Rivastigmine for dementia associated with Parkinson's disease
Identifieur interne : 000379 ( PascalFrancis/Curation ); précédent : 000378; suivant : 000380Rivastigmine for dementia associated with Parkinson's disease
Auteurs : Murat Emre [Turquie] ; Dag Aarsland [Norvège] ; Albeao Albanese [Italie] ; E. Jane Byrne [Royaume-Uni] ; Günther Deuschl [Allemagne] ; Peter P. De Deyn [Belgique] ; Franck Durif [France] ; Jaime Kulisevsky [Espagne] ; Teus Van Laar [Pays-Bas] ; Andrew Lees [Royaume-Uni] ; Werner Poewe [Autriche] ; Alain Robillard [Canada] ; Mario M. Rosa [Portugal] ; Erik Wolters [Pays-Bas] ; Peter Quarg [Suisse] ; Sibel Tekin [États-Unis] ; Roger Lane [États-Unis]Source :
- The New England journal of medicine [ 0028-4793 ] ; 2004.
Descripteurs français
- Pascal (Inist)
- Wicri :
- topic : Association, Médecine.
English descriptors
- KwdEn :
Abstract
BACKGROUND Cholinergic deficits are prominent in patients who have dementia associated with Parkinson's disease. We investigated the effects of the dual cholinesterase inhibitor rivastigmine in such patients. METHODS Patients in whom mild-to-moderate dementia developed at least 2 years after they received a clinical diagnosis of Parkinson's disease were randomly assigned to receive placebo or 3 to 12 mg of rivastigmine per day for 24 weeks. Primary efficacy variables were the scores for the cognitive subscale ofthe Alzheimer's Disease Assessment Scale (ADAS-cog) and Alzheimer's Disease Cooperative Study-Clinician's Global Impression of Change (ADCS-CGIC). Secondary clinical outcomes were the scores for the Alzheimer's Disease Cooperative Study-Activities of Daily Living, the 10-item Neuropsychiatric Inventory, the Mini-Mental State Examination, Cognitive Drug Research power of attention tests, the Verbal Fluency test, and the Ten Point Clock-Drawing test. RESULTS A total of 541 patients were enrolled, and 410 completed the study. The outcomes were better among patients treated with rivastigmine than among those who received placebo; however, the differences between these two groups were moderate and similar to those reported in trials of rivastigmine for Alzheimer's disease. Rivastigmine-treated patients had a mean improvement of2.1 points in the score for the 70-point ADAS-cog, from a baseline score of 23.8, as compared with a 0.7-point worsening in the placebo group, from a baseline score of 24.3 (P<0.001). Clinically meaningful improvements in the scores for the ADCS-CGIC were observed in 19.8 percent of patients in the rivastigmine group and 14.5 percent ofthose in the placebo group, and clinically meaningful worsening was observed in 13.0 percent and 23.1 percent, respectively (mean score at 24 weeks, 3.8 and 4.3, respectively; P=0.007). Significantly better outcomes were seen with rivastigmine with respect to all secondary efficacy variables. The most frequent adverse events were nausea (affecting 29.0 percent of patients in the rivastigmine group and 11.2 percent of those in the placebo group, P<0.001), vomiting (16.6 and 1.7 percent, P<0.001), and tremor (10.2 and 3.9 percent, P=:0.01). CONCLUSIONS In this placebo-controlled study, rivastigmine was associated with moderate improvements in dementia associated with Parkinson's disease but also with higher rates of nausea, vomiting, and tremor.
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<author><name sortKey="Byrne, E Jane" