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Article type: Research Article
Authors: Bu, Kuna; 1 | Patel, Devashrub; 1 | Morris, Robertc; d; 1 | Han, Weirua | Umeukeje, Gibretc | Zhu, Tianruic | Cheng, Fengc; d; *
Affiliations: [a] Department of Mathematics & Statistics, College of Art and Science, University of South Florida, Tampa, FL, USA | [b] College of Computing, Georgia Institute of Technology, Atlanta, GA, USA | [c] Department of Pharmaceutical Science, Taneja College of Pharmacy, University of South Florida, Tampa, FL, USA | [d] Department of Biostatistics & Epidemiology, College of Public Health, University of South Florida, Tampa, FL, USA
Correspondence: [*] Correspondence to: Feng Cheng PhD, Department of Pharmaceutical Science, Taneja College of Pharmacy, University of South Florida, 12901 Bruce B Downs Blvd, MDC30, Tampa, FL 33613, USA. Tel.: +1 813 974 4288; E-mail: fcheng1@usf.edu.
Note: [1] These authors contributed equally to this work.
Abstract: Background:Dysphagia has been reported as an adverse event for patients receiving rivastigmine for Alzheimer’s disease (AD) treatment. Objective:The purpose of this study was to determine the association between dysphagia and the usage of rivastigmine by using the pharmacovigilance data from the FDA Adverse Event Reporting System (FAERS). Methods:The risk of dysphagia in patients who took rivastigmine was compared with those of patients who took other medications. In addition, this study sought to determine if the dysphagia risk was influenced by sex, age, dosage, and medication routes of administration. Results:When compared to patients prescribed donepezil, galantamine, or memantine, individuals prescribed rivastigmine were almost twice as likely to report dysphagia as an adverse event. The dysphagia risk in individuals prescribed rivastigmine is comparable to individuals prescribed penicillamine but significantly higher than clozapine, drugs of which have been previously shown to be associated with elevated dysphagia likelihood. Individuals older than 80 were 122% more likely to report having dysphagia after being prescribed rivastigmine than patients that were 50–70 years of age. Oral administration of rivastigmine was associated with approximately 2 times greater likelihood of reporting dysphagia relative to users of the transdermal patch. In addition, dysphagia showed higher association with pneumonia than other commonly reported adverse events. Conclusion:Patients prescribed rivastigmine were at greater risk of reporting dysphagia as an adverse event than patients prescribed many other medicines. This increase in dysphagia occurrence may be attributed to the dual inhibition of both acetylcholinesterase and butyrylcholinesterase.
Keywords: Exelon, FAERS, FDA, patch, pharmacovigilance, pneumonia, swallow, transdermal
DOI: 10.3233/JAD-220583
Journal: Journal of Alzheimer's Disease, vol. 89, no. 2, pp. 721-731, 2022
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