Evaluating Response to High‐Dose 13.3?mg/24?h Rivastigmine Patch in Patients with Severe Alzheimer's Disease

摘要

Summary Aims To identify factors predicting improvement/stabilization on the Alzheimer's Disease Cooperative Study–Clinical Global Impression of Change ( ADCS ‐ CGIC ) and investigate whether early treatment responses can predict long‐term outcomes, during a trial of 13.3 mg/24 h versus 4.6 mg/24 h rivastigmine patch in patients with severe Alzheimer's disease ( AD ). Methods Logistic regression was used to relate Week 24 ADCS ‐ CGIC score to potential baseline predictors. Additional analyses based on receiver‐operating characteristic curves were performed using Week 8/16 ADCS ‐ CGIC scores to predict response (13.3 mg/24 h patch) at Week 24. ADCS ‐ CGIC score of (1) 1–3 = “improvement,” (2) 1–4 = “improvement or no change”. Results “Treatment” (13.3 mg/24 h patch) and increased age were significant predictors of “improvement” ( P = 0.01 and P = 0.003, respectively), and “treatment” ( P = 0.001), increased age ( P = 0.002), and prior AD treatment ( P = 0.03) for “improvement or no change”. At Week 8 and 16, ADCS ‐ CGIC scores of 4 and 5 were optimal thresholds in predicting “improvement,” and “improvement or no change,” respectively, at Week 24. Conclusions A significant therapeutic effect of high‐dose rivastigmine patch on ADCS ‐ CGIC response was observed. The 13.3 mg/24 h patch was identified as a predictor of “improvement” or “improvement or no change”. Patients with minimal worsening/improvemento change after treatment initiation may be more likely to respond following long‐term therapy.