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An open-label, comparative study of rivastigmine, donepezil and galantamine in a real-world setting.
Curr Med Res Opin. 2004 Nov; 20(11):1747-52.CM

Abstract

OBJECTIVE

We analysed the effects of donepezil, rivastigmine and galantamine, prescribed for the treatment of Alzheimer disease in a real-world setting in Italy.

METHODS

Outcome measures included the MiniMental State Examination (MMSE), the Alzheimer Disease Assessment Scale cognitive subscale (ADAS-cog), Instrumental Activity of Daily Living (IADL) and ADL scales.

RESULTS

Seventy patients were treated with donepezil, 121 with rivastigmine and 51 with galantamine. At 6 months, rivastigmine-treated patients improved by 1.29 points from baseline on the ADAS-cog, while donepezil- and galantamine-treated patients showed 'no change' (changes of < 0.2 points). On the IADL, patients treated with rivastigmine, donepezil and galantamine showed decreases of 0.42, 0.58 and 0.75 points, respectively. On the ADL, donepezil- and galantamine-treated patients showed decreases of 0.44 and 0.86 points, respectively, while there was 'no change' with rivastigmine. On the MMSE, donepezil- and rivastigmine-treated patients showed 'no change' and galantamine-treated patients showed a mean decrease of 1.19 points. A subgroup analysis of 'pseudo-randomised' patients (rivastigmine, n = 63; donepezil, n = 55; galantamine, n = 51) supported the main findings. Side effects were similar (in type and frequency) in the three treatment groups.

CONCLUSIONS

This is the first study to compare the effects of the three most commonly-used cholinesterase inhibitors on the MMSE, ADAS-cog, IADL and ADL. Limitations included its small population size, its open-label design, and the fact that patients were randomised only after the introduction of galantamine. There were no statistically significant differences between the three drugs at 3 months. While numerical trends were observed suggesting the effect of rivastigmine > donepezil > galantamine, larger, longer-term prospective studies are needed to confirm whether there are important differences in the long-term efficacy of the three drugs.

Authors+Show Affiliations

Department of Clinical, Morphological and Technological Science, UCO of Clinical Psychiatry, University of Trieste, Trieste, Italy. aguglia@univ.trieste.itNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Comparative Study
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

15537474

Citation

Aguglia, E, et al. "An Open-label, Comparative Study of Rivastigmine, Donepezil and Galantamine in a Real-world Setting." Current Medical Research and Opinion, vol. 20, no. 11, 2004, pp. 1747-52.
Aguglia E, Onor ML, Saina M, et al. An open-label, comparative study of rivastigmine, donepezil and galantamine in a real-world setting. Curr Med Res Opin. 2004;20(11):1747-52.
Aguglia, E., Onor, M. L., Saina, M., & Maso, E. (2004). An open-label, comparative study of rivastigmine, donepezil and galantamine in a real-world setting. Current Medical Research and Opinion, 20(11), 1747-52.
Aguglia E, et al. An Open-label, Comparative Study of Rivastigmine, Donepezil and Galantamine in a Real-world Setting. Curr Med Res Opin. 2004;20(11):1747-52. PubMed PMID: 15537474.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - An open-label, comparative study of rivastigmine, donepezil and galantamine in a real-world setting. AU - Aguglia,E, AU - Onor,M L, AU - Saina,M, AU - Maso,E, PY - 2004/11/13/pubmed PY - 2005/3/18/medline PY - 2004/11/13/entrez SP - 1747 EP - 52 JF - Current medical research and opinion JO - Curr Med Res Opin VL - 20 IS - 11 N2 - OBJECTIVE: We analysed the effects of donepezil, rivastigmine and galantamine, prescribed for the treatment of Alzheimer disease in a real-world setting in Italy. METHODS: Outcome measures included the MiniMental State Examination (MMSE), the Alzheimer Disease Assessment Scale cognitive subscale (ADAS-cog), Instrumental Activity of Daily Living (IADL) and ADL scales. RESULTS: Seventy patients were treated with donepezil, 121 with rivastigmine and 51 with galantamine. At 6 months, rivastigmine-treated patients improved by 1.29 points from baseline on the ADAS-cog, while donepezil- and galantamine-treated patients showed 'no change' (changes of < 0.2 points). On the IADL, patients treated with rivastigmine, donepezil and galantamine showed decreases of 0.42, 0.58 and 0.75 points, respectively. On the ADL, donepezil- and galantamine-treated patients showed decreases of 0.44 and 0.86 points, respectively, while there was 'no change' with rivastigmine. On the MMSE, donepezil- and rivastigmine-treated patients showed 'no change' and galantamine-treated patients showed a mean decrease of 1.19 points. A subgroup analysis of 'pseudo-randomised' patients (rivastigmine, n = 63; donepezil, n = 55; galantamine, n = 51) supported the main findings. Side effects were similar (in type and frequency) in the three treatment groups. CONCLUSIONS: This is the first study to compare the effects of the three most commonly-used cholinesterase inhibitors on the MMSE, ADAS-cog, IADL and ADL. Limitations included its small population size, its open-label design, and the fact that patients were randomised only after the introduction of galantamine. There were no statistically significant differences between the three drugs at 3 months. While numerical trends were observed suggesting the effect of rivastigmine > donepezil > galantamine, larger, longer-term prospective studies are needed to confirm whether there are important differences in the long-term efficacy of the three drugs. SN - 0300-7995 UR - https://www.unboundmedicine.com/medline/citation/15537474/An_open_label_comparative_study_of_rivastigmine_donepezil_and_galantamine_in_a_real_world_setting_ L2 - http://www.tandfonline.com/doi/full/10.1185/030079904X6273 DB - PRIME DP - Unbound Medicine ER -