Retrospective

Ms. Pauline Kwan

Clinical Neurology Research Centre, 10/F Clinical

2635-2160

paulinewkwan@gmail.com

Dept of Medicine and Therapeutics, CUHK

Prof. Vincent CT Mok

Dept of Medicine and Therapeutics, 9/F Clinical

2632-2195

vctmok@cuhk.edu.hk

Dept of Medicine and Therapeutics, CUHK

Yes

2009-12-11

Drug

Exelon Patch (rivastigmine transdermal system)

6 months

Nil, as the present study is an uncontrolled trial

1. Dementia patients who are indicated for AChIs are potentially eligible for this study, i.e. AD, are of mild to moderate severity (i.e. MMSE between 10-26).
2. Patients who are currently on a sub-maximal dose of oral AChIs (e.g. 5mg daily donepezil, 6mg daily rivastigmine, 16 mg daily galantamine) due to intolerability to a higher dose.
3. Patients who are intolerable to even low dose of oral AChIs and are thus not on any oral AChIs.

1. Dementia patients who are already on and are tolerating well the maximal dose of oral AChIs.
2. Dementing illnesses (e.g. frontotemporal dementia, Huntington’s chorea, head trauma) other than AD and DLB.
3. Subjects with the following co-existing medical conditions:
a. Uncontrolled epilepsy, convulsions, asthmatic
b. Current clinically significant psychiatric disease, as judged by DSM-IV criteria, in particular current major depression or schizophrenia. Subjects with moderate to severe or uncontrolled behavioral disturbances are excluded. Subjects with mild disturbances who are well controlled with stable use of medication may be included.
c. Peptic ulcer: if the ulcer is considered to be still ‘active’, i.e., if treatment for this condition started <3 months ago or if treatment is not successful (symptoms still present), the subject is not eligible.
d. Clinically significant hepatic, renal, pulmonary, metabolic or endocrine disturbances.
e. Clinically significant urinary outflow obstruction. Those with prostatomegaly who is on long term foley catheterization can be included.
4. Current, clinically significant cardiovascular disease that would be expected to limit the subject’s ability to complete a 26-week trial. The following would usually be considered clinically significant cardiovascular disease:
a. Cardiac surgery or myocardial infarction within the past 6 months.
b. Unstable cardiac disease that required a change in medication within the last 3 months.
c. Decompensated congestive heart failure, i.e., when symptoms occur in a subject on stable medication during rest or light exercise (NYHA III and IV).
d. Cardiac disease potentially resulting in syncope, near syncope or other alternations of mental status. In addition, the following conditions should lead to exclusion: uncontrolled atrial fibrillation, bradycardia<50 beats/min., atrioventricular block great than first degree.
e. Severe mitral, aortic valvular disease, or sick sinus syndrome.
f. Uncontrolled high blood pressure (systolic blood pressure greater than 170 mmHg or diastolic blood pressure greater than 110 mmHg) or sustained hypertension.
5. Female subject childbearing potential without adequate contraception. Barrier, spermicidal and hormonal methods are considered adequate contraception. Females of childbearing potential must not be pregnant at screening and must agree not to become pregnant during the trial. Females who are breast feeding are also excluded.
6. History of severe drug allergy or hypersensitivity; including recorded hypersensitivity to cholinesterase inhibitors, choline agonists or similar agents or bromide.

N/A

N/A

Both Male and Female

Non-randomized

Uncontrolled

Open label

Single group

No