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Skinfold thickness for rivastigmine patch application in Alzheimer’s disease

  • Ping-Song Chou
  • Kai-Ming Jhang
  • Ling-Chun Huang
  • Wen-Fu WangEmail author
  • Yuan-Han YangEmail author
Original Investigation

Abstract

Rationale

Rivastigmine patches are used for patients with Alzheimer’s disease (AD), but little is known about the serum concentration of rivastigmine and its metabolite or clinical adherence in relation to skinfold thickness after rivastigmine patch application.

Objectives

The aim of this study was to examine the association between rivastigmine and NAP 226-90 serum concentration and skinfold thickness and to determine the appropriate skinfold thickness for the use of rivastigmine patch in patients with AD.

Methods

Patients with AD who continuously used rivastigmine patches (4.6 mg/24 h, 5 cm2) for more than 6 months were recruited. The serum concentrations of rivastigmine and NAP 226-90 were measured. Skinfold thickness was measured using a Lange Skinfold Caliper.

Results

In total, 91 patients with AD (40 men and 51 women) participated in this study on skinfold thickness measurement. Among them, 27 patients were examined for rivastigmine and NAP 226-90 serum concentrations, with mean concentrations of 1.0 ± 0.6 ng/mL and 3.6 ± 3.6 ng/mL, respectively. The skinfold thickness in the subscapular area was significantly negatively correlated with the NAP 226-90 serum concentration (Spearman’s rank correlation coefficient = − 0.47, P = .01). In addition, patients with AD and a subscapular skinfold thickness of ≥25 mm exhibited a significantly high risk of decreased Mini-Mental Status Examination score and nonadherence to a rivastigmine patch (odds ratio 3.00; 95% confidence interval = 1.076–8.366, P = .03).

Conclusions

Subscapular skinfold thickness was significantly negatively correlated with the NAP 226-90 serum concentration and may be considered an appropriate predictor of response and adherence to clinical application of a rivastigmine patch.

Keywords

Alzheimer’s disease NAP 226-90 Rivastigmine patch Skinfold thickness 

Notes

Acknowledgements

This manuscript was edited by Wallace Academic Editing.

Funding

This study was supported by grants from Kaohsiung Medical University Hospital (KMUH-9M40) and Kaohsiung Medical University and Changhua Christian Hospital (105-CCH-KMU-011).

Compliance with ethical standards

All procedures were approved by the Institutional Review Boards of Changhua Christian Hospital and Kaohsiung Medical University Hospital. All of the participants or their legal representatives provided written informed consent.

Conflict of interest

The authors declare that they have no conflict of interest.

