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Psych Congress  

Efficacy of 13.3 mg/24 h versus 4.6 mg/24 h rivastigmine patch on activities of daily living in severe Alzheimer’s disease: a factor analysis

Authors  
Alan Dengiz, MD. Joseph Micca, MD. Drew Velting, MD. Xiangyi Meng, PhD.
Sponsor  
Novartis Pharmaceuticals Corporation

Introduction: Stabilizing/reducing decline in the ability to perform activities of daily living (ADL) is important in the management of Alzheimer’s disease (AD). The 24-week, randomized, double-blind ACTION (ACTivities of daily living and cognitION) study demonstrated efficacy of 13.3 mg/24 h versus 4.6 mg/24 h rivastigmine patch on ADL (Alzheimer’s Disease Cooperative Study–ADL scale–Severe Impairment Version [ADCS-ADL-SIV]) in patients with severe AD. 
Objective: To investigate the efficacy of the 13.3 mg/24 h patch in patients with severe AD on ADL domains derived using factor analysis.
Methods: In the current retrospective analysis of the ACTION study, the PROC FACTOR procedure (SAS) was used to establish a ‘best fit’ for the 19 ADCS-ADL-SIV items into new domains. Change from baseline at Week 24 on these domains was calculated. Treatment differences (13.3 mg/24 h versus 4.6 mg/24 h patch) were assessed using ANCOVA, with treatment and center as factors, and baseline as a covariate. 
Results: ADCS-ADL-SIV data were provided by patients randomized to 13.3 mg/24 h patch (N=315) or 4.6 mg/24 h patch (N=317). Factor analysis yielded four new domains, termed ‘daily function’, ‘communication’, ‘independence’ and ‘environment’. The 13.3 mg/24 h patch demonstrated significantly greater efficacy versus 4.6 mg/24 h patch on ‘daily function’ (p=0.038) and a trend towards greater efficacy on ‘communication’ (p=0.052). No significant between-group differences were observed on ‘independence’ (p=0.60) and ‘environment’ (p=0.261). 
Conclusions: The 13.3 mg/24 h patch demonstrated superior efficacy to 4.6 mg/24 h patch on select ADL domains in patients with severe AD.  

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