Studi Express ed Exceed: Ricadute cliniche

Dementia is highly prevalent in Parkinson's disease and is increasingly being recognized as a major prognostic factor for progressive disability and nursing home placement. A number of studies have recently appeared on the cholinergic changes in Parkinson's disease and dementia and dementia with Lewy bodies, and on the use of cholinesterase inhibitors in the treatment of patients with cognitive impairment. In Express Study was investigated the effects of the dual cholinesterase inhibitor rivastigmine in patients who have dementia associated with Parkinson's disease. Rivastigmine was associated with moderate improvements in dementia associated with Parkinson's disease but also with higher rates of nausea, vomiting, and tremor. The Exceed study was a double-blind, randomised, controlled, multicentre trial was designed to evaluate the efficacy and tolerability of cholinesterase inhibitor treatment in patients with moderate to moderately-severe Alzheimer's disease over a 2-year period. Patients were randomly assigned to rivastigmine 3-12 mg/day or donepezil 5-10 mg/day. Both drugs performed similarly on cognition and behaviour, rivastigmine may provide greater benefit in activities of daily living and global function. The results of the two studies demonstrate the potential clinical implications of cholinesterase inhibitors in the treatment of dementia.