Drug Profile: Transdermal Rivastigmine Patch in the Treatment of Alzheimer Disease

Emre, Murat; Bernabei, Roberto; Blesa, Rafael; Bullock, Roger; Cunha, Luís; Daniels, H.; Dziadulewicz, Edward K.; Förstl, Hans; Frölich, Lutz; Gabryelewicz, Tomasz; Левин, О С; Lindesay, James; Martínez-Lage, Pablo; Monsch, Andreas U.; Tsolaki, Magda; Laar, Teus van

doi:10.1111/j.1755-5949.2010.00141.x

Cited by 28 publications

(23 citation statements)

References 33 publications

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“…Authors have alleged that, in general, patches would be advantageous for informal caregivers providing care at home [13,15,19,20,37,38,39]. However, in this study, almost every institutionalized patient received rivastigmine by transdermal route.…”

Section: Discussionmentioning

confidence: 83%

Transdermal Is Better than Oral: Observational Research of the Satisfaction of Caregivers of Patients with Alzheimer’s Disease Treated with Rivastigmine

Boada

Arranz²

2013

Dement Geriatr Cogn Disord

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Background and Aims: Poor adherence to anti-dementia drugs is common among patients with Alzheimer’s disease. This study evaluated whether caregivers were more satisfied with, and patients more adherent to, transdermal rivastigmine than oral rivastigmine. Methods: Neurologists, psychiatrists and geriatricians collected sociodemographic and clinical data from 1,078 patients and administered the Treatment Satisfaction with Medicines (SATMED-Q) and the Morisky-Green questionnaires to their caregivers at outpatient consultations. Results: Satisfaction reported was greater with transdermal than oral rivastigmine: mean ± SD of the total SATMED-Q score, 72.5 ± 14.1 vs. 65.2 ± 12.5, p < 0.001. The proportion of adherent patients was greater with transdermal than with oral rivastigmine (65.0 vs. 41.4%, p < 0.001). Satisfaction, in turn, was significantly greater in adherent cases than in nonadherent cases. Conclusions: Facilitating the administration of anti-dementia drugs would improve adherence.

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Section: Discussionmentioning

confidence: 83%

Transdermal Is Better than Oral: Observational Research of the Satisfaction of Caregivers of Patients with Alzheimer’s Disease Treated with Rivastigmine

Boada

Arranz²

2013

Dement Geriatr Cogn Disord

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“…Recently, for rivastigmine, a transdermal formulation (‘patch’) has been introduced [10]. Potential advantages were shown, such as improved drug delivery due to different pharmacokinetic features, and better tolerability [11,12,13]. The claim of ease of administration is particularly interesting regarding the caregiver burden.…”

Section: Introductionmentioning

confidence: 99%

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

Riedel¹,

Emmrich²,

Dodel³

et al. 2012

Dement Geriatr Cogn Disord Extra

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Background: Data on indirect effects of dementia treatment on caregiver burden obtained from naturalistic studies are still lacking. We explored differences between patients with oral and transdermal application of acetylcholine esterase inhibitors regarding caregiver’s time burden and psychopathology. Methods: A cross-sectional naturalistic cohort study of 403 patients in outpatient care with three treatment groups (none, oral, and transdermal) was conducted. Assessments included a standardized clinical burden questionnaire and a standardized caregiver interview. Results: Any treatment was associated with lower burden in most measures. Transdermal treatment was superior regarding (1) administration time (p < 0.001); (2) rates of administration problems (p = 0.031); (3) burden in activities of daily living (p = 0.008), and (4) caregiver anxiety (OR 0.25; 95% CI 0.05–0.99). Caregivers did not report better quality of life regarding mental/physical health. Physicians’ and caregivers’ ratings of patients’ improvements were not associated (ĸ = 0.01–0.06). Conclusions: Benefits associated with transdermal treatment do not translate into a better ‘generic quality of life’ of the caregiver. The substantially different perceptions of patients’ improvements need to be considered in future studies.

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“…This formulation provides smooth and continuous drug delivery through the skin and into the bloodstream, avoiding first‐pass effects in the gut and the liver 12 . The indication for rivastigmine transdermal patch is the symptomatic treatment of mild to moderate Alzheimer's dementia 13 . With this formulation, trough levels at steady state are approximately 50% of peak levels, in contrast to oral administration, with which concentrations fall off to virtually zero between doses.…”

Section: Introductionmentioning

confidence: 99%

Safety and tolerability of rivastigmine transdermal patch formulation in newly diagnosed patients with Alzheimer's dementia in naturalistic conditions

Pregelj

2012

Psychogeriatrics

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Aim: The majority of available data on safety and tolerability issues regarding cholinesterase inhibitors used for the treatment of Alzheimer's disease has been available for orally administered formulations. The objective of this prospective, 24 week, observational, non-interventional post-marketing surveillance study was to evaluate the safety and tolerability, as well as the efficacy, of the rivastigmine transdermal patch formulation in newly diagnosed patients with Alzheimer's dementia in naturalistic conditions. Methods: Safety and tolerability assessment included the monitoring and recording of adverse events and withdrawals at any time during the study. The efficacy parameter was determined based on the score of the MiniMental State Examination. Results: Out of the 433 patients, 11 patients (2.54%) suffered serious adverse events. Non-serious adverse events were reported in 179 patients (41.34%). As adverse event is defined as any untoward medical occurrence that may present during treatment with a pharmaceutical product but that does not necessarily have a causal relationship with this treatment. The most common adverse event in the present study was a decline in the Mini-Mental State Examination score in 97 patients (22.40%). The second most common non-serious adverse event was a skin reaction in 61 patients (14.09%). Treatment with rivastigmine continued in 139 cases (32.10%) and was discontinued in 40 cases (9.24%). The median Mini-Mental State Examination score observed at the time of inclusion was 21.0, and after 6 months, it was 22.0 (W 63441; P < 0.001). Because of several limitations, the open-label design of the present study necessitates caution when interpreting the results. Conclusions:The results of this study suggest that the rivastigmine transdermal patch is safe and tolerable for Alzheimer's dementia patients in naturalistic conditions.

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Drug Profile: Transdermal Rivastigmine Patch in the Treatment of Alzheimer Disease

Cited by 28 publications

References 33 publications

Transdermal Is Better than Oral: Observational Research of the Satisfaction of Caregivers of Patients with Alzheimer’s Disease Treated with Rivastigmine

Transdermal Is Better than Oral: Observational Research of the Satisfaction of Caregivers of Patients with Alzheimer’s Disease Treated with Rivastigmine

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

Safety and tolerability of rivastigmine transdermal patch formulation in newly diagnosed patients with Alzheimer's dementia in naturalistic conditions

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