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Rivastigmine, Donepezil Combination Well Tolerated and Efficacious: Presented at IADRD

By Peggy Peck
Special to DG News

STOCKHOLM, SWEDEN -- July 22, 2002 -- Preliminary findings from a study of combination therapy with rivastigmine (Exelon) and donepezil (Aricept) versus monotherapy with rivastigmine suggest that the combination is well tolerated and effective.

The research was presented July 21 here at the 8^th International Conference on Alzheimer's disease and Related Disorders.

Joshua Shua-Haim, MD, of the Memory Disorders Institute, Manchester Township, New Jersey, United States, and colleagues in Scotland and the United States evaluated combination therapy in 27 patients and rivastigmine monotherapy in 49 patients. All patients met criteria for diagnosis of possible Alzheimer's disease or mild to moderate Alzheimer's disease and were treated for a minimum of four months with evaluations at two-month intervals.

Average scores on the Mini Mental Status Exam (MMSE) at baseline were 16 in the combination therapy group and 19 in the monotherapy group. At one year, 33.3 percent of the patients on combination therapy were maintained on combination treatment and among these patients the average MMSE score was 1.2 above baseline measurement.

In the group treated with rivastigmine alone, 24 patients or 48.9 percent were still compliant with the treatment after one year, but in this group the average MMSE score declined by 2.8 points from baseline.

The reasons for stopping treatment were similar for the combination group and the rivastigmine group: adverse events (six vs. five, respectively), cost of treatment (three vs. nine), lack of efficacy (two vs. six), and recommendation from other physicians (seven vs. five).

Among those who discontinued treatment, the combination group had an average length of treatment of four months and the single therapy group had an average of five months of treatment.

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