Is Rivastigmine Effective in the Treatment of Alzheimer’s Disease?

OBJECTIVE: The objective of this selective EBM review is to determine whether or not rivastigmine is effective for the treatment of Alzheimer’s Disease. STUDY DESIGN: Review of two trials in the English language published in 2007 and 2010, and an open-label, singlearm, multi-center study from 2008. DATA SOURCES: Randomized, double-blind, placebo-controlled trials comparing rivastigmine to a visually-matched capsule (placebo) was found using PubMed and Cochrane databases. OUTCOMES MEASURED: Overall global performance using the Alzheimer’s Disease Assessment Scale (ADAS-cog), ability to perform activities of daily living, cognitive function using the mini mental status exam (MMSE), and neuropsychiatric symptoms using BEHAVEAD. RESULTS: The two RCTs included in the review along with the open-label study showed that rivastigmine did help improve symptoms, but usually in patients with a more severe or progressive form of dementia. Rivastigmine was also shown to be more effective in preventing cognitive decline when given at higher doses and to participants who did not have other confounding symptoms, such as hallucinations. CONCLUSIONS: The results of the RCTs and open-label study show that rivastigmine for the treatment of Alzheimer’s disease is safe and effective.