Patch Better for Alzheimers Drug?

July 19, 2006 -- New research shows that putting the Alzheimer's diseaseAlzheimer's disease drug Exelon in a patch instead of pills may simplify use and cut the drug's side effect of nausea and vomiting.

Bengt Winblad, MD, PhD, and colleagues presented those findings at the 10th International Conference on Alzheimer's Disease and Related Disorders, being held this week in Madrid, Spain. Winblad works at the Karolinska Institute near Stockholm, Sweden.

The experimental skin patch "may provide optimal delivery" of Exelon in treating Alzheimer's disease, write Winblad and colleagues.

Patches deliver drugs through the skin, while pills go to the stomach. By bypassing the stomach, medicine delivered via patches may help avoid gastrointestinal side effects such as nausea and vomiting.

Patches may also be simpler to use than pills. Patients don't have to remember when to take their pills, which may be particularly helpful with Alzheimer's disease, since Alzheimer's affects the brain. Patients wearing patches also don't have to swallow pills, a task that's difficult for some patients.

Patch Project

Winblad's team studied 1,195 Alzheimer's patients in 21 countries. The patients were 50-85 years old.

For 24 weeks, patients got one of three treatments:

• a small Exelon patch (about 4 square inches) that delivered 9.5 milligrams of the drug every day
• a larger Exelon patch (nearly 8 square inches) that delivered 17.4 milligrams of the drug per day
• Exelon pills (6 milligrams twice daily, which is the maximum oral dose)

For comparison, other patients got a placebo, which contained no Exelon or other medicine.

The results:

• Exelon patches and pills performed equally well, both beating the placebo.
• The smaller Exelon patch was associated with one-third the rate of reported nausea and vomiting, compared to the Exelon pills.

About 7% of the patients wearing the smaller Exelon patch reported nausea, compared to 23% of those taking the Exelon pills. Roughly 6% of the patients wearing the smaller Exelon patch reported vomiting, compared to 17% of those taking the Exelon pills.

Specific results aren't available for the larger Exelon patch, but the researchers report the larger patch had "similar tolerability" to the pills. The patches created few skin problems, according to the study.

Winblad notes that he has financial ties to Novartis, the drug company that makes Exelon; some of the researchers involved in the study work for Novartis. Novartis is a WebMD sponsor.

SOURCES: 10th International Conference on Alzheimer's Disease and Related Disorders, Madrid, Spain, July 15-20, 2006. News release, Alzheimer's Association.