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KMID : 1130620110070030137
Journal of Clinical Neurology
2011 Volume.7 No. 3 p.137 ~ p.142
Efficacy and Safety of Switching from Oral Cholinesterase Inhibitors to the Rivastigmine Transdermal Patch in Patients with Probable Alzheimer¡¯s Disease
Han Hyun-Jeong

Lee Jeong-Ju
Park Sun-A.
Park Hyun-Young
Kim Jeong-Eun
Shim Young-Soo
Shim Dong-Seok
Kim Eun-Joo
Yoon Soo-Jin
Choi Seong-Hye
Abstract
Background and Purpose: The goal of this study was to estimate the efficacy and safety of the rivastigmine transdermal patch in patients with probable Alzheimer¡¯s disease (AD) who cannot tolerate or do not respond to oral cholinesterase inhibitors (ChEIs).

Methods: A 24-week, prospective, open-label, single-arm, multicenter study was conducted from June 2009 to June 2010 in patients with probable AD. The enrolled patients had either a poor response or a decline in global function after treatment with oral ChEIs, or they were not able to tolerate treatment with oral ChEIs due to adverse events such as nausea or vomiting. A poor response was defined as a decrease of at least 2 points on the Korean version of the Mini-Mental State Examination (K-MMSE) within the previous 6 months (the decline in global function was determined by the investigator or caregiver). The efficacy of treatment was assessed using a follow-up Clinical Global Impression of Change (CGIC) assessment and K-MMSE conducted after 24 weeks, and safety was measured by the occurrence of adverse events and patient disposition.

Results: In total, 164 patients aged 74.7¡¾7.52 years (mean¡¾SD) and with 5.12¡¾3.64 years of education were included. The study was completed by 70% of the patients (n=116), with 12.2% discontinuing due to adverse events. The most frequently reported adverse events (11%) were skin lesions, such as erythema or itching, followed by gastrointestinal problems (1.2%). Either an improvement or no decline in CGIC scores was reported for 82% of the patients.

Conclusions: The immediate switching of patients from an oral ChEI to the rivastigmine transdermal patch without a washout period was safe and well tolerated by the probable-AD patients in this study.
KEYWORD
cholinesterase inhibitors, rivastigmine transdermal patch, efficacy, safety, Alzheimer¡¯s disease
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