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Chang CC, Chan L, Chou HH, Yang YW, Chen TF, Chen TB, Chen CI, Yang A, Hu CJ. Effectiveness of the 10 cm 2 Rivastigmine Patch in Taiwanese Patients with Mild-to-Moderate Alzheimer's Dementia: A 48-Week Real-World Observational Study. Adv Ther 2021; 38:5286-5301. [PMID: 34506009 PMCID: PMC8478746 DOI: 10.1007/s12325-021-01893-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 08/11/2021] [Indexed: 11/28/2022]
Abstract
Introduction The current study aimed to provide data on the effectiveness of the 10 cm2 rivastigmine patch in patients with Alzheimer’s disease (AD) in a real-world setting in Taiwan. Methods This was a 48-week, single-arm, open-label, observational, and post-marketing study conducted across seven centers in Taiwan between May 5, 2016 and July 10, 2017. Eligible patients (aged 55–95 years) treated with the 10 cm2rivastigmine patch were enrolled based on physicians’ judgment and according to the Taiwan reimbursement criteria of the drug. Data were prospectively collected at Week 0 (baseline), Week 24, and Week 48. The primary endpoint was the change in the cognitive assessment screening instrument (CASI) scores at Week 48 versus baseline. The changes from baseline in clinical dementia rating (CDR), mini-mental state examination (MMSE), and neuropsychiatric inventory (NPI) scores were evaluated, as were treatment persistence and the safety profile. Results Of the 285 eligible patients [full analysis set (FAS)], 216 (75.8%) completed the study protocol while 180 (63.2%) persisted on the 10 cm2 rivastigmine patch for the full 48 weeks. At baseline, 89.8% of patients had a CDR score of 0.5 or 1, while the change in CDR score at Week 48 was not significant. In the FAS, both the CASI and MMSE scores had numerical improvement at Week 24 but declined by 2.1 and 0.4 points, respectively, at Week 48 (p = 0.005 and p = 0.022). The increment in NPI scores was not significant. The most common drug-related adverse events (AEs) were pruritus (11.2%), nausea (3.5%), rash (3.2%), and vomiting (2.8%). Conclusions The use of the 10 cm2 rivastigmine patch in the mild stage of AD maintained cognitive function at Week 24 and neuropsychiatric function at Week 48. The treatment persistency and safety profile support the clinical tolerability of the rivastigmine patch in the management of mild-to-moderate AD in Taiwan. Supplementary Information The online version contains supplementary material available at 10.1007/s12325-021-01893-6.
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Affiliation(s)
- Chiung-Chih Chang
- Department of Neurology, Institute for Translational Research in Biomedicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Lung Chan
- Department of Neurology and Dementia Center, Shung Ho Hospital, School of Medicine, College of Medicine, Taipei Medical University, New Taipei, Taiwan
| | - Hsi-Hsien Chou
- Department of Neurology, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Yu-Wan Yang
- Department of Neurology, China Medical University Hospital, Taichung, Taiwan
| | - Ta-Fu Chen
- Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan
| | - Ting-Bin Chen
- Department of Neurology, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Chin-I Chen
- Department of Neurology, Wan Fang Hospital, Taipei, Taiwan
| | | | - Chaur-Jong Hu
- Department of Neurology and Dementia Center, Shung Ho Hospital, School of Medicine, College of Medicine, Taipei Medical University, New Taipei, Taiwan.
