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Volume 352:1387 March 31, 2005 Number 13
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Rivastigmine for Dementia Associated with Parkinson's Disease

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by Emre, M.
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To the Editor: Emre et al. (Dec. 9 issue)1 report "moderate improvements" with rivastigmine in patients with dementia associated with Parkinson's disease. We believe that the small size of the effect, significant side effects, and overlooked biases in the study do not support the use of rivastigmine for dementia associated with Parkinson's disease.

The absolute difference in the rate of "clinically meaningful improvement" on the Alzheimer's Disease Cooperative Study–Clinician's Global Impression of Change (ADCS–CGIC) was only 5.3 percentage points between rivastigmine and placebo. Although the number needed to treat to achieve this benefit is 19, the "number needed to harm" . . . [Full Text of this Article]



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