Pharmacokinetics of a novel transdermal rivastigmine patch for the treatment of Alzheimer's disease: a review

被引:104
|
作者
Kurz, A. [1 ]
Farlow, M. [2 ]
Lefevre, G. [3 ]
机构
[1] Tech Univ Munich, Dept Psychiat & Psychotherapy, Munich, Germany
[2] Indiana Univ, Sch Med, Dept Neurol, Indianapolis, IN 46202 USA
[3] Novartis, Translat Sci, Basel, Switzerland
关键词
HEALTHY-VOLUNTEERS; CONTROLLED-TRIAL; CAPSULES; DRUGS;
D O I
10.1111/j.1742-1241.2009.02052.x
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Cholinesterase inhibitors have all been available in oral formulations, but a rivastigmine transdermal patch has now been developed and is approved in many countries worldwide for the treatment of mild-to-moderate Alzheimer's disease (AD) (including the USA, Latin America, Europe and Asia). To review the available pharmacokinetic data that supported the rationale behind the development of the rivastigmine transdermal patch and its clinical effects in dementia therapy. This article will also discuss how the patch may alter the treatment paradigm for patients with AD. The 9.5 mg/24 h rivastigmine patch was shown to provide comparable exposure to the highest recommended doses of capsules (12 mg/day) with significantly lower maximum plasma concentration (C(max) 8.7 vs. 21.6 ng/ml) and slower absorption rate (t(max) 8.1 vs. 1.4 h). In a clinical trial of 1195 AD patients, this translated into similar efficacy with three times fewer reports of nausea and vomiting (7.2% vs. 23.1%, and 6.2% vs. 17.0% respectively). Consequently, more patients in the 9.5 mg/24 h patch group achieved their target therapeutic dose at the end of the study, compared with those in the 12 mg/day capsule group (95.9% vs. 64.4%). The rivastigmine patch provides continuous drug delivery over 24 h and similar efficacy to the highest recommended dose of oral rivastigmine with improved tolerability. This may allow patients to achieve optimal therapeutic doses and to benefit from a longer duration of treatment.
引用
收藏
页码:799 / 805
页数:7
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