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Lai SH, Tsoi T, Tang CT, Hui RJY, Tan KK, Yeo YWS, Kua EH. An integrated, collaborative healthcare model for the early diagnosis and management of dementia: Preliminary audit results from the first transdisciplinary service integrating family medicine and geriatric psychiatry services to the heart of patients' homes. BMC Psychiatry 2019; 19:61. [PMID: 30736756 PMCID: PMC6368696 DOI: 10.1186/s12888-019-2033-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Accepted: 01/21/2019] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND The number of dementia cases is expected to rise exponentially over the years in many parts of the world. Collaborative healthcare partnerships are envisaged as a solution to this problem. Primary care physicians form the vanguard of early detection of dementia and influence clinical care that these patients receive. However, evidence suggests that they will benefit from closer support from specialist services in dementia care. An interdisciplinary, collaborative memory clinic was established in 2012 as a collaborative effort between a large family medicine based service and a specialist geriatric psychiatry service in Singapore. It is the first service in the world that integrates a family medicine based service with geriatric psychiatry expertise in conjunction with community-based partnerships in an effort to provide holistic, integrated care right into the heart of patients' homes as well as training in dementia care for family medicine physicians. We describe our model of care and the preliminary findings of our audit on the results of this new model of care. METHODS This was a retrospective audit done on the electronic medical records of all patients seen at the Memory Clinic in Choa Chu Kang Polyclinic from August 2013 to March 2016. The information collected included gender, referral source, patient trajectories, presence of behavioural and psychological symptoms of dementia and percentage of caregivers found to be in need of support. A detailed outline of the service workflow and processes were described. RESULTS A majority (93.5%) of the patients had their memory problems managed at the memory clinic without escalation to other specialist services. 22.7% of patients presented with behavioural and psychological symptoms of dementia. When initially assessed, a majority (82.2%) of patients' caregivers were found to be in need of support with 99.5% of such caregivers' needs addressed with memory clinic services. CONCLUSION Our model of care has the potential to shape future dementia care in Singapore and other countries with a similar healthcare setting. Redesigning and evolving healthcare services to promote close collaboration between primary care practitioners and specialist services for dementia care can facilitate seamless delivery of care for the benefit of patients.
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Affiliation(s)
- Shan Hui Lai
- Choa Chu Kang Polyclinic, National University Polyclinics, 2 Teck Whye Crescent #01-00, Singapore, 688846 Singapore
| | - Tung Tsoi
- Department of Psychological Medicine, National University Hospital, NUHS Tower Block Level 9, 1E, Kent Ridge Road, 119228 Singapore
| | - Chao Tian Tang
- National Healthcare Group(NHG) National Psychiatry Residency Programme, 3 Fusionopolis Link #03-08, Nexus@one-north, Singapore, 138543 Singapore
| | - Richard Jor Yeong Hui
- Choa Chu Kang Polyclinic, National University Polyclinics, 2 Teck Whye Crescent #01-00, Singapore, 688846 Singapore
| | - Kim Kiat Tan
- Choa Chu Kang Polyclinic, National University Polyclinics, 2 Teck Whye Crescent #01-00, Singapore, 688846 Singapore
| | - Yehudi Wee Shung Yeo
- Choa Chu Kang Polyclinic, National University Polyclinics, 2 Teck Whye Crescent #01-00, Singapore, 688846 Singapore
| | - Ee Heok Kua
- Choa Chu Kang Polyclinic, National University Polyclinics, 2 Teck Whye Crescent #01-00, Singapore, 688846 Singapore
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Khoury R, Rajamanickam J, Grossberg GT. An update on the safety of current therapies for Alzheimer's disease: focus on rivastigmine. Ther Adv Drug Saf 2018; 9:171-178. [PMID: 29492246 DOI: 10.1177/2042098617750555] [Citation(s) in RCA: 76] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2017] [Accepted: 12/06/2017] [Indexed: 01/05/2023] Open
Abstract
Alzheimer's disease (AD) is the most common cause of major neurocognitive disorders worldwide. Despite all research efforts, therapeutic options for AD are still limited to two drug classes: cholinesterase inhibitors (ChEIs) and the NMDA-receptor antagonist memantine. Donepezil, rivastigmine and galantamine are the three ChEIs FDA-approved as first-line treatment for AD. Although they share the same mode of action, they differ in terms of their pharmacologic characteristics and route of administration, which can impact their safety and tolerability profile. Rivastigmine, available in both oral and transdermal patch formulations, is a slowly reversible dual inhibitor of acetyl and butyryl cholinesterase, selective for the G1 isoform of acetylcholinesterase, without hepatic metabolism by the CYP-450 system. Despite its unique features, it has been associated with a higher incidence of adverse events in comparison to other ChEIs. The oral form, approved for the treatment of mild to moderate AD, is associated with a higher incidence of gastrointestinal side effects. The transdermal patch formulation approved for use across all stages of AD has been shown to have a better tolerability profile in comparison to both the oral form and even other ChEIs. One important tolerability concern is adverse dermatologic reactions, which are mostly benign, and can be either preventable or manageable. One important safety concern is the risk of treatment overdose by administering multiple patches at the same time, potentially leading to fatal outcomes. This can be prevented by educating patients and caregivers about the proper use of the patch. The goal for the future would be to optimize the patch formulation to increase both efficacy and safety.
