2026-04-03T22:27:45Zhttps://recercat.cat/oai/request

oai:recercat.cat:2072/3347062024-12-13T10:15:17Zcom_2072_96855com_2072_96852com_2072_2015col_2072_228885

00925njm 22002777a 4500 dc Muñoz Moreno, Jose Antonio author Prats, Anna author Moltó, José author Garolera Freixa, Maite author Pérez Álvarez, Núria author Díez Quevedo, Crisanto author Miranda, Cristina author Rodríguez Fumaz, Carmina author Ferrer, María José author Clotet, Bonaventura author To assess the efficacy and safety of transdermal rivastigmine for the treatment of HIV-associated cognitive impairment. Methods, we recruited HIV-infected patients with cognitive impairment on stable antiretroviral therapy in a randomized controlled pilot trial with a 48-week follow-up. An additional assessment was held at 12 weeks. Participants received transdermal rivastigmine (9.5 mg daily), lithium (400 mg twice daily, titrated progressively), or remained in a control group (no new medication). The primary efficacy endpoint was change in a global cognitive score (NPZ-7). Secondary endpoints included change in specific cognitive measures, domains, and functional parameters. Safety covered the frequency of adverse events and changes in laboratory results. Seventy-six subjects were screened, and 29 were finally enrolled. Better cognitive outcomes were observed in all groups, although there were no significant differences between the arms (mean NPZ-7 change [SD]): rivastigmine, 0.35 (0.14); lithium, 0.25 (0.40); control, 0.20 (0.44) (p = 0.78). The rivastigmine group showed the highest positive trend (mean NPZ-7 [SD], baseline vs week 48): rivastigmine, -0.47 (0.22) vs -0.11 (0.29), p = 0.06; lithium, -0.50 (0.40) vs -0.26 (0.21), p = 0.22; control, -0.52 (0.34) vs -0.32 (0.52), p = 0.44. The cognitive domains with the highest positive trends were information processing speed at week 12 and executive function at week 48 (rivastigmine vs control): information processing speed, 0.35 (0.64) vs ¿0.13 (0.25), p = 0.17, d = 0.96; and executive functioning, 0.73 (0.33) vs 0.03 (0.74), p = 0.09, d = 1.18. No relevant changes were observed regarding functional outcomes. A total of 12 (41%) individuals dropped out of the study: 2 (20%) were due to medication-related effects in the rivastigmine group and 4 (36%) in the lithium group. No severe adverse events were reported. Conclusions, the results from this small randomized trial indicate that transdermal rivastigmine did not provide significant cognitive benefits in people with HAND on stable antiretroviral therapy, even though positive trends were found in specific cognitive domains. Relevant tolerability issues were not observed. Muñoz-Moreno,J., Prats, A., Moltó, J., Garolera, M., Pérez-Álvarez N, Díez-Quevedo C, et al. (2017). Transdermal rivastigmine for HIVassociated cognitive impairment: A randomized pilot study. PLoS ONE 12(8), e0182547. doi: 10.1371/journal.pone.0182547 10.1371/journal.pone.0182547 http://www.doi.org/10.1371/journal.pone.0182547 PMC5576750 (PMC) http://hdl.handle.net/10609/85445 cognitive impairment combination antiretroviral therapy deterioro cognitivo tratamiento antirretroviral combinado deterioració cognitiva tractament antiretroviral combinat AIDS (Disease) Sida Sida Transdermal rivastigmine for HIV-associated cognitive impairment: A randomized pilot study