Long-term rivastigmine treatment in a routine clinical setting


Lennart Minthon, MD, PhD, Associate Professor, Neuropsychiatric Clinic, Clinical Memory Research Unit, Department of Clinical Sciences, Malmö, Lund University, University Hospital MAS, SE-205 02 Malmö, Sweden
Tel.: +46 40 33 55 13
Fax: +46 40 33 56 54
e-mail: lennart.minthon@skane.se


Objective –  The aim of the study was to observe the effects of long-term rivastigmine treatment in patients with mild to moderate Alzheimer’s disease (AD) in a routine clinical setting.

Methods –  This was a prospective, open-label, observational, multicentre, non-randomized study. Outcome measures included the Mini Mental State Examination (MMSE), the Clinician’s Interview-Based Impression of Change (CIBIC) and the Alzheimer’s Disease Assessment Scale – cognitive subscale (ADAS-cog).

Results –  Of 217 patients initiated into rivastigmine treatment, 62% (= 135) remained on treatment for 24 months. Most patients droped out due to nursing home placement or side effects. Eighty per cent and 67% of completers exhibited a symptomatic attenuation of cognitive decline (≤ 4-point deterioration) as assessed by using the MMSE and ADAS-cog respectively. Forty-four per cent showed an unchanged/improved CIBIC rating.

Conclusions –  Over 60% of patients remained on treatment for 2 years in this routine clinical setting. In patients who remained on treatment, rivastigmine appeared to stabilize their condition and prevented or delayed symptomatic decline.