Donepezil, rivastigmine, galantamine and memantine for ...

TABLE 16 MMSE for rivastigmine
BVRT
The Benton Visual Retention Test (BVRT) was
used as an outcome measure by Agid and
colleagues. 59 The low-dose (4 mg/day) group’s
mean change in score was 0.3 (SD 2.6), the highdose
group changed by 0.2 (SD 2.6) points on
average and the placebo group’s mean change was
0.2 (SD 2.7). No statistically significant differences
were reported.
TMT
Agid and colleagues 59 reported on the Trail
Making Test (TMT), which assesses speed of visual
search, attention, mental flexibility and motor
function. The score is the time taken to complete a
test successfully. The study compared two
treatment dose groups (4 and 6 mg/day) with
placebo. The mean changes from baseline score
were –1.6 ± 39.0, –7.3 ± 48.9 and 0.5 ± 28.7 for
the low-dose, high-dose and placebo groups,
respectively. No statistically significant differences
were observed between the two treatment groups
and the placebo group.
Wechsler logical memory test
Forette and colleagues 60 reported on the
immediate recall aspect of the Wechsler Logical
Memory Test. This test is part of the Wechsler
Memory Scale, which is the most frequently used
clinical measure of memory in the USA. They
found that participants receiving twice daily doses
of rivastigmine scored better than those
participants receiving treatment medication three
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Health Technology Assessment 2006; Vol. 10: No. 1
Agid et al., 1998 59 Mean change from baseline
1. Rivastigmine 2. Rivastigmine 3. Placebo (n = 117) p-Value versus placebo
4 mg/day (n = 111) 6 mg/day (n = 103)
0.0 ± 3.3 0.3 ± 3.1 –0.0 ± 2.6 Not reported
Corey-Bloom et al., 199857 Observed case analysis
1. Rivastigmine 2. Rivastigmine 3. Placebo (n = 234) p-Value versus placebo
1–4 mg/day (n = 233) 6–12 mg/day (n = 231)
–0.34 0.30 –0.79 2. p < 0.05
Rösler et al., 199958 Mean change from baseline (95% CI)
1. Rivastigmine 2. Rivastigmine 3. Placebo (n = 239) p-Value versus placebo
1–4 mg/day (n = 243 ) 6–12 mg/day (n = 243)
–0.62 (–1.05 to –0.15) 0.21 (–0.24 to 0.64) –0.47 (–0.96 to –0.04) 2. p < 0.05
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times daily. Mean scores for these two groups
were 1.8 ± 2.3 and 0.1 ± 2.3, respectively,
p = 0.012.
FOME
Agid and colleagues 59 used the Fuld Object
Memory Evaluation (FOME) as an outcome
measure. They reported two aspects of the
evaluation: ‘total storage’ and ‘total retrieval’. At
week 13, total storage was statistically significantly
better for both the high-dose group (6 mg/day)
and the low-dose group (4 mg/day) than for
placebo (0.7 ± 6.2 and 0.4 ± 6.2 versus –0.9 ±
5.5, respectively, p ≤ 0.05). For the retrieval part of
the test, only the high-dose group was statistically
significantly better than placebo at 13 weeks
(1.1 ± 4.2 versus 0.1 ± 4.3, p ≤ 0.05).
DSST
Agid and colleagues 59 used the Digit Symbol
Substitution Subtest (DSST) as an outcome
measure. The DSST is a subset of the WAIS-R. At
week 13, there was a statistically significant
difference of 2.3 between the high-dose group
(6 mg/day) and placebo (2.8 ± 8.1 versus 0.5 ± 6.9,
p < 0.05). The difference between the low-dose
group (4 mg/day) and placebo group was 1.2, but
this was not statistically significant. Forette and
colleagues list the digit span subset of the WAIS-R
as an outcome measure, but do not present results
as there was no statistically significant difference
found between treatment and placebo groups for
this test.
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