Clin Psychopharmacol Neurosci.
2021 Aug;19(3):459-469. 10.9758/cpn.2021.19.3.459.
Real-world Evaluation of Tolerability, Safety and Efficacy of Rivastigmine Oral Solution in Patients with Mild to Moderate Alzheimer’s Disease Dementia
- Affiliations
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- 1Department of Neurology, Kaohsiung Municipal Siao-Gang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
- 2Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
- 3Neuroscience Research Center, Kaohsiung Medical University, Kaohsiung, Taiwan.
- 4Department of Neurology, China Medical University Hsinchu Hospital, Taichung, Taiwan.
- 5Department of Neurology, China Medical University Hospital, Taichung, Taiwan.
- 6School of Medicine, China Medical University, Taichung, Taiwan.
- 7Department of Neurology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.
- 8Department of Neurology, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
- 9Department of Neurology, Changhua Christian Hospital, Changhua, Taiwan.
- 10Department of Holistic Wellness, Ming Dao University, Changhua, Taiwan.
- 11Department of Neurology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
- 12Department of and Master's Program in Neurology, Faculty of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
- 13Chinese Mentality Protection Association, Kaohsiung, Taiwan.
- KMID: 2519554
- DOI: http://doi.org/10.9758/cpn.2021.19.3.459
Abstract
Objective
The purpose of this study is to investigate the safety, tolerability and efficacy of titrating dose of rivastigmine oral solution in patients with mild to moderate Alzheimer’s disease (AD) in Taiwan.
Methods
We recruited 108 mild to moderate AD patients with RivastⓇ (rivastigmine oral solution 2 mg/ml) treatment for 52 weeks. We recorded the demographic characteristics, initial cognition by mini-mental state examination (MMSE), initial global status by clinical dementia rating (CDR) with CDR-Sum of Boxes (CDR-SB), initial dose, and titrating dose at each visit. We investigated the adherence, proportion of possible side effects, optimal dose, and time to optimal dose. We demonstrated the proportion of cognitive decline and its possible risk factors.
Results
During the course, 9 patients discontinued the rivastigmine oral solution due to poor compliance or preference. Twelve out of 99 patients (12.1%) reported possible side effects. Among 87 patients, the mean age was 77.2 ± 9.0 years ago with female predominant (65.2%). The optimal dose was 3.6 ± 1.4 ml in average and 4 ml (n = 31, 35.6%) in mode. The duration to optimal dose was 12.5 ± 10.2 weeks and 24 weeks (n = 35, 40.2%) in mode. It presented 25% with cognitive decline in MMSE, 27% with global function decline in CDR and 63% with global function decline in CDR-SB.
Conclusion
We demonstrated the clinical experience of rivastigmine oral solution in mild to moderate AD patients. It suggested rivastigmine oral solution 4ml is the optimal dose with 24 weeks to the optimal dose for at least one third of patients.
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