Randomised multicentre trial on safety and efficacy of rivastigmine in cognitively impaired multiple sclerosis patients

Background: Cognitive decline has been recognised as a frequent symptom in multiple sclerosis (MS). Cholinesterase inhibitors (ChEIs) are employed for the treatment of Alzheimer’s disease, but there is some evidence that ChEIs might also be effective in MS patients with cognitive deficits, particula...

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Bibliographic Details
Published in:Multiple sclerosis 2013-04, Vol.19 (5), p.631-638
Main Authors: Mäurer, M, Ortler, S, Baier, M, Meergans, M, Scherer, P, Hofmann, WE, Tracik, F
Format: Article
Language:English
Subjects:
Adult
Biological and medical sciences
Cholinesterase Inhibitors - therapeutic use
Cognition Disorders - drug therapy
Cognition Disorders - etiology
Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases
Double-Blind Method
Female
Humans
Male
Medical sciences
Mental Recall
Middle Aged
Multiple Sclerosis - complications
Multiple sclerosis and variants. Guillain barré syndrome and other inflammatory polyneuropathies. Leukoencephalitis
Neurology
Phenylcarbamates - therapeutic use
Rivastigmine
Treatment Outcome
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Summary:Background: Cognitive decline has been recognised as a frequent symptom in multiple sclerosis (MS). Cholinesterase inhibitors (ChEIs) are employed for the treatment of Alzheimer’s disease, but there is some evidence that ChEIs might also be effective in MS patients with cognitive deficits, particularly deficits of memory function. Objective: The aim of this study was to evaluate efficacy on memory function and safety of the ChEI rivastigmine in MS patients with cognitive deficits as measured by the change from baseline of the total recall score of the selective reminding test (SRT) after 16 weeks of treatment. Methods: Efficacy and safety of rivastigmine were analysed in a 16-week, multicentre, double-blind, randomised, placebo-controlled study, followed by an optional one-year open-label treatment phase. Effects of rivastigmine and placebo were compared by an analysis of covariance. Results: In total, 86 patients were enrolled. Patients who received rivastigmine (n = 43) showed a non-significant increase in total recall score (sum of all words immediately recalled over all six trials) over placebo (n = 38) after 16 weeks of treatment (p = 0.2576). Other outcome measures provided no evidence supporting benefits of rivastigmine. Treatment with rivastigmine was well tolerated. Conclusions: With the results of this study, the need for an effective therapy in cognitively impaired MS patients is still required. Thus, intensive and continued clinical research is required to explore therapeutic options for cognitive deficits in MS patients.
ISSN:1352-4585
1477-0970
DOI:10.1177/1352458512463481