treatment effects.; Conclusions: These findings suggest that rivastigmine may benefit specific ADL, particularly in patients who are already exhibiting functional impairment. Further research is required to improve understanding of how drugs such as rivastigmine exert their clinical effects.; Copyright © 2010 John Wiley & Sons, Ltd.

Bibtex Citation

@article{Alva_2011, doi = {10.1002/gps.2534}, url = {http://dx.doi.org/10.1002/gps.2534}, year = 2011, month = {mar}, publisher = {Wiley-Blackwell}, volume = {26}, number = {4}, pages = {356--363}, author = {Gustavo Alva and George T. Grossberg and Frederick A. Schmitt and Xiangyi Meng and Jason T. Olin}, title = {Efficacy of rivastigmine transdermal patch on activities of daily living: item responder analyses}, journal = {Int. J. Geriat. Psychiatry} }

Keywords

activities of daily living, administration & dosage, aged, aged, 80 and over, alzheimer disease, and, capsules, cholinesterase inhibitors, double-blind method, drug therapy, female, humans, male, middle aged, oncedaily, patch, phenylcarbamates, quality of life, retrospective studies, rivastigmine, therapeutic use, transdermal, transdermal patch, twicedaily

Countries of Study

USA

Types of Dementia

Alzheimer’s Disease

Types of Study

Randomised Controlled Trial

Type of Outcomes

ADLs/IADLs

Type of Interventions

Pharmaceutical Interventions

Pharmaceutical Interventions

Anti-Alzheimer medications, e.g.: donezepil, galantamine, rivastigmine, memantime