References

  1. American Alliance for Health PE, Recreation, and Dance (1980) AAHPERD lifetime health related physical fitness: test manualGoogle Scholar
  2. Birks JS, Chong LY, Grimley Evans J (2015) Rivastigmine for Alzheimer’s disease. Cochrane Database Syst Rev 9:CD001191PubMedGoogle Scholar
  3. Chen TH, Chou MC, Lai CL, Wu SJ, Hsu CL, Yang YH (2017) Factors affecting therapeutic response to Rivastigmine in Alzheimer’s disease patients in Taiwan. Kaohsiung J Med Sci 33:277–283CrossRefGoogle Scholar
  4. Chou MC, Chen CH, Liu CK, Chen SH, Wu SJ, Yang YH (2012) Concentrations of rivastigmine and NAP 226-90 and the cognitive response in Taiwanese Alzheimer’s disease patients. J Alzheimers Dis 31:857–864CrossRefGoogle Scholar
  5. Cutler NR, Polinsky RJ, Sramek JJ, Enz A, Jhee SS, Mancione L, Hourani J, Zolnouni P (1998) Dose-dependent CSF acetylcholinesterase inhibition by SDZ ENA 713 in Alzheimer’s disease. Acta Neurol Scand 97:244–250CrossRefGoogle Scholar
  6. Durnin JV, Womersley J (1974) Body fat assessed from total body density and its estimation from skinfold thickness: measurements on 481 men and women aged from 16 to 72 years. Br J Nutr 32:77–97CrossRefGoogle Scholar
  7. Enz A, Chappuis A, Dattler A (2004) A simple, rapid and sensitive method for simultaneous determination of rivastigmine and its major metabolite NAP 226-90 in rat brain and plasma by reversed-phase liquid chromatography coupled to electrospray ionization mass spectrometry. Biomed Chromatogr 18:160–166CrossRefGoogle Scholar
  8. Gottwald MD, Rozanski RI (1999) Rivastigmine, a brain-region selective acetylcholinesterase inhibitor for treating Alzheimer’s disease: review and current status. Expert Opin Investig Drugs 8:1673–1682CrossRefGoogle Scholar
  9. Ho BL, Kao YH, Chou MC, Yang YH (2016) Cerebral white matter changes on therapeutic response to rivastigmine in Alzheimer’s disease. J Alzheimers Dis 54:351–357CrossRefGoogle Scholar
  10. Hsieh YH, Yang YH, Yeh HH, Lin PC, Chen SH (2009) Simultaneous determination of galantamine, rivastigmine and NAP 226-90 in plasma by MEKC and its application in Alzheimer’s disease. Electrophoresis 30:644–653CrossRefGoogle Scholar
  11. Kurz A, Farlow M, Lefevre G (2009) Pharmacokinetics of a novel transdermal rivastigmine patch for the treatment of Alzheimer’s disease: a review. Int J Clin Pract 63:799–805CrossRefGoogle Scholar
  12. Lefevre G, Buche M, Sedek G, Maton S, Enz A, Lorch U, Sagan C, Appel-Dingemanse S (2009) Similar rivastigmine pharmacokinetics and pharmacodynamics in Japanese and white healthy participants following the application of novel rivastigmine patch. J Clin Pharmacol 49:430–443CrossRefGoogle Scholar
  13. Lefevre G, Sedek G, Huang HL, Saltzman M, Rosenberg M, Kiese B, Fordham P (2007) Pharmacokinetics of a rivastigmine transdermal patch formulation in healthy volunteers: relative effects of body site application. J Clin Pharmacol 47:471–478CrossRefGoogle Scholar
  14. McKhann G, Drachman D, Folstein M, Katzman R, Price D, Stadlan EM (1984) Clinical diagnosis of Alzheimer’s disease: report of the NINCDS-ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer’s Disease. Neurology 34:939–944CrossRefGoogle Scholar
  15. Mercier F, Lefevre G, Huang HL, Schmidli H, Amzal B, Appel-Dingemanse S (2007) Rivastigmine exposure provided by a transdermal patch versus capsules. Curr Med Res Opin 23:3199–3204CrossRefGoogle Scholar
  16. Orphanidou C, McCargar L, Birmingham CL, Mathieson J, Goldner E (1994) Accuracy of subcutaneous fat measurement: comparison of skinfold calipers, ultrasound, and computed tomography. J Am Diet Assoc 94:855–858CrossRefGoogle Scholar
  17. Rosler M, Anand R, Cicin-Sain A, Gauthier S, Agid Y, Dal-Bianco P, Stahelin HB, Hartman R, Gharabawi M (1999) Efficacy and safety of rivastigmine in patients with Alzheimer’s disease: international randomised controlled trial. BMJ 318:633–638CrossRefGoogle Scholar
  18. Winblad B, Cummings J, Andreasen N, Grossberg G, Onofrj M, Sadowsky C, Zechner S, Nagel J, Lane R (2007) A six-month double-blind, randomized, placebo-controlled study of a transdermal patch in Alzheimer’s disease—rivastigmine patch versus capsule. Int J Geriatr Psychiatry 22:456–467CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of and Master’s Program in Neurology, Faculty of Medicine, College of Medicine, and Neuroscience Research CenterKaohsiung Medical UniversityKaohsiungTaiwan
  2. 2.Department of NeurologyKaohsiung Medical University HospitalKaohsiungTaiwan
  3. 3.Department of NeurologyChanghua Christian HospitalChanghuaTaiwan
  4. 4.Department of Neurology, Kaohsiung Municipal Ta-Tung HospitalKaohsiung Medical UniversityKaohsiungTaiwan
  5. 5.Department of Holistic WellnessMing Dao UniversityChanghuaTaiwan

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