IDEAL: A 6-month, double-blind, placebo-controlled study of the first skin patch for Alzheimer disease

@article{Winblad2007IDEALA6,
  title={IDEAL: A 6-month, double-blind, placebo-controlled study of the first skin patch for Alzheimer disease},
  author={Bengt Winblad and George T. Grossberg and Lutz Fr{\"o}lich and Martin R. Farlow and Stefan Zechner and Jennifer Nagel and Roger M. Lane},
  journal={Neurology},
  year={2007},
  volume={69},
  pages={S14-S22}
}
The rivastigmine patch is the first transdermal treatment for Alzheimer disease (AD). By providing continuous delivery of drug into the bloodstream over 24 hours, transdermal delivery may offer benefits superior to those of oral administration. This study compared the efficacy, safety and tolerability of rivastigmine patches with capsules and placebo. IDEAL (Investigation of transDermal Exelon in ALzheimer’s disease) was a 24-week, double-blind, double-dummy, placebo- and active-controlled… 
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Rivastigmine patches and capsules provide significant effects in both total and subscale ADLs in patients with probable AD, with significantly superior performance in Alzheimer’s Disease Cooperative Study—Activities of Daily Living.
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Switching from any other oral acetylcholinesterase inhibitor to transdermal rivastigmine may improve cognition, and the percentage of patients taking psychotropic comedication decreased, particularly in first-time treated rivASTigmine patients.
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TLDR
With the higher caregiver preference and a good patient compliance, the trans-dermal rivastigmine patch is a suitable treatment choice for patients with mild-to-moderate AD, especially for patients intolerant to oral therapies.
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TLDR
A novel trial in the development of rivastigmine, as it uses a design that does not include a placebo arm, is recruiting patients with severe AD, and includes an ADL measure as a co-primary efficacy variable.
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