Objective: Efficacy and safety of rivastigmine solution in the treatment of dementia with Lewy bodies (DLB) and Parkinson’s disease dementia (PDD) is not well studied and still has controversy.

Background: We aimed to study the efficacy and persistency of rivastigmine solution in the long-term treatment of DLB and PDD.

Methods: A prospective, open-label one-year follow up study of patients who met the criteria for mild to moderate dementia due to DLB or PDD receiving rivastigmine solution. Efficacy evaluations were conducted with Mini-Mental State Examination (MMSE), Cognitive Abilities Screening Instrument (CASI), Clinical Dementia Rating (CDR), sum of boxed of CDR (CDR-SB), and Neuropsychiatric Inventory (NPI) scales performed at baseline, 6 months and 12 months. Persistency and causes of withdrawal were summarized descriptively.

Results: A total of 36 patients were enrolled. Among them, 24 patients with PDD and 12 patients with DLB. Comparison of demographical data revealed no significantly different in age, gender, CDR, CDR-SB, MoCA, CASI, NPI, or daily dose of rivastigmine solution [Table 1]. Both groups showed no decline of cognitive function at 6 months or 12 months compared with baseline performance according to total MoCA [Figure 1] and CASI scores [Figure 2]. Besides, both groups showed stabilization of neuropsychiatric symptoms according to the mean change from baseline of total NPI score (2.2 in DLB and -1.0 in AD) after one-year treatment with rivastigmine solution [Figure 3]. There is no significant difference in changing from baseline of cognitive function or neuropsychiatric symptoms between DLB and AD group. The persistency of medication is not different between both groups (67% of PDD and 92% of DLB at 6 months; 67% of PDD and 67% of DLB at 12 months).

Conclusions: Based on the results of this study, rivastigmine solution was found to be effective and well tolerated in patients not only with PDD but also with DLB in one-year treatment. Rivastigmine solution demonstrated the efficacy of maintenance of cognition and stabilization of neuropsychiatric symptoms of patients with DLB and PDD.

References: 1. Rolinski M, Fox C, Maidment I, McShane R. Cochrane Database Syst Rev. 2012 Mar 14; (3): CD006504. Epub 2012 Mar 14.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/rivastigmine-solution-in-the-one-year-treatment-of-parkinsons-disease-dementia-and-dementia-with-lewy-bodies/