Rivastigmine for the treatment of Parkinson's disease dementia [Rivastigmina no tratamento da demência da doença de Parkinson]

• Tipo: Outra Publicação em Revista Científica Internacional
• Data: 2014

Autores

João Massano (Autor) FMUP

Revista

Título: Sinapse

Vol. 14

Páginas: 21-25

ISSN: 1645-281X

Editora: Sociedade Portuguesa de Neurologia

Indexação

Scopus - 0 Citações

Outras Informações

ID Authenticus: P-00M-8DB

Abstract (EN): Introduction: There is a high prevalence of dementia in Parkinson's disease, which is cumulative along disease course. Parkinson's disease dementia (PDD) causes additional significant disability, with loss of independence and troublesome behavioral disorders. Aim: Review and synthesis of published scientific data regarding the clinical results of rivastigmine in PDD. Results: The EXPRESS trial was published in 2004; this was randomized, controlled, doubleblind trial that demonstrated the efficacy of rivastigmine capsules (up to 12 mg/day) in PDD, concerning cognition, behavioral and activities of daily living. The open label extension phase of this trial showed clinical long term benefits of rivastigmine in PDD. Most adverse events associated with rivastigmine were cholinergic, and caused interruption of therapy in some cases. The IDEAL trial, a randomized, double blind, double dummy trial enrolling Alzheimer's disease patients only, demonstrated that the rivastigmine transdermal patch and the capsules were equally effective at the higher dosages. Tolerability was similar to patch and placebo, and much better than to capsules. A recently published randomized open label study compared the long-term safety of rivastigmine capsules (12 mg/day) and patch (9.5 mg/24h) in PDD, showing that safety was similar for both formulations, but a higher incidence of cholinergic adverse events was seen with capsules, and skin erythema was noticed in a small portion of patients treated with the transdermal patch. Conclusion: Available scientific data suggest that rivastigmine is an effective and safe drug for the treatment of PDD. Literature supports the clinical usefulness of both capsules (up to 12 mg/day) and transdermal patch (9.5 mg/24h), with additional benefits with the latter concerning tolerability, with the exception of erythema, which leads to treatment discontinuation in a small portion of cases. Rivastigmine is a leading drug in the treatment of PDD, and transdermal patch is a clinically valuable option.

Idioma: Inglês

Tipo (Avaliação Docente): Científica