Alzheimer’s Disease: Differences of Transdermal versus Oral Treatment on Caregiving Time

Riedel, Oliver; Emmrich, A.; Dodel, Richard; Förstl, Hans; Maier, Wolfgang; Reichmann, Heinz; Wittchen, Hans‐Ulrich

doi:10.1159/000342929

Cited by 9 publications

(8 citation statements)

References 60 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Conversely, in patients taking RV-CP, there is a progressive deterioration of cognitive performance, together with a progressively greater difference compared with MMSE score in RV-TDP recipients. Our results confirm and extend previous studies showing the potential therapeutic advantage of TV-TDP vs RV-CP treatment ( Winblad et al, 2007 ; Riedel et al, 2012 ). The transdermal formulation of RV is a prolonged-release drug, which avoids fluctuations in blood concentrations of RV.…”

Section: Discussionsupporting

confidence: 92%

Comparison of the effects of transdermal and oral rivastigmine on cognitive function and EEG markers in patients with Alzheimerâ€™s disease

Moretti

Frisoni

Binetti

et al. 2014

Front. Aging Neurosci.

View full text Add to dashboard Cite

Background: Alzheimer’s disease (AD) is the most common cause of dementia in older patients. Rivastigmine (RV, Exelon, Novartis), a reversible cholinesterase inhibitor, improves clinical manifestations of AD and may enhance ACh-modulated electroencephalogram (EEG) alpha frequency. This pilot study aimed to determine the effects of two formulations of RV [transdermal patch (RV-TDP) and oral capsules (TV-CP)] on alpha frequency, in particular the posterior dominant rhythm, and cognitive function [assessed by the Mini-Mental State Examination (MMSE)] in patients with AD.Methods: Subjects with AD were assigned to receive either RV-TDP 10 cm2 or RV-CP 12 mg/day. All patients underwent EEG recordings at the beginning and end of the 18-month study period using P3, P4, O1, and O2 electrodes, each at high (10.5–13.0 Hz) and low (8.0–10.5 Hz) frequency. MMSE scores were determined at the start of the study (T0) and at three successive 6-month intervals (T1, T2, and T3).Results: RV-TDP administration (n = 10) maintained cognitive function as evidenced by stable MMSE scores from baseline to 18 months (21.07 ± 2.4–21.2 ± 3.1) compared with a decrease in MMSE score with RV-CP (n = 10) over 18 months [18.3 ± 3.6–13.6 ± 5.06 (adjusted for covariates p = 0.006)]. MMSE scores were significantly different between treatment groups from 6 months (p = 0.04). RV-TDP also increased the spectral power of alpha waves in the posterior region measured with electrode P3 in a significantly great percentage of patients than TV-CP from baseline to 18 months; 80% vs 30%, respectively [p = 0.025 (χ2 test)].Conclusions: RV-TDP was associated with a greater proportion of patients with increased posterior region alpha wave spectral power and significantly higher cognitive function at 18 months, compared with RV-CP treatment. Our findings suggest that RV-TDP provides an effective long-term management option in patients with AD compared with oral RV-CP. This study is a pilot, open-label study with a clear explorative purpose and with a small number of patients. Further randomized, double-blind, placebo-controlled trial studies with a bigger sample size as well as healthy controls are needed to support these initial results.

show abstract

Section: Discussionsupporting

confidence: 92%

Comparison of the effects of transdermal and oral rivastigmine on cognitive function and EEG markers in patients with Alzheimerâ€™s disease

Moretti

Frisoni

Binetti

et al. 2014

Front. Aging Neurosci.

