Real-life effectiveness and tolerability of the rivastigmine transdermal patch in patients with mild-to-moderate Alzheimer’s disease: the EMBRACE study

Gauthier, Serge; Robillard, Alain; Cohen, Sharon; Black, Sandra E.; Sampalis, John S.; Colizza, Diane F.; Takacsy, Frederica de; Schecter, Robyn

doi:10.1185/03007995.2013.802230

Cited by 16 publications

(12 citation statements)

References 54 publications

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“…The results of the current study showed higher caregivers’ preference (82.4%) to rivastigmine transdermal patch for patients exposed to both forms of medication, and the findings were consistent with previous studies. 12 , 19 The current study, however, did not show a clear preference of caregivers for either oral or transdermal treatment, which was due to the prior exposure to particular form of therapy influencing the caregivers’ preference.…”

Section: Discussioncontrasting

confidence: 79%

“…Previously, the IDEAL, 12 Alzheimer disease: eXamination of patiEnt comPliance and caregiver satisfacTion (AXEPT), 20 Effective Management of Alzheimer’s Disease By TReating pAtients and relieving Caregivers with Exelon Patch (EMBRACE), 19 ENTERPRISE, 21 global RECAP study, 13 and an observational clinical study 22 have assessed the caregiver preference and/or satisfaction for the treatment of AD. IDEAL was the first pivotal trial 17 , 23 to demonstrate the non-inferiority of the rivastigmine transdermal patch over oral capsules; the study 12 also showed higher caregivers’ preference (72%) for the rivastigmine transdermal patch compared with oral capsules.…”

Section: Discussionmentioning

confidence: 99%

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Real-world evaluation of compliance and preference in Alzheimer’s disease treatment: an observational study in Taiwan 

Lai¹,

Wang²,

Yip³

et al. 2016

PPA

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PurposeAmong the medications approved for Alzheimer’s disease (AD), rivastigmine is the only one available as transdermal patch. The aim of this study was to evaluate compliance and caregivers’ preference with oral and transdermal (rivastigmine) monotherapy in patients with mild-to-moderate AD from Taiwan.MethodsReal-world Evaluation of Compliance And Preference in Alzheimer’s disease treatment (RECAP) in Taiwan was a prospective, noninterventional, observational study with a 24-week (±8 weeks) observational period for each participant. Eligible patients were grouped into one of the two treatment cohorts based on the baseline AD therapy: oral (donepezil, galantamine, rivastigmine, or memantine) or transdermal (rivastigmine patch). The primary end points were caregiver preference and caregiver assessment of patients’ compliance to the current medication (oral or transdermal medication) at Week 24 (end of the study). Safety was assessed by recording any adverse events.ResultsA total of 301 patients (age: 77.6±7.19 years) were enrolled from nine centers in Taiwan, of whom 138 (45.8%) patients were in the transdermal monotherapy cohort. Caregivers of patients who were exposed to both forms of therapies demonstrated a higher preference for transdermal rivastigmine monotherapy than the oral monotherapy (82.4% [n=61] versus 17.6% [n=13], P<0.0001); for patients treated with only one therapy, the caregivers’ preference was significantly in favor of the treatment to which the patient was exposed (both P<0.0001). In both cohorts, patients showed good compliance, with an overall score of 8.65±1.38 on an 11-point scale. Of 301 enrolled patients, 102 (33.9%) reported at least one adverse event during the study (51 patients each in the two cohorts).ConclusionWith the higher caregiver preference and a good patient compliance, the trans-dermal rivastigmine patch is a suitable treatment choice for patients with mild-to-moderate AD, especially for patients intolerant to oral therapies.

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Section: Discussioncontrasting

confidence: 79%

Section: Discussionmentioning

confidence: 99%

Real-world evaluation of compliance and preference in Alzheimer’s disease treatment: an observational study in Taiwan 

Lai¹,

Wang²,

Yip³

et al. 2016

PPA

View full text Add to dashboard Cite

show abstract

“… 19 Similarly, the EMBRACE (Effective Management of Alzheimer’s disease By tReating pAtients and relieving Caregivers with Exelon patch) study, which assessed the real-life effectiveness and tolerability of rivastigmine patch, showed high caregivers’ preference (88.2%) for the patch over oral medication in patients with mild-to-moderate AD. 15 Moreover, results from a recent observational study in patients with mild-to-moderate AD have reported that the transdermal formulation of rivastigmine reduces caregiver burden in daily practice. 31 Compared with these studies, the RECAP study was unique in geographical scope and was conducted in countries where patients with AD are reported to live predominantly in households with extended families.…”