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Affiliation(s)
- Rita Khoury
- Division of Geriatric Psychiatry, St. Louis University School of Medicine, 1438 S Grand Blvd, St. Louis, MO 63104, USA
| | - Jayashree Rajamanickam
- Division of Geriatric Psychiatry, St. Louis University School of Medicine, St. Louis, MO, USA
| | - George T Grossberg
- Division of Geriatric Psychiatry, St. Louis University School of Medicine, St. Louis, MO, USA
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Mohammad D, Chan P, Bradley J, Lanctôt K, Herrmann N. Acetylcholinesterase inhibitors for treating dementia symptoms - a safety evaluation. Expert Opin Drug Saf 2017; 16:1009-1019. [PMID: 28678552 DOI: 10.1080/14740338.2017.1351540] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
INTRODUCTION The prevalence of Alzheimer's disease (AD) continues to rise, while treatment options for cognitive impairment are limited. Acetylcholinesterase inhibitors (AChEIs) aim to provide symptomatic benefit for cognitive decline, however these drugs are not without adverse events (AEs). The safety profile of each drug must be taken carefully into consideration before being prescribed, as new dosages and formulations have recently been approved. Areas covered: Donepezil, galantamine and rivastigmine are the three AChEIs approved for the treatment of varying stages of AD. Numerous clinical trials and post-marketing studies have evaluated the safety of these medications. This article will review the safety, efficacy and tolerability of these drugs in treating AD. Topics including pharmacovigilance databases, concomitant drug interactions, prescribing cascades, and treatment discontinuation are also covered. Expert opinion: AChEI use in those with mild, moderate or severe AD provide modest improvements in cognition, function and behavior. The pharmacological treatment of AD using AChEIs is associated with generally mild AEs. Differences in drug formulations should be taken into account when determining the most appropriate route of administration for each individual. Furthermore, discontinuation of AChEIs must be carefully monitored as it may be associated with worsening cognitive impairment.
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Affiliation(s)
- Dana Mohammad
- a Department of Pharmacology and Toxicology , University of Toronto , Toronto , ON , Canada.,b Neuropsychopharmacology Research Group, Hurvitz Brain Sciences Program , Sunnybrook Research Institute , Toronto , ON , Canada
| | - Parco Chan
- a Department of Pharmacology and Toxicology , University of Toronto , Toronto , ON , Canada.,b Neuropsychopharmacology Research Group, Hurvitz Brain Sciences Program , Sunnybrook Research Institute , Toronto , ON , Canada
| | - Janelle Bradley
- b Neuropsychopharmacology Research Group, Hurvitz Brain Sciences Program , Sunnybrook Research Institute , Toronto , ON , Canada
| | - Krista Lanctôt
- a Department of Pharmacology and Toxicology , University of Toronto , Toronto , ON , Canada.,b Neuropsychopharmacology Research Group, Hurvitz Brain Sciences Program , Sunnybrook Research Institute , Toronto , ON , Canada.,c Department of Psychiatry , University of Toronto , Toronto , ON , Canada
| | - Nathan Herrmann
- b Neuropsychopharmacology Research Group, Hurvitz Brain Sciences Program , Sunnybrook Research Institute , Toronto , ON , Canada.,c Department of Psychiatry , University of Toronto , Toronto , ON , Canada
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Lee KJ, Cho SJ, Kim BC, Park M, Lee JH. Caregiver Preference and Treatment Compliance in Patients with Mild-to-Moderate Alzheimer's Disease in South Korea: RECAP Study Results. Adv Ther 2017; 34:481-494. [PMID: 28000168 DOI: 10.1007/s12325-016-0465-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2016] [Indexed: 10/20/2022]
Abstract
INTRODUCTION The aim of this study was to assess caregiver preference and treatment compliance with oral and transdermal medications in a "real-world" setting in patients with mild-to-moderate Alzheimer's disease (AD) in South Korea. METHODS Real-world evaluation of compliance and preference in Alzheimer's disease treatment (RECAP) was a 24-week, multicenter, prospective, non-interventional study in patients with AD treated with oral or transdermal therapy. Here, we report data from patients living in South Korea. Eligible patients were grouped into one of two treatment cohorts: oral (donepezil, galantamine, rivastigmine, or memantine) or transdermal (rivastigmine patch). Caregiver preference, patient compliance, and physician preference were assessed at week 24 (end of the study). Safety was assessed by reported adverse events (AEs). RESULTS A total of 398 patients were enrolled (oral 51.8%; transdermal 48.2%) and 79.4% completed the study. Caregivers of patients that were exposed to either the oral or transdermal monotherapy showed a preference for the treatment to which the patients were exposed (both p < 0.0001). However, caregivers of patients that were exposed to both forms of treatments reported a higher preference for transdermal monotherapy (65.9%; p < 0.0041). Patients in both treatment cohorts showed good compliance, with an overall mean (SD) score of 8.84 (1.514) (a median of 9). Of the 15 participating physicians, eight indicated their preference for transdermal therapy and seven preferred oral therapy at week 24. A total of 133 (33.4%) patients reported at least one AE during the study period (oral: 60 patients; transdermal: 73 patients). CONCLUSION The study showed higher caregiver preference for transdermal monotherapy over oral monotherapy when patients with AD were exposed to both forms of treatment and good patient compliance for both oral and transdermal treatments.
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Deardorff WJ, Grossberg GT. Pharmacotherapeutic strategies in the treatment of severe Alzheimer's disease. Expert Opin Pharmacother 2016; 17:1789-800. [PMID: 27450461 DOI: 10.1080/14656566.2016.1215431] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
INTRODUCTION Alzheimer's disease (AD) is a slowly progressive neurodegenerative disease. Patients with severe AD often require assistance with daily functioning and have a substantially higher probability of admission to nursing homes compared to the general population. AREAS COVERED Medications approved by the US Food and Drug Administration for the treatment of severe AD include the cholinesterase inhibitors (ChEIs), donepezil (10 and 23 mg/day) and rivastigmine (transdermal patch, 13.3 mg/24 hours), and the N-methyl-D-aspartate receptor antagonist memantine (immediate- and extended-release formulations). This article will review the efficacy, safety, and tolerability data of these agents in the treatment of severe AD. Issues related to combination therapy, neuropsychiatric symptoms, and treatment discontinuation are also discussed. EXPERT OPINION AD therapeutics provide benefits on measures of cognition, functioning, behavior, and global status even in the severe stages of AD. Combination therapy with memantine and ChEIs may provide additive benefits compared with ChEI monotherapy. Decisions regarding discontinuation of these medications should be made on a case-by-case basis, with some evidence suggesting that discontinuation may worsen cognition and functional impairment. It is recommended that patients entering the terminal stages of AD discontinue all medications not necessary for comfort.
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Affiliation(s)
| | - George T Grossberg
- a Department of Psychiatry , St. Louis University School of Medicine , St Louis , MO , USA
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Nieto RA, Deardorff WJ, Grossberg GT. Efficacy of rivastigmine tartrate, transdermal system, in Alzheimer’s disease. Expert Opin Pharmacother 2016; 17:861-70. [DOI: 10.1517/14656566.2016.1159296] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Lai TH, Wang WF, Yip BS, Yang YW, Peng GS, Tsai SJ, Liao YC, Pai MC. Real-world evaluation of compliance and preference in Alzheimer's disease treatment: an observational study in Taiwan. Patient Prefer Adherence 2016; 10:383-90. [PMID: 27099476 PMCID: PMC4821393 DOI: 10.2147/ppa.s95271] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
PURPOSE Among the medications approved for Alzheimer's disease (AD), rivastigmine is the only one available as transdermal patch. The aim of this study was to evaluate compliance and caregivers' preference with oral and transdermal (rivastigmine) monotherapy in patients with mild-to-moderate AD from Taiwan. METHODS Real-world Evaluation of Compliance And Preference in Alzheimer's disease treatment (RECAP) in Taiwan was a prospective, noninterventional, observational study with a 24-week (±8 weeks) observational period for each participant. Eligible patients were grouped into one of the two treatment cohorts based on the baseline AD therapy: oral (donepezil, galantamine, rivastigmine, or memantine) or transdermal (rivastigmine patch). The primary end points were caregiver preference and caregiver assessment of patients' compliance to the current medication (oral or transdermal medication) at Week 24 (end of the study). Safety was assessed by recording any adverse events. RESULTS A total of 301 patients (age: 77.6±7.19 years) were enrolled from nine centers in Taiwan, of whom 138 (45.8%) patients were in the transdermal monotherapy cohort. Caregivers of patients who were exposed to both forms of therapies demonstrated a higher preference for transdermal rivastigmine monotherapy than the oral monotherapy (82.4% [n=61] versus 17.6% [n=13], P<0.0001); for patients treated with only one therapy, the caregivers' preference was significantly in favor of the treatment to which the patient was exposed (both P<0.0001). In both cohorts, patients showed good compliance, with an overall score of 8.65±1.38 on an 11-point scale. Of 301 enrolled patients, 102 (33.9%) reported at least one adverse event during the study (51 patients each in the two cohorts). CONCLUSION With the higher caregiver preference and a good patient compliance, the trans-dermal rivastigmine patch is a suitable treatment choice for patients with mild-to-moderate AD, especially for patients intolerant to oral therapies.
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Affiliation(s)
- Tzu-Hsien Lai
- Section of Neurology, Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei, Taiwan
- Department of Neurology, National Yang-Ming University School of Medicine, Taipei, Taiwan
| | - Wen-Fu Wang
- Department of Neurology, Changhua Christian Hospital, Changhua, Taiwan
| | - Bak-Sau Yip
- Department of Neurology, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu, Taiwan
| | - Yu-Wan Yang
- Department of Neurology, China Medical University Hospital, Taichung, Taiwan
| | - Giia-Sheun Peng
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Shih-Jei Tsai
- Department of Neurology, Chung Shan Medical University Hospital, Taichung, Taiwan
- School of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Yi-Chu Liao
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Ming-Chyi Pai
- Division of Behavioral Neurology, Department of Neurology, College of Medicine, National Cheng Kung University, Tainan City, Taiwan
- Alzheimer’s Disease Research Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan City, Taiwan
- Correspondence: Ming-Chyi Pai, Division of Behavioral Neurology, Department of Neurology and Alzheimer’s Disease Research Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138 Sheng-Li Road, North District, Tainan City 70428, Taiwan, Tel +886 6 235 3535 extn 5534, Fax +886 6 208 8036, Email
