title: Efficacy of higher dose 13.3 mg/24 h rivastigmine patch on instrumental activities of daily living in patients with mild-to-moderate Alzheimer's disease.
abstract: BACKGROUND
  Stabilizing/reducing decline in the ability to perform activities of daily living (ADLs) is important in management of Alzheimer's disease (AD).
  
  
  METHODS
  Post hoc analysis of OPtimizing Transdermal Exelon In Mild-to-moderate Alzheimer's disease (OPTIMA), a double-blind trial comparing 13.3 and 9.5 mg/24 h rivastigmine patch in patients with AD demonstrating functional and cognitive decline with 9.5 mg/24 h patch. Efficacy on Alzheimer's disease Cooperative Study-instrumental ADL (ADCS-IADL) items, higher level function (HLF), and autonomy factors was assessed.
  
  
  RESULTS
  The ADCS-IADL, HLF, and autonomy factors favored 13.3 mg/24 h patch at all time points, reaching significance from weeks 16 to 48, 24 to 48, and 32 to 48, respectively. Higher dose patch demonstrated significantly greater efficacy on 10 of 17 ADCS-IADL items at 1 or more time points (P < .05 vs 9.5 mg/24 h patch). More adverse events were observed with higher dose patch; study discontinuations were similar between the doses.
  
  
  CONCLUSIONS
  Greater efficacy of 13.3 versus 9.5 mg/24 h patch on ADL, including autonomy and HLF factors, supports this additional dosing option to prolong patients' independence.
authors: Department of Neurology and Psychiatry, St Louis University School of Medicine, St Louis, MO 61304, USA. grossbgt@slu.edu
authors: George
authors: G
authors: Grossberg
authors: Jeffrey
authors: J
authors: Cummings
authors: Lutz
authors: L
authors: Frölich
authors: Giuseppe
authors: G
authors: Bellelli
authors: José L
authors: JL
authors: Molinuevo
authors: Tillmann
authors: T
authors: Krahnke
authors: Christine
authors: C
authors: Strohmaier
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000188:drug therapy*; D002800:Cholinesterase Inhibitors / Q000008:administration & dosage*; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D026684:Personal Autonomy; D048448:Phenylcarbamates / Q000008:administration & dosage*; D000068836:Rivastigmine; D012720:Severity of Illness Index; D057968:Transdermal Patch; D016896:Treatment Outcome
chemical_list: D002800:Cholinesterase Inhibitors; D048448:Phenylcarbamates; D000068836:Rivastigmine
keywords: activities of daily living; efficacy; higher dose; rivastigmine patch
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