Differential qualitative responses to rivastigmine in APOE E4 carriers and noncarriers

M. Farlow, R. Lane, S. Kudaravalli, Y. He

Research output: Contribution to journalArticle

35 Scopus citations


This retrospective analysis of two double-blind, placebo-controlled studies in patients with mild to moderately severe AD investigated the efficacy of rivastigmine 6-12 mg/day on cognitive outcomes in patients with or without the apolipoprotein (APOE) E4 allele. APOE data were collected from patients who consented to pharmacogenetic testing. Treatment differences within each subgroup were compared, using the Observed Case (OC) population. The APOE E4 and non-APOE E4 subgroups comprised 246 and 121 patients, respectively. Overall, APOE E4 noncarriers showed greater decline than carriers (P<0.05). However, at 26 weeks, placebo-treated APOE E4 patients declined 3.04 points below baseline on the cognitive subscale of the Alzheimer's Disease Assessment Scale (ADAS-cog), and rivastigmine-treated patients improved by 1.67 points. Non-APOE E4 placebo-treated patients declined by 4.59 points and rivastigmine-treated patients declined by 0.48 points. Thus, non-APOE E4 carriers showed a less favorable course under either placebo or rivastigmine, but both genotype-defined subgroups showed quantitatively similar responses to therapy (both P<0.05 vs placebo).

Original languageEnglish (US)
Pages (from-to)332-335
Number of pages4
JournalPharmacogenomics Journal
Issue number5
StatePublished - 2004


  • Alzheimer's disease
  • Apolipoprotein E
  • Rivastigmine

ASJC Scopus subject areas

  • Pharmacology
  • Molecular Medicine
  • Genetics

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