Reports from the Field
Study compares two Alzheimer’s drugs
A head-to-head study of two Alzheimer’s drugs found that donepezil hydrochloride was much better tolerated in patients with mild to moderate Alzheimer’s disease than rivastigmine tartrate, according to researchers who presented their findings at a recent scientific meeting in Munich.
The study used manufacturers’ recommended dosages to compare the two current Alzheimer’s treatment options. The multinational, head-to-head, random, double-blind, open-label study was designed to compare the tolerability and ease of use of donepezil hydrochloride to rivastigmine tartrate in 111 patients with mild to moderate Alzheimer’s disease.
The two treatment groups had similar improvements from baseline in Alzheimer’s Disease Assessment Scale-cognitive subscale scores throughout the 12-week treatment period. ADAS-cog is a clinically validated measure of cognitive function. Testing was administered by independent raters who were blinded to the study medication. Findings include:
• 41.8% of patients in the rivastigmine tartrate group reported nausea compared with 10.7% in the donepezil hydrochloride group.
• 23.6% of patients in the rivastigmine tartrate group reported vomiting compared with 7.1% in the donepezil hydrochloride group.
• 87.5% of patients were able to remain at the maximum daily dose of donepezil hydrochloride compared with 47.3% of patients who were able to remain on the maximum daily dose of rivastigmine tartrate.
Physicians were surveyed about their overall satisfaction with study medication for each patient. Physicians reported being "very satisfied" with the study medication for 46.4% of patients treated with donepezil hydrochloride compared to 18.9% of patients treated with rivastigmine tartrate.
"Despite the often devastating nature of the disease, tolerability is still very important to patients with Alzheimer’s disease," says David Wilkinson, MD, director of the Memory Assessment and Research Centre at Moorgreen Hospital in Southampton, England, an investigator in the study. "Patients tend to be elderly and often have other medical conditions that can make treating Alzheimer’s disease more complex. It is therefore important to treat patients with medications that are well-tolerated and easy to use, such as donepezil hydrochloride."
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