Department of and Master's Program in Neurology, Faculty of Medicine, College of Medicine, and Neuroscience Research Center, Kaohsiung Medical University, Kaohsiung, Taiwan.
Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
Psychopharmacology (Berl). 2019 Apr;236(4):1255-1260. doi: 10.1007/s00213-018-5135-x. Epub 2019 Jan 15.
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.
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.
Patients with AD who continuously used rivastigmine patches (4.6 mg/24 h, 5 cm) 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.
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).
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.
利伐斯的明贴片被用于治疗阿尔茨海默病（AD）患者，但人们对利伐斯的明及其代谢物在使用利伐斯的明贴片后的血清浓度与皮褶厚度之间的关系知之甚少，也不清楚其与临床依从性的关系。
本研究旨在探讨利伐斯的明和 NAP 226-90 血清浓度与皮褶厚度之间的相关性，并确定 AD 患者使用利伐斯的明贴片的合适皮褶厚度。
本研究纳入了连续使用利伐斯的明贴片（4.6mg/24h，5cm）超过 6 个月的 AD 患者。测量了利伐斯的明和 NAP 226-90 的血清浓度。使用 Lange皮褶卡尺测量皮褶厚度。
共有 91 例 AD 患者（40 名男性和 51 名女性）参与了本研究的皮褶厚度测量。其中，27 例患者进行了利伐斯的明和 NAP 226-90 血清浓度检测，其平均浓度分别为 1.0±0.6ng/mL 和 3.6±3.6ng/mL。肩胛下区皮褶厚度与 NAP 226-90 血清浓度呈显著负相关（Spearman 秩相关系数=-0.47，P=0.01）。此外，AD 患者的肩胛下皮褶厚度≥25mm 时，其简易精神状态检查评分降低和不依从利伐斯的明贴片治疗的风险显著增加（比值比 3.00；95%置信区间=1.076-8.366，P=0.03）。
肩胛下皮褶厚度与 NAP 226-90 血清浓度显著负相关，可作为预测利伐斯的明贴片临床应用效果和依从性的一个合适指标。
