Systematic review of the efficacy of rivastigmine for patients with Alzheimer's disease

L. S. Schneider, R. Anand, M. R. Farlow

Research output: Contribution to journalArticle

104 Scopus citations


Cholinesterase inhibition appears to be the most promising current option for the symptomatic treatment of the primary cognitive deficits of Alzheimer's disease (AD). We review three prospective, randomized, double- blind, placebo-controlled studies of rivastigmine, an acetylcholinesterase (AChE) subtype-selective, 'pseudo-irreversible' AChE inhibitor, and report results from a pooled analysis of these studies. The overall phase III assessment program enrolled more than 3300 patients at 116 centers in 10 countries. Two studies were based in the USA and one predominantly in Europe, with some US and Canadian centers. The three clinical trials reviewed here included 2126 patients with mild to moderately severe probable AD treated with a flexible dosage range of rivastigmine 6-12 mg/day or 1-4 mg/day, a fixed-dose regimen of 3, 6 or 9 mg/day, or placebo for 26 weeks. In all trials patients showed significant benefit in measures of cognition (Alzheimer's Disease Assessment Scale-cognitive subscale) and clinician's assessment of change (Clinician Interview-Based Impression of Change incorporating caregiver information); in the two pivotal studies patients also showed significant improvement in activities of daily living (as measured prospectively by the domain-specific Progressive Deterioration Scale). The pooled analyses further confirm the efficacy of rivastigmine in the treatment of both the cognitive and functional deficits of mild to moderately severe AD.

Original languageEnglish (US)
Pages (from-to)S26-S34
JournalInternational Journal of Geriatric Psychopharmacology
Issue numberSUPPL. 1
StatePublished - Dec 23 1998
Externally publishedYes


  • ADAS-Cog
  • Acetylcholinesterase inhibitors
  • Alzheimer's disease
  • CIBIC-Plus
  • Progressive Deterioration Scale
  • Rivastigmine

ASJC Scopus subject areas

  • Neuropsychology and Physiological Psychology
  • Pharmacology, Toxicology and Pharmaceutics(all)
  • Geriatrics and Gerontology
  • Pharmacology (medical)

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