View full text Add to dashboard Cite

show abstract

“…The design of the IDEA study has been described elsewhere in greater detail (Riedel et al 2012). Briefly, the study was conducted in two stages.…”

Section: Methodsmentioning

confidence: 99%

Overlooking Informal Dementia Caregivers' Burden

Riedel¹,

Wittchen²

2016

Research in Gerontological Nursing

View full text Add to dashboard Cite

Patients with Alzheimer's disease (AD) need early caregiver support. Caregivers often have poor health, but usually do not have time to seek medical advice for their own conditions. Patients' physicians, who are frequently the sole medical practitioner caregivers contact regularly, have an important function in recognizing family caregivers' burdens. The current study investigated to what extent medical practitioners recognized family caregivers' problems. In a two-staged survey in neurology outpatient care, caregivers of patients with mild or moderate AD were enrolled and assessed by physicians regarding their physical and mental burden, as well as need for help and advice about AD. Subsequently, caregivers' mental health was evaluated in a comprehensive diagnostic interview by blinded psychologists. Overall, 73.7% of caregivers had at least one somatic condition and 43.7% had clinically relevant depressive symptoms (of these, 37.5% met criteria for major depression). The findings suggest that the burden of a substantial proportion of affected family caregivers is overlooked. [Res Gerontol Nurs. 2016; 9(4):167-174.].

show abstract

“…It is therefore notable that, when questioned in this regard, most (e.g. [70 % [43,44]) caregivers have expressed a preference for patches over capsules [43][44][45][46]. Caregivers have also indicated a reduction in burden, in that patches interfere less with their daily activities [43][44][45][46].…”

Section: Place Of Rivastigmine 133 Mg/24 H Transdermal Patch In the mentioning

confidence: 99%

Rivastigmine Transdermal Patch 13.3 mg/24 h: A Review of Its Use in the Management of Mild to Moderate Alzheimer’s Dementia

Frampton¹

2014

Drugs Aging

View full text Add to dashboard Cite

Rivastigmine is unique among cholinesterase inhibitors commonly used in the treatment of mild to moderate Alzheimer's disease (AD) in that it is available as a transdermal patch formulation (Exelon(®) patch, Rivastach(®) patch, Prometax(®) patch). The patch is applied once daily and, in the EU (and US), is available in three sizes: 5, 10 and 15 cm(2) (releasing 4.6, 9.5 and 13.3 mg rivastigmine/24 h, respectively). In the phase III OPTIMA trial, patients with mild to moderate AD who experienced functional and cognitive decline on the 10 cm(2) patch-the recommended maintenance dose-gained additional benefit when their dose was increased to the 15 cm(2) patch. For example, 15 cm(2) patch recipients showed significantly less functional and cognitive decline than 10 cm(2) patch recipients after 24 weeks of double-blind treatment. Patients receiving the 15 cm(2) patch also showed significantly less functional, but not cognitive, decline than those receiving the 10 cm(2) patch after 48 weeks of double-blind treatment; as such, OPTIMA only met one of its two co-primary endpoints. The 15 cm(2) patch was generally well tolerated; although more 15 cm(2) than 10 cm(2) patch recipients reported adverse events (e.g. nausea and vomiting), fewer 15 cm(2) than 10 cm(2) patch recipients discontinued treatment due to adverse events. By further slowing functional deterioration without markedly compromising tolerability, increasing the transdermal rivastigmine dose to the 15 cm(2) patch has a favourable benefit-risk profile-and therefore represents a valid option-in the treatment of patients with mild to moderate AD who have previously experienced functional and cognitive decline while receiving the 10 cm(2) patch.

show abstract

Alzheimer’s Disease: Differences of Transdermal versus Oral Treatment on Caregiving Time

Cited by 9 publications

References 60 publications

Comparison of the effects of transdermal and oral rivastigmine on cognitive function and EEG markers in patients with Alzheimerâ€™s disease

Comparison of the effects of transdermal and oral rivastigmine on cognitive function and EEG markers in patients with Alzheimerâ€™s disease

Overlooking Informal Dementia Caregivers' Burden

Rivastigmine Transdermal Patch 13.3 mg/24 h: A Review of Its Use in the Management of Mild to Moderate Alzheimer’s Dementia

Contact Info

Product

Resources

About