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Fewer side effects observed with 9.5-mg transdermal rivastigmine when compared with oral capsules in Alzheimer's disease treatment
A transdermal rivastigmine patch is as effective as twice-daily oral treatment and is associated with 3 times fewer reports of nausea and vomiting, according to results of the Investigation of Transdermal Exelon in Alzheimer's Disease (IDEAL) trial reported at the 131st Annual Meeting of the American Neurological Association in Chicago, Ill.
A transdermal rivastigmine patch is as effective as twice-daily oral treatment and is associated with 3 times fewer reports of nausea and vomiting, according to results of the Investigation of Transdermal Exelon in Alzheimer's Disease (IDEAL) trial reported at the 131st Annual Meeting of the American Neurological Association in Chicago, Ill.
IDEAL included 1,195 patients randomized to use a transdermal patch delivering either rivastigmine 9.5 mg (n=291) or 17.4 mg (n=303) every 24 hours, conventional treatment consisting of 1 rivastigmine 6-mg capsule twice daily (n=294), or placebo (n=302) for 24 weeks. Patients had a baseline score of 10 to 20 on the Mini-Mental State Examination (MMSE).
Primary outcome measures were the Alzheimer's Disease Assessment Scale-Cognitive Subscale (ADAS-Cog) and the Alzheimer's Disease Cooperative Study-Clinical Global Impression of Change (ADCS-CGIC). Secondary outcome measures were MMSE score and assessment of activities of daily living, behavior, executive and visuospatial function and attention, visual tracking, and motor processing speed.
The 9.5-mg patch significantly reduced the common side effects of nausea and vomiting compared with oral treatment, whereas the 17.4-mg patch produced nausea and vomiting at rates similar to those observed with oral treatment. Among patients receiving oral treatment, 23.1% reported nausea and 17% reported vomiting. Among those using the 17.4-mg rivastigmine patch, the rates were 21.1% and 18.8%, respectively. Patients using the 9.5-mg patch demonstrated a 7.2% incidence of nausea and a 6.2% incidence of vomiting.
Results of a questionnaire distributed to caregivers of IDEAL study patients demonstrated that 70% of caregivers preferred transdermal rivastigmine administration versus oral treatment.
SOURCE Winblad B, Cummings J, Zechner S, et al. IDEAL: A 6-month placebo-controlled study of the first transdermal patch in Alzheimer's disease–rivastigmine patch versus capsule [abstract]. Presented at: 131st Annual Meeting of the American Neurological Association; Chicago, Ill; October 8–11, 2006; Abstract M88.
Coalition promotes important acetaminophen dosing reminders
November 18th 2014It may come as a surprise that each year Americans catch approximately 1 billion colds, and the Centers for Disease Control and Prevention estimates that as many as 20% get the flu. This cold and flu season, 7 in 10 patients will reach for an over-the-counter (OTC) medicine to treat their coughs, stuffy noses, and sniffles. It’s an important time of the year to remind patients to double check their medicine labels so they don’t double up on medicines containing acetaminophen.
Support consumer access to specialty medications through value-based insurance design
June 30th 2014The driving force behind consumer cost-sharing provisions for specialty medications is the acquisition cost and not clinical value. This appears to be true for almost all public and private health plans, says a new report from researchers at the University of Michigan Center for Value-Based Insurance Design (V-BID Center) and the National Pharmaceutical Council (NPC).
Management of antipsychotic medication polypharmacy
June 13th 2013Within our healthcare-driven society, the increase in the identification and diagnosis of mental illnesses has led to a proportional increase in the prescribing of psychotropic medications. The prevalence of mental illnesses and subsequent treatment approaches may employ monotherapy as first-line treatment, but in many cases the use of combination of therapy can occur, leading to polypharmacy.1 Polypharmacy can be defined in several ways but it generally recognized as the use of multiple medications by one patient and the most common definition is the concurrent use of five more medications. The presence of polyharmacy has the potential to contribute to non-compliance, drug-drug interactions, medication errors, adverse events, or poor quality of life.
Medical innovation improves outcomes
June 12th 2013I have been diagnosed with stage 4 cancer of the pancreas, a disease that’s long been considered not just incurable, but almost impossible to treat-a recalcitrant disease that some practitioners feel has given oncology a bad name. I was told my life would be measured in weeks.
