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Abstract Details

Rivastigmine for Cognitive Impairment in Multiple sclerosis : A Parallel Group Randomised Open Label Study with Blinded End Point assessment
Multiple Sclerosis
MS and CNS Inflammatory Disease Posters (7:00 AM-5:00 PM)
186
 To evaluate the effects of Rivastigmine on cognitive impairment in Multiple Sclerosis in terms of efficacy and safety.
Memory impairment in Multiple Sclerosis is a commonly underdiagnosed condition affecting quality of life in  young adults. No satisfactory treatment exists till date for its symptomatic improvement

This  parallel group randomised  open label  single centre study  included patients of RRMS, SPMS, PPMS between 18-65 years of age satisfying Revised 2017 McDonald criteria .Patients were randomly assigned (1:1) to oral Rivastigmine (1.5 mg for 4 weeks followed by dose escalation to 3 mg BD for 8 weeks) or control arm.   Primary outcome was improvement in memory functions as assessed by change in Logical Memory subtest of Welscher[DKP1]  Memory Scale III, India at end of 12 weeks compared to baseline. Secondary outcomes were effect on fatigue (  Modified Fatigue Impact Scale V), depression ( Montgomery Asberg Depression Rating Scale ) and safety . Complete case ( modified Intention to treat ) analysis for  efficacy outcomes was performed. For safety outcomes, all patients who received atleast one dose of trial medication were included.

 [DKP1]Check name to be sure?
 Between 2019- 2020, 60 patients were enrolled . 30 were assigned to Rivastigmine arm ;30 to control arm. 3 in intervention arm did not initiate treatment; 5 discontinued due to side effects. In complete case analysis ,at  end of 12 weeks,  there was statistically significant improvement in memory function in intervention arm as compared to control arm ;mean difference 7.56 [ 95%CI 0.67 to 14.46;p 0.032]. In sensitivity analysis ( worst case scenario ), this difference was statistically not significant .]There was no statistically significant improvement in fatigue and depression in complete case and sensitivity analysis. Rivastigmine was found to be safe with no serious adverse effects. 

Rivastigmine improves memory function in cognitively impaired Multiple Sclerosis patients. More studies are needed to establish its efficacy and safety.
Authors/Disclosures
Jagdish J. Gotur, DM (All India Institute Of Medical Sciences, New Delhi)
PRESENTER 		Dr. Gotur has nothing to disclose.
Kameshwar Prasad, MD (Rajendra Institute of Medical Sciences, Ranchi) The institution of Prof. Prasad has received research support from Government of India Departments of Health Research and Biotechnology.
Achal K. Srivastava, MD, FAAN (AIIMS) Dr. Srivastava has nothing to disclose.
Deepti Vibha, MD (All India Institute of Medical Sciences) Dr. Vibha has nothing to disclose.
No disclosure on file
Roopa Rajan (Sree Chitra Tirunal Institute for Medical Sciences and Technology) Roopa Rajan has received research support from DBT. Roopa Rajan has received research support from DST-SERB. The institution of Roopa Rajan has received research support from Michael J Fox Foundaton.