Alberto Castagna1, Antonino Maria Cotroneo2, Giovanni Ruotolo3, Pietro Gareri4. 1. Center for Cognitive Disorders and Dementia, Catanzaro Lido and Soverato-Chiaravalle-ASP Catanzaro, 88100, Catanzaro, Italy. 2. Hospital and Territorial Geriatrics, ASL Turin2, Turin, Italy. 3. Geriatric Unit, Azienda Ospedaliera "Pugliese-Ciaccio", Catanzaro, Italy. 4. Center for Cognitive Disorders and Dementia, Catanzaro Lido and Soverato-Chiaravalle-ASP Catanzaro, 88100, Catanzaro, Italy. pietro.gareri@alice.it.
Abstract
BACKGROUND: Acetylcholinesterase inhibitors (AchEIs), such as rivastigmine, coadministered with cholinergic precursors, such as citicoline, could be effective in Alzheimer's disease (AD) and in mixed dementia (MD), because they are able to increase the intrasynaptic levels of acetylcholine more than the single drugs given alone. OBJECTIVE: The aim of the present study was to show the effectiveness of oral citicoline plus rivastigmine in patients with AD and MD. METHODS: The CITIRIVAD study was a retrospective case-control study on 174 consecutive outpatients aged ≥65 years, affected with AD or MD, mean age 81.3 ± 4.5 years. Of the 174 patients, 92 had been treated with rivastigmine + citicoline 1000 mg/day given orally (group A); 82 patients had been treated with rivastigmine (group B). In both groups rivastigmine patch had been used for at least six months at the highest tolerated dosage. Group A comprised 62 patients affected with AD and 30 patients with MD. Group B comprised 53 patients affected with AD and 29 with MD. Cognitive functions had been assessed by Mini Mental State Examination (MMSE), daily life functions by activities of daily living (ADL) and instrumental activities (IADL), behavioral symptoms by neuropsychiatric inventory (NPI), comorbidities by the Cumulative Illness Rating Scale and mood by geriatric depression scale (GDS)-short form tests, which had been administered at baseline, 3 and 9 months. RESULTS AND CONCLUSIONS: Data show the effectiveness of combined administration versus the AchEI alone, mainly in slowing disease progression and consequently in disease management, both in AD and in MD. No differences regarding the combined treatment were found between the two groups. Treatment with citicoline plus rivastigmine was safe and well tolerated.
BACKGROUND: Acetylcholinesterase inhibitors (AchEIs), such as rivastigmine, coadministered with cholinergic precursors, such as citicoline, could be effective in Alzheimer's disease (AD) and in mixed dementia (MD), because they are able to increase the intrasynaptic levels of acetylcholine more than the single drugs given alone. OBJECTIVE: The aim of the present study was to show the effectiveness of oral citicoline plus rivastigmine in patients with AD and MD. METHODS: The CITIRIVAD study was a retrospective case-control study on 174 consecutive outpatients aged ≥65 years, affected with AD or MD, mean age 81.3 ± 4.5 years. Of the 174 patients, 92 had been treated with rivastigmine + citicoline 1000 mg/day given orally (group A); 82 patients had been treated with rivastigmine (group B). In both groups rivastigmine patch had been used for at least six months at the highest tolerated dosage. Group A comprised 62 patients affected with AD and 30 patients with MD. Group B comprised 53 patients affected with AD and 29 with MD. Cognitive functions had been assessed by Mini Mental State Examination (MMSE), daily life functions by activities of daily living (ADL) and instrumental activities (IADL), behavioral symptoms by neuropsychiatric inventory (NPI), comorbidities by the Cumulative Illness Rating Scale and mood by geriatric depression scale (GDS)-short form tests, which had been administered at baseline, 3 and 9 months. RESULTS AND CONCLUSIONS: Data show the effectiveness of combined administration versus the AchEI alone, mainly in slowing disease progression and consequently in disease management, both in AD and in MD. No differences regarding the combined treatment were found between the two groups. Treatment with citicoline plus rivastigmine was safe and well tolerated.
Authors: Patrizia Rinaldi; Patrizia Mecocci; Claudia Benedetti; Sara Ercolani; Mario Bregnocchi; Giuseppe Menculini; Marco Catani; Umberto Senin; Antonio Cherubini Journal: J Am Geriatr Soc Date: 2003-05 Impact factor: 5.562