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Nervenheilkunde 2008; 27(09): 794-799
DOI: 10.1055/s-0038-1627219
Originaler Artikel
Schattauer GmbH

Ein transdermales Pflaster zur Therapie der Alzheimer-Demenz

A transdermal patch for the treatment of Alzheimer‘s disease
L. Frölich
1   Zentralinstitut für Seelische Gesundheit, Mannheim
,
M. Riepe
2   Sektion Gerontopsychiatrie BKH Günzburg, Universität Ulm
› Author Affiliations
Further Information

Publication History

Eingegangen am: 13 June 2008

angenommen am: 23 June 2008

Publication Date:
22 January 2018 (online)

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Zusammenfassung

Das transdermale Rivastigmin-Pflaster (Exelon® Pflaster) stellt die erste, für die Alzheimer Krankheit (AD) entwickelte, transdermale Therapieform dar. Transdermale Applikationsformen, wie z. B. Pflaster sorgen für eine gleichmäßige und kontinuierliche Wirkstoffabgabe über die Haut ins Serum, senken dabei die Absorptionsrate und garantieren - verglichen mit der herkömmlichen oralen Verabreichung - einen konstanteren Plasmaspiegel. Im Falle des Rivastigmin- Pflasters kommt es hierdurch zu einer Reduktion von akuten gastrointestinalen Nebenwirkungen (wie beispielsweise Übelkeit und Erbrechen), die üblicherweise von Alzheimer- Patienten während der Einstellungsphase mit Cholinesterasehemmern berichtet werden. Dies wiederum erleichtert den Zugang zu optimalen therapeutischen Dosen, sorgt für eine bessere Compliance und hat positive Auswirkungen auf die Wirksamkeit der Therapie. Dieser Artikel bietet einen Überblick über die aus verschiedenen Studien vorliegenden Daten zum transdermalen Rivastigmin-Pflaster, das zur symptomatischen Behandlung von leichter bis mittelschwerer AD eingesetzt wird. Ferner wird der Nutzen der Pflasteranwendung gegenüber der Einnahme von Kapseln erörtert. Besonderes Augenmerk gilt dabei den Ergebnissen der richtungsweisenden IDEAL-Studie.

Summary

The rivastigmine transdermal patch (Exelon® transdermal patch) is the first transdermal treatment developed for Alzheimer’s disease (AD). Patches provide smooth and continuous drug delivery through the skin and into the bloodstream, lowering the rate of absorption and providing steadier plasma levels versus conventional oral administration. In the case of the rivastigmine patch, this has the potential to reduce the incidence of acute gastrointestinal adverse events (such as nausea and vomiting) that are typically reported by AD patients during the titration phase of cholinesterase inhibitor treatments. This in turn may allow easier access to optimal therapeutic doses, help to improve compliance, and have a positive impact on the efficacy of treatment. This article reviews the available pharmacokinetic and clinical data from various studies of a novel rivastigmine transdermal patch for the symptomatic treatment of mild to moderate AD. We also discuss the potential benefits of patch administration over capsule administration, with a focus on the results of the landmark IDEAL trial.

Schlüsselwörter

Alzheimer Krankheit - Rivastigmin - Cholinesterasehemmer - Demenz - transdermal - Pflaster

Keywords

Alzheimer’s disease - rivastigmine - cholinesterase inhibitors - dementia - transdermal - patch
 

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