nnpNeurology, Neuropsychiatry, PsychosomaticsНеврология, нейропсихиатрия, психосоматика2074-27112310-1342"IMA-Press", LLC10.14412/2074-2711-2012-413nnp-153Research ArticleArticlesСтатьиThe specific features of using a rivastigmine transdermal formulation in Alzheimer’s diseaseОсобенности применения трансдермальной формы ривастигмина при болезни АльцгеймераVaseninaElena EvgenyevnaVaseninaElena Evgenyevna

Кафедра неврологии

Kafedra nevrologii

vas@mail.ruLevinO SLevinO S

Кафедра неврологии

Kafedra nevrologii

-20121409201243NO3 (2012)9699Copyright © Vasenina E.E., Levin O.S., 20122012Vasenina E.E., Levin O.S.Vasenina E.E., Levin O.S.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://nnp.ima-press.net/nnp/article/view/153

Cholinergic deficiency associated mainly with the degeneration of neurons in the nucleus basalis of Meynert is one of the key factors of the development of cognitive impairments in Alzheimer’s disease (AD). Cholinesterase inhibitors are used to treat mild and moderate dementia in AD. However, the wide use of this group of agents is limited by the high incidence of some side effects. The application of a novel rivastigmine transdermal (patch) formulation substantially reduces the risk of adverse reactions chiefly associated with a negative effect on the gastrointestinal tract and increases treatment adherence. Thus, there is a rise in the number of patients who may be given the drug in the optimal therapeutic dose for a long time.

Одним из ключевых факторов развития когнитивных нарушений при болезни Альцгеймера (БА) является холинергический дефицит, связанный преимущественно с дегенерацией нейронов базального ядра Мейнерта. В лечении легкой и среднетяжелой деменции при БА используют ингибиторы холинэстеразы. Однако широкое применение препаратов этой группы сдерживается высокой частотой некоторых побочных эффектов. Применение новой лекарственной формы ривастигмина для трансдермального введения (пластырь) существенно снижает риск побочного действия, связанного, прежде всего, с негативным влиянием на желудочно-кишечный тракт, и повышает приверженность лечению. Таким образом, увеличивается число больных, которым можно длительно назначать препарат в оптимальной терапевтической дозе.

болезнь Альцгеймераингибиторы холинэстеразыривастигминтрансдермальное введениеAlzheimer’s diseasecholinesterase inhibitorsrivastigminetransdermal administrationReferences<div><p>Дамулин И.В. Сосудистая деменция и болезнь Альцгеймера. М., 2002;90 с.</p><p>Левин О.С. Алгоритмы диагностики и лечения деменции. М.: Медпресс-информ, 2011;127 с.</p><p>Яхно Н.Н. Когнитивные расстройства в неврологической клинике. Неврол журн 2006;11(прил 1):4—13.</p><p>Гаврилова С.И. Фармакотерапия болезни Альцгеймера. М.: Пульс, 2003;319 с.</p><p>Дамулин И.В. Использование ривастигмина при деменциях: от симптоматического эффекта к нейропротекции. Журн неврол и психиатр 2010;9:76-82.</p><p>Левин О.С. Диагностика и лечение деменции в клинической практике. М.: Медпресс-информ, 2009;255 с.</p><p>Alva G., Cummings J.L. Relative tolerability of Alzheimer's disease treatments. Psychiatry (Edgemont) 2008;5:27-36.</p><p>Spencer C.M., Noble S. Rivastigmine. A review of its use in Alzheimer's disease. Drugs Aging 1998;13:391-411.</p><p>Grossberg G.T., Stahelin H.B., Messina J.C. et al. Lack of adverse pharmacodynamic drug interactions with rivastigmine and twenty two classes of medications. Int J Geriatr Psychiatry 2000;15:242-7.</p><p>Ritchie C.W., Ames D., Clayton T. et al. Metaanalysis of randomized trials of the efficacy and safety of donepezil, galantamine, and rivastigmine for the treatment of Alzheimer disease. Am J Geriatr Psychiatry. 2004;12(4):358—69.</p><p>Birks J., Iakovidou V., Tsolaki M. Rivastigmine for Alzheimer's disease. Cochrane Database Syst Rev 2009;2:CD001191.</p><p>Verny M., Fremont P., Bourrin J.C. et al. Reduced psychotropic drug use in patients with Alzheimer's disease receiving rivastigmine: results of the EXELAN study. J Drug Ass 2004;7:1-10.</p><p>Lefe'vre G., Sedek G., Jhee S. et al. Pharmacokinetics and pharmacodynamics of the novel daily rivastigmine transdermal patch compared with twice-daily capsules in Alzheimer's disease patients. Clin Pharmacol Ther 2008;83:106-14.</p><p>Levin C., Maibach H. Transdermal drug delivery system: an overview. In: Marzulli and Maibach's Dermatotoxicology. 7th edn. H. Zhai, H.I. Maibach (eds). Boca Raton, FL: CRC Press, 2008:101-6.</p><p>Winblad B., Machado J.C. Use of rivastigmine transdermal patch in the treatment of Alzheimer's disease. Expert Opin Drug Deliv 2008;5:1377-86.</p><p>Mercier F., Lefe'vre G., Huang H.L. et al. Rivastigmine exposure provided by a transdermal patch versus capsules. Curr Med Res Opin 2007;23:3199-204.</p><p>Winblad B., Cummings J., Andreasen N. et al. A six-month doubleblind, randomized, placebo-controlled study of a transdermal patch in Alzheimer's disease — rivastigmine patch versus capsule. Int J Geriatr Psychiatry 2007;22:456-67.</p><p>Winblad B., Grossberg G., Frölich L. et al. IDEAL: a 6-month, double-blind, placebo-controlled study of the first skin patch for Alzheimer disease. Neurology 2007;69(Suppl 1):S14—22.</p><p>Blesa R., Ballard C., Orgogozo J.-M. et al. Caregiver preference for rivastigmine patches versus capsules for the treatment of Alzheimer disease. Neurol 2007;69(Suppl 1):S23—8.</p><p>Winblad B., Kawata A.K., Beusterien K.M. et al. Caregiver preference for rivastigmine patch relative to capsules for treatment of probable Alzheimer's disease. Int J Geriatr Psychiatry 2007;22:485-91.</p><p>Schmidt R., Alf C., Bancher C. et al. Transdermal rivastigmine patch in outpatient services in Austria: a naturalistic study in 103 patients with Alzheimer dementia. Neuropsychiatrie 2009; 23: 58-63.</p><p>Feldman H.H., Lane R. Rivastigmine: a placebo-controlled trial of BID and TID regimens in patients with Alzheimer's disease. J Neurol Neurosurg Psychiatry 2007;78:1056-63.</p></div><br /><div><p>Дамулин И.В. Сосудистая деменция и болезнь Альцгеймера. М., 2002;90 с.</p><p>Левин О.С. Алгоритмы диагностики и лечения деменции. М.: Медпресс-информ, 2011;127 с.</p><p>Яхно Н.Н. Когнитивные расстройства в неврологической клинике. Неврол журн 2006;11(прил 1):4—13.</p><p>Гаврилова С.И. Фармакотерапия болезни Альцгеймера. М.: Пульс, 2003;319 с.</p><p>Дамулин И.В. Использование ривастигмина при деменциях: от симптоматического эффекта к нейропротекции. Журн неврол и психиатр 2010;9:76-82.</p><p>Левин О.С. Диагностика и лечение деменции в клинической практике. М.: Медпресс-информ, 2009;255 с.</p><p>Alva G., Cummings J.L. Relative tolerability of Alzheimer's disease treatments. Psychiatry (Edgemont) 2008;5:27-36.</p><p>Spencer C.M., Noble S. Rivastigmine. A review of its use in Alzheimer's disease. Drugs Aging 1998;13:391-411.</p><p>Grossberg G.T., Stahelin H.B., Messina J.C. et al. Lack of adverse pharmacodynamic drug interactions with rivastigmine and twenty two classes of medications. Int J Geriatr Psychiatry 2000;15:242-7.</p><p>Ritchie C.W., Ames D., Clayton T. et al. Metaanalysis of randomized trials of the efficacy and safety of donepezil, galantamine, and rivastigmine for the treatment of Alzheimer disease. Am J Geriatr Psychiatry. 2004;12(4):358—69.</p><p>Birks J., Iakovidou V., Tsolaki M. Rivastigmine for Alzheimer's disease. Cochrane Database Syst Rev 2009;2:CD001191.</p><p>Verny M., Fremont P., Bourrin J.C. et al. Reduced psychotropic drug use in patients with Alzheimer's disease receiving rivastigmine: results of the EXELAN study. J Drug Ass 2004;7:1-10.</p><p>Lefe'vre G., Sedek G., Jhee S. et al. Pharmacokinetics and pharmacodynamics of the novel daily rivastigmine transdermal patch compared with twice-daily capsules in Alzheimer's disease patients. Clin Pharmacol Ther 2008;83:106-14.</p><p>Levin C., Maibach H. Transdermal drug delivery system: an overview. In: Marzulli and Maibach's Dermatotoxicology. 7th edn. H. Zhai, H.I. Maibach (eds). Boca Raton, FL: CRC Press, 2008:101-6.</p><p>Winblad B., Machado J.C. Use of rivastigmine transdermal patch in the treatment of Alzheimer's disease. Expert Opin Drug Deliv 2008;5:1377-86.</p><p>Mercier F., Lefe'vre G., Huang H.L. et al. Rivastigmine exposure provided by a transdermal patch versus capsules. Curr Med Res Opin 2007;23:3199-204.</p><p>Winblad B., Cummings J., Andreasen N. et al. A six-month doubleblind, randomized, placebo-controlled study of a transdermal patch in Alzheimer's disease — rivastigmine patch versus capsule. Int J Geriatr Psychiatry 2007;22:456-67.</p><p>Winblad B., Grossberg G., Frölich L. et al. IDEAL: a 6-month, double-blind, placebo-controlled study of the first skin patch for Alzheimer disease. Neurology 2007;69(Suppl 1):S14—22.</p><p>Blesa R., Ballard C., Orgogozo J.-M. et al. Caregiver preference for rivastigmine patches versus capsules for the treatment of Alzheimer disease. Neurol 2007;69(Suppl 1):S23—8.</p><p>Winblad B., Kawata A.K., Beusterien K.M. et al. Caregiver preference for rivastigmine patch relative to capsules for treatment of probable Alzheimer's disease. Int J Geriatr Psychiatry 2007;22:485-91.</p><p>Schmidt R., Alf C., Bancher C. et al. Transdermal rivastigmine patch in outpatient services in Austria: a naturalistic study in 103 patients with Alzheimer dementia. Neuropsychiatrie 2009; 23: 58-63.</p><p>Feldman H.H., Lane R. Rivastigmine: a placebo-controlled trial of BID and TID regimens in patients with Alzheimer's disease. J Neurol Neurosurg Psychiatry 2007;78:1056-63.</p></div><br />

The authors declare that there are no conflicts of interest present.