Section: Discussionmentioning

confidence: 99%

Real-world evaluation of compliance and preference in Alzheimer’s disease treatment

Pai

Aref

Bassil

et al. 2015

CIA

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PurposeRivastigmine transdermal patch has shown higher caregiver satisfaction and greater preference than oral formulation in patients with Alzheimer’s disease. However, there is limited literature available related to caregiver preference or treatment compliance in real-world clinical settings. To date, no such data are available from Asia and the Middle East, which account for a sizeable proportion of patients with Alzheimer’s disease. The objective of this study was to evaluate treatment preference and compliance with oral and transdermal medications in daily clinical practice in an ethnically diverse patient population from Asia and the Middle East with mild-to-moderate Alzheimer’s disease.Patients and methodsRECAP (Real-world Evaluation of Compliance And Preference in the treatment of Alzheimer’s disease) was a 24-week, multicenter, prospective, noninterventional study. Two treatment cohorts were observed during the study: oral (cholinesterase inhibitors or memantine) and transdermal (rivastigmine patch). Caregiver preference, physician preference, and patient compliance were evaluated at week 24.ResultsA total of 978 of 1,931 enrolled patients (mean age: 72.8 years; 50.5% female) were in the transdermal cohort. For patients with exposure to both oral and transdermal monotherapy (n=330), a significant caregivers’ preference for the transdermal monotherapy was observed (82.7%; P<0.0001). Of the 89 participating physicians, 71 indicated preference for transdermal monotherapy. Patient compliance was also significantly higher for transdermal than oral monotherapy (P<0.0001).ConclusionOur study showed higher caregiver and physician preference and greater patient compliance with transdermal monotherapy in daily practice.

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“…98 As with other cholinesterase inhibitors, it can be safely co-administered with memantine, an N-methyl-Daspartate antagonist. 99 The efficacy of the rivastigmine transdermal system is established in multiple randomized, double-blind, placebo-controlled clinical trials in persons with Alzheimer's disease 100,101,102,103 and one controlled trial of the oral formulation of rivastigmine in persons with dementia associated with Parkinson disease. 104 In controlled trials the adverse effects most commonly reported were nausea, vomiting, and diarrhea, which were dose-related and also more frequently reported in patients receiving the capsule formulation.…”

Section: Rivastigmine (Exelon)mentioning

confidence: 99%

The Use of Transdermal Therapeutic Systems in Psychiatric Care: A Primer on Patches

et al. 2015

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Real-life effectiveness and tolerability of the rivastigmine transdermal patch in patients with mild-to-moderate Alzheimer’s disease: the EMBRACE study

Cited by 16 publications

References 54 publications

Real-world evaluation of compliance and preference in Alzheimer’s disease treatment: an observational study in Taiwan

Real-world evaluation of compliance and preference in Alzheimer’s disease treatment: an observational study in Taiwan

Real-world evaluation of compliance and preference in Alzheimer’s disease treatment

The Use of Transdermal Therapeutic Systems in Psychiatric Care: A Primer on Patches

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Real-life effectiveness and tolerability of the rivastigmine transdermal patch in patients with mild-to-moderate Alzheimer’s disease: the EMBRACE study

Cited by 16 publications

References 54 publications

Real-world evaluation of compliance and preference in Alzheimer&rsquo;s disease treatment: an&nbsp;observational study in Taiwan&nbsp;

Real-world evaluation of compliance and preference in Alzheimer&rsquo;s disease treatment: an&nbsp;observational study in Taiwan&nbsp;

Real-world evaluation of compliance and preference in Alzheimer&rsquo;s disease treatment

The Use of Transdermal Therapeutic Systems in Psychiatric Care: A Primer on Patches

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Product

Resources

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Real-world evaluation of compliance and preference in Alzheimer’s disease treatment: an observational study in Taiwan

Real-world evaluation of compliance and preference in Alzheimer’s disease treatment: an observational study in Taiwan

Real-world evaluation of compliance and preference in Alzheimer’s disease treatment