[Rivastigmine for Alzheimer disease; evaluation of preliminary results and of structured assessment of efficacy].
OBJECTIVE
Evaluation of the initial experiences with rivastigmine in Alzheimer's disease.


METHODS
Retrospective.


METHODS
Data were collected from patients with Alzheimer's disease who were treated with rivastigmine between 1 October 1998-30 November 1999 at the Memory Disorders Outpatients Clinic at the Academic Medical Centre or the Slotervaart Hospital, both in Amsterdam, the Netherlands. Before, and 6 months after treatment, the course of the disease was evaluated using clinimetric scales relating to cognitive functions, behavioural abnormalities and instrumental daily functions. The treatment results were considered to be 'favourable' if they corresponded with a disease course seen in less than 10% of untreated Alzheimer patients.


RESULTS
During the study period, 53 patients were treated, 36 women and 17 men, with a mean age of 77 years (range: 57-89). Follow-up data were incomplete for four patients. Of the remaining patients, 27 (55%; 95% CI: 40-69) withdrew from treatment during the first 6 months, mainly because of gastrointestinal side-effects. Of the other 22 patients (45%; 31-60) 18 continued with rivastigmine treatment (18/49 = 37%; 23-52), and in three of these patients the disease course was favourable (3/49 = 6%; 1-17).


CONCLUSIONS
In daily practice, over 50% of the patients were unable to tolerate rivastigmine. Structured evaluation of treatment efficacy was feasible in this population. Treatment with rivastigmine seemed to be beneficial in a small proportion of the patients.
Richard
E
E
Afd. Neurologie, Academisch Medisch Centrum, Meibergdreef 9, 1105 AZ Amsterdam.
Walstra
G J
GJ
van Campen
J
J
Vissers
E
E
van Gool
W A
WA
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000188:drug therapy*; D002219:Carbamates / Q000009:adverse effects / Q000627:therapeutic use*; D002800:Cholinesterase Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018696:Neuroprotective Agents / Q000627:therapeutic use*; D010352:Patient Dropouts; D048448:Phenylcarbamates; D011569:Psychiatric Status Rating Scales; D012189:Retrospective Studies; D000068836:Rivastigmine; D016896:Treatment Outcome
D002219:Carbamates; D002800:Cholinesterase Inhibitors; D018696:Neuroprotective Agents; D048448:Phenylcarbamates; D000068836:Rivastigmine