A 24-Week, Randomized, Controlled Study to Evaluate the Tolerability, Safety and Efficacy of 2 Different Titration Schemes of the Rivastigmine Patch in Japanese Patients with Mild to Moderate Alzheimer's Disease

• Main Authors: Yu Nakamura, Christine Strohmaier, Kaoru Tamura, Naoko Kataoka, Masayuki Nakano, Shoichiro Oda, Kazuma Nishimura, Akira Homma
• Format: Article
• Language: English
• Published: Karger Publishers 2015-09-01
• Series: Dementia and Geriatric Cognitive Disorders Extra
• Subjects: Alzheimerߣs disease; Cholinesterase inhibitors; Japan; Randomized clinical trial; Rivastigmine patch; Titration scheme
• Online Access: http://www.karger.com/Article/FullText/439269

Aim: To investigate whether 1-step titration of the rivastigmine patch (initiated at 5 cm2 and titrated to 10 cm2 after 4 weeks) is well tolerated in Japanese patients with Alzheimer's disease (AD) as compared to 3-step titration (initiated at 2.5 cm2 and titrated by 2.5 cm2 every 4 weeks to 10 cm2). Methods: A 24-week, multicenter, randomized, double-blind study was conducted in Japan between July 2012 and May 2014. Patients with mild to moderate AD aged 50-85 years were randomized 1:1 to 1-step or 3-step titration of the rivastigmine once-daily patch. The primary endpoint was the proportion of patients with adverse events leading to discontinuation. Results: Of 216 patients randomized, 215 (1-step, n = 107; 3-step, n = 108) were included in the safety analysis. The primary endpoint outcome was 15.0% in the 1-step group and 18.5% in the 3-step group. The observed treatment difference was −3.6% (95% confidence interval: −17.0, 9.6), falling within the prespecified acceptance range. Conclusion: The tolerability of two different titration schemes was similar in Japanese patients with AD.