한국인 치매환자에서의 리바스티그민 패취 사용 경험; 예비 연구
Clinical Experience of the Transdermal Patch of Rivastigmine in Korean Patients with Dementia; Preliminary Study
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초록
While rivastigmine transdermal patch has consistently demonstrated better tolerability and similar efficacy compared to conventional rivastigmine capsules in clinical studies; it has not been specifically evaluated in Korean dementia patients. From February to November 2008, 94 patients with dementia and mild cognitive impairment (MCI) were treated with rivastigmine transdermal patch at Konkuk University Hospital and Bobath Memorial Hospital. To evaluate the safety and tolerability in Korean patients with dementia and MCI, we reviewed the clinical data of the patients. The participating subjects were diagnosed as Alzheimer’s disease (n= 34), mild cognitive impairment (n=5), vascular dementia (n=26), Parkinson’s disease dementia (n=13), dementia with Lewy body (n=3), frontotemporal dementia (n=2) and other types of dementia (n=11). All of the patients were followed within 3 months (90±14 days), in terms of evaluating adverse events. Adverse events occurred in 11 cases (11.7%) and adherence of the patch was good in 91 cases (96.8%). Most of the participants showed clinical improvement similar to other acetylcholinesterase inhibitors (AchEIs). The most common adverse effects were skin-related problems including simple skin irritation, itching sensation, erythematous lesion, patch marks (contact dermatitis) and even severe symptoms mixed with all of the above (allergic contact dermatitis), occurred in eight cases (8.5%). Gastrointestinal (GI) discomfort was reported in two cases (2.1%). Among patients who stopped rivastigmine transdermal patch, six patients (6.3%) withdrew due to adverse events. Rivastigmine transdermal patch provides a good tolerability profile in treating Korean patients with the various subtypes of dementia and may be effective for the improvement of cognitive function in Korean patients with Alzheimer’s disease.
Abstract
While rivastigmine transdermal patch has consistently demonstrated better tolerability and similar efficacy compared to conventional rivastigmine capsules in clinical studies; it has not been specifically evaluated in Korean dementia patients. From February to November 2008, 94 patients with dementia and mild cognitive impairment (MCI) were treated with rivastigmine transdermal patch at Konkuk University Hospital and Bobath Memorial Hospital. To evaluate the safety and tolerability in Korean patients with dementia and MCI, we reviewed the clinical data of the patients. The participating subjects were diagnosed as Alzheimer’s disease (n= 34), mild cognitive impairment (n=5), vascular dementia (n=26), Parkinson’s disease dementia (n=13), dementia with Lewy body (n=3), frontotemporal dementia (n=2) and other types of dementia (n=11). All of the patients were followed within 3 months (90±14 days), in terms of evaluating adverse events. Adverse events occurred in 11 cases (11.7%) and adherence of the patch was good in 91 cases (96.8%). Most of the participants showed clinical improvement similar to other acetylcholinesterase inhibitors (AchEIs). The most common adverse effects were skin-related problems including simple skin irritation, itching sensation, erythematous lesion, patch marks (contact dermatitis) and even severe symptoms mixed with all of the above (allergic contact dermatitis), occurred in eight cases (8.5%). Gastrointestinal (GI) discomfort was reported in two cases (2.1%). Among patients who stopped rivastigmine transdermal patch, six patients (6.3%) withdrew due to adverse events. Rivastigmine transdermal patch provides a good tolerability profile in treating Korean patients with the various subtypes of dementia and may be effective for the improvement of cognitive function in Korean patients with Alzheimer’s disease.
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