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Supportive Slides Alzheimer Disease Assessment Scale—Cognitive Subscale (ADAS-cog) 11-Item Score range Memory and new learning 0 - 35 Word recall (mean.

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Presentation on theme: "Supportive Slides Alzheimer Disease Assessment Scale—Cognitive Subscale (ADAS-cog) 11-Item Score range Memory and new learning 0 - 35 Word recall (mean."— Presentation transcript:

1 Supportive Slides Alzheimer Disease Assessment Scale—Cognitive Subscale (ADAS-cog) 11-Item Score range Memory and new learning 0 - 35 Word recall (mean number of words not recalled) 0 - 10 Orientation (one point for each incorrect response) 0 - 8 Word recognition (mean number of incorrect responses) 0 - 12 Remembering test instructions 0 - 5 Language 0 - 25 Commands Spoken language ability Naming objects/fingers Word-finding difficulty Comprehension Praxis Constructional praxis Ideational praxis Total 0 - 70 Increasing scores indicate worsening cognitive function. Rosen WG, et al. Am J Psychiatry. 1984;141:

2 LS mean difference (95% CI).
Supportive Slides Treatment Difference at Wk 24 on ADAS-cog by Country Core Study—ITT+RDO Population Austria (N = 9) Belgium (N = 21) Canada (N = 41) Germany (N = 63) Spain (N = 59) France (N = 63) Great Britain (N = 48) Italy (N = 118) Netherlands (N = 18) –39.67 46.92 Norway (N = 7) –29.92 Portugal (N = 9) Turkey (N = 45) –20 –10 10 20 Favor placebo Favor Exelon LS mean difference (95% CI).

3 Supportive Slides Duration of Nausea and Vomiting and Number of Events per Patient Core Study Nausea n (%) Vomiting n (%) Duration Events, N = 137 Events, N = 77 1 - 7 days 55 (40.1) 47 (61.0) days 16 (11.7) 7 (9.1) days 13 (9.5) 8 (10.4) days 11 (8.0) 5 (6.5) > 28 days 22 (16.1) 4 (5.2) Continuing† 20 (14.6) 6 (7.8) Number of events/patient Patients, N = 105 Patients, N = 60 1 81 (77.1) 49 (81.7) 2 19 (18.1) 8 (13.3) 3 2 (1.9) 1 (1.7) > 3 3 (2.9) 2 (3.3) † Events with no end dates recorded, which may or may not have resolved by last study visit.

4 Duration of Tremor and Number of These Events per Patient Core Study
Supportive Slides Duration of Tremor and Number of These Events per Patient Core Study Tremor n (%) Duration Total events = 40 1 - 7 days 11 (27.5) days 3 (7.5) days 1 (2.5) days > 28 days 4 (10.0) Continuing† 18 (45.0) Number of events/patient Total patients = 37 1 34 2 3 > 3 1 episode: 34 patients; 2 episodes: 3 patients. † Events with no end dates recorded, which may or may not have resolved by last study visit.

5 AE of Tremor Over Time Core and Extension Studies
Supportive Slides AE of Tremor Over Time Core and Extension Studies Core Extension Exelon n/N (%) Placebo n/N (%) Exe-Exelon n/N (%) Plc-Exelon n/N (%) Titration period, wk 0 - 4 7/362 (1.9) 3/179 (1.7) 1/123 (0.8) > 4 - 8 9/343 (2.6) > 3/207 (1.4) 6/119 (5.0) > 15/324 (4.6) 1/165 (0.6) > 2/202 (1.0) 6/115 (5.2) > 6/301 (2.0) 2/162 (1.2) > 2/195 (1.0) 2/107 (1.9) Maintenance period, wk > 2/281 (0.7) 1/158 (0.6) > 1/191 (0.5) 1/102 (1.0) > 1/271 (0.4) Patients are counted more than once if event continues through multiple periods.

6 Change on ADAS-cog Sub-items at Wk 24 Core Study—OC Population
Supportive Slides Change on ADAS-cog Sub-items at Wk 24 Core Study—OC Population Mean ± SD Exelon (N = 290) Placebo (N = 159) ADAS-cog sub-item N Change at Wk 24 p value† Item 1: word recall 255 0.5 ± 1.3 139 0.1 ± 1.3 0.014* Item 2: commands 258 0.3 ± 1.2 141 0.0 ± 1.3 0.023* Item 3: constructional praxis 249 0.2 ± 1.0 135 –0.1 ± 1.1 0.095 Item 4: naming objects/fingers 0.1 ± 0.8 142 –0.1 ± 0.9 0.037* Item 5: ideational praxis 245 0.4 ± 1.5 134 –0.1 ± 1.3 < 0.001* Item 6: orientation 259 0.4 ± 1.8 143 –0.1 ± 1.7 0.060 Item 7: word recognition 0.5 ± 3.3 137 –0.2 ± 3.6 0.106 Item 8: remembering test instructions 256 0.2 ± 1.3 –0.1 ± 1.2 0.013* Item 9: spoken language ability 0.1 ± 1.2 –0.3 ± 1.0 0.032* Item 10: word finding difficulty 0.1 ± 1.0 0.0 ± 1.0 0.421 Item 11: comprehension –0.2 ± 1.0 0.012* *p < 0.05 † p value based on van Elteren test blocking for country.

7 Major Protocol Violations Core Study
Supportive Slides Major Protocol Violations Core Study Exelon Placebo Total Protocol violation N = 362 n (%) N = 179 n (%) N = 541 n (%) ≥ 1 protocol violation 82 (22.7) 33 (18.4) 115 (21.3) MMSE score < 10 or > 24 6 (1.7) 3 (1.7) 9 (1.7) Date diagnosis PD > date of first symptoms of PDD –2 yr 14 (3.9) 17 (3.1) Increased dose or newly introduced psychotropic/ dopaminergic medication 39 (10.8) 18 (10.1) 57 (10.5)

8 Supportive Slides Dopaminergic Agents— Dose Increase After Start of Study Drug Core Study Exelon N = 362 n (%) Placebo N = 179 n (%) Dopa and dopa derivatives 20 (5.5) 8 (4.5) Dopamine agonists 3 (0.8) 1 (0.6) Other dopaminergic agents 2 (0.6) Doses were required to remain unchanged unless clinically indicated.


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