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Pai MC, Aref H, Bassil N, Kandiah N, Lee JH, Srinivasan AV, diTommaso S, Yuksel O. Real-world evaluation of compliance and preference in Alzheimer's disease treatment. Clin Interv Aging 2015; 10:1779-87. [PMID: 26622172 PMCID: PMC4639476 DOI: 10.2147/cia.s85319] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Purpose Rivastigmine transdermal patch has shown higher caregiver satisfaction and greater preference than oral formulation in patients with Alzheimer’s disease. However, there is limited literature available related to caregiver preference or treatment compliance in real-world clinical settings. To date, no such data are available from Asia and the Middle East, which account for a sizeable proportion of patients with Alzheimer’s disease. The objective of this study was to evaluate treatment preference and compliance with oral and transdermal medications in daily clinical practice in an ethnically diverse patient population from Asia and the Middle East with mild-to-moderate Alzheimer’s disease. Patients and methods RECAP (Real-world Evaluation of Compliance And Preference in the treatment of Alzheimer’s disease) was a 24-week, multicenter, prospective, noninterventional study. Two treatment cohorts were observed during the study: oral (cholinesterase inhibitors or memantine) and transdermal (rivastigmine patch). Caregiver preference, physician preference, and patient compliance were evaluated at week 24. Results A total of 978 of 1,931 enrolled patients (mean age: 72.8 years; 50.5% female) were in the transdermal cohort. For patients with exposure to both oral and transdermal monotherapy (n=330), a significant caregivers’ preference for the transdermal monotherapy was observed (82.7%; P<0.0001). Of the 89 participating physicians, 71 indicated preference for transdermal monotherapy. Patient compliance was also significantly higher for transdermal than oral monotherapy (P<0.0001). Conclusion Our study showed higher caregiver and physician preference and greater patient compliance with transdermal monotherapy in daily practice.
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Affiliation(s)
- Ming-Chyi Pai
- Division of Behavioral Neurology, Department of Neurology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan City, Taiwan ; Alzheimer's Disease Research Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan City, Taiwan
| | - Hany Aref
- Department of Neurology, Ain Shams University, Cairo, Egypt
| | - Nazem Bassil
- Saint Georges Hospital Medical Center, Balamand University, Beirut, Lebanon
| | - Nagaendran Kandiah
- Department of Neurology, National Neuroscience Institute, Tan Tock Seng Hospital, Singapore
| | - Jae-Hong Lee
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Songpa-gu, Seoul, South Korea
| | - A V Srinivasan
- The Tamil Nadu Dr MGR Medical University, Chennai, Tamil Nadu, India
| | | | - Ozgur Yuksel
- Novartis Pharma AG, Postfach, Basel, Switzerland
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Stevens JR, Justin Coffey M, Fojtik M, Kurtz K, Stern TA. The Use of Transdermal Therapeutic Systems in Psychiatric Care: A Primer on Patches. PSYCHOSOMATICS 2015. [DOI: 10.1016/j.psym.2015.03.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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Factors Influencing Skin Tolerability to the Rivastigmine Patch in Patients with Alzheimer's Disease. Dement Neurocogn Disord 2015. [DOI: 10.12779/dnd.2015.14.1.31] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Amanatkar HR, Grossberg GT. Transdermal rivastigmine in the treatment of Alzheimer’s disease: current and future directions. Expert Rev Neurother 2014; 14:1119-25. [DOI: 10.1586/14737175.2014.955852] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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Xie Y, Yang W, Chen X, Xiao J. Inhibition of flavonoids on acetylcholine esterase: binding and structure–activity relationship. Food Funct 2014; 5:2582-9. [PMID: 25143139 DOI: 10.1039/c4fo00287c] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Hydroxyl groups on the aromatic rings of flavonoids are favorable for inhibiting AChE, and the hydroxylation increases the affinities for AChE. However, methoxylation may decrease or increase the activities depending on the class of flavonoids.
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Affiliation(s)
- Yixi Xie
- School of Chemistry and Chemical Engineering
- Central South University
- Changsha 410083, China
| | - Weijie Yang
- School of Chemistry and Chemical Engineering
- Central South University
- Changsha 410083, China
| | - Xiaoqing Chen
- School of Chemistry and Chemical Engineering
- Central South University
- Changsha 410083, China
| | - Jianbo Xiao
- College of Life and Environmental Science
- Shanghai Normal University
- Shanghai 200235, China
- Institut für Pharmazie und Lebensmittelchemie
- Universität Würzburg
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