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Three-year outcome of rivastigmine treatment in Alzheimer's disease in a routine clinical setting.

Wattmo, Carina LU ; Minthon, Lennart LU and Wallin, Åsa LU (2013) 11th International Conference on Alzheimer’s & Parkinson’s Diseases (AD/PD 2013)
Abstract
Objectives: Long-term, placebo-controlled studies of cholinesterase inhibitors (ChEIs) in Alzheimer’s disease (AD) are not permitted for ethical reasons. Therefore, the advancement of knowledge on longitudinal outcomes in different domains warrants well-designed naturalistic studies. The aim of this study was to explore the 3-year effectiveness of rivastigmine treatment. Methods: The Swedish Alzheimer Treatment Study (SATS) is a prospective, open, non-randomised, multicentre study evaluating ChEI therapy in clinical practice. In total, 269 outpatients with a clinical diagnosis of AD received rivastigmine. Patients were assessed using cognitive tests (MMSE, ADAS-cog), global performance (CIBIC) and instrumental ADL (IADL) at baseline, after... (More)
Objectives: Long-term, placebo-controlled studies of cholinesterase inhibitors (ChEIs) in Alzheimer’s disease (AD) are not permitted for ethical reasons. Therefore, the advancement of knowledge on longitudinal outcomes in different domains warrants well-designed naturalistic studies. The aim of this study was to explore the 3-year effectiveness of rivastigmine treatment. Methods: The Swedish Alzheimer Treatment Study (SATS) is a prospective, open, non-randomised, multicentre study evaluating ChEI therapy in clinical practice. In total, 269 outpatients with a clinical diagnosis of AD received rivastigmine. Patients were assessed using cognitive tests (MMSE, ADAS-cog), global performance (CIBIC) and instrumental ADL (IADL) at baseline, after 2 months and every 6 months for a total period of 3 years. The outcomes were compared with mathematical models of change in untreated AD patients or with historical controls. Results: After 3 years of rivastigmine treatment, the mean decline from baseline in MMSE score was 2.8 points (95% CI, 2.1–3.6); in ADAS-cog score, 5.7 points (3.7–7.7); and in IADL score, 6.2 points (5.2–7.2). This was better than expected compared with mathematical models and historical cohorts of untreated AD patients. Three-year completers (n = 117, 44%) received higher mean ± SD doses of rivastigmine than did drop-outs (7.2 ± 1.9 vs 5.5 ± 2.0 mg/day, p<0.001). Among the completers, 26% exhibited global improvement or were unchanged after 3 years of treatment. Conclusions: Long-term rivastigmine treatment in AD yielded positive cognitive, global and functional outcomes in the routine clinical setting. Completers of the 3-year study tolerated higher doses of rivastigmine better. (Less)
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Contribution to conference
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published
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conference name
11th International Conference on Alzheimer’s & Parkinson’s Diseases (AD/PD 2013)
language
English
LU publication?
yes
id
093db451-566c-4fef-93c2-7de4a86dfc21 (old id 4175580)
date added to LUP
2013-12-27 16:04:06
date last changed
2017-08-01 10:08:45
@misc{093db451-566c-4fef-93c2-7de4a86dfc21,
  abstract     = {Objectives: Long-term, placebo-controlled studies of cholinesterase inhibitors (ChEIs) in Alzheimer’s disease (AD) are not permitted for ethical reasons. Therefore, the advancement of knowledge on longitudinal outcomes in different domains warrants well-designed naturalistic studies. The aim of this study was to explore the 3-year effectiveness of rivastigmine treatment. Methods: The Swedish Alzheimer Treatment Study (SATS) is a prospective, open, non-randomised, multicentre study evaluating ChEI therapy in clinical practice. In total, 269 outpatients with a clinical diagnosis of AD received rivastigmine. Patients were assessed using cognitive tests (MMSE, ADAS-cog), global performance (CIBIC) and instrumental ADL (IADL) at baseline, after 2 months and every 6 months for a total period of 3 years. The outcomes were compared with mathematical models of change in untreated AD patients or with historical controls. Results: After 3 years of rivastigmine treatment, the mean decline from baseline in MMSE score was 2.8 points (95% CI, 2.1–3.6); in ADAS-cog score, 5.7 points (3.7–7.7); and in IADL score, 6.2 points (5.2–7.2). This was better than expected compared with mathematical models and historical cohorts of untreated AD patients. Three-year completers (n = 117, 44%) received higher mean ± SD doses of rivastigmine than did drop-outs (7.2 ± 1.9 vs 5.5 ± 2.0 mg/day, p&lt;0.001). Among the completers, 26% exhibited global improvement or were unchanged after 3 years of treatment. Conclusions: Long-term rivastigmine treatment in AD yielded positive cognitive, global and functional outcomes in the routine clinical setting. Completers of the 3-year study tolerated higher doses of rivastigmine better.},
  author       = {Wattmo, Carina and Minthon, Lennart and Wallin, Åsa},
  language     = {eng},
  title        = {Three-year outcome of rivastigmine treatment in Alzheimer's disease in a routine clinical setting.},
  year         = {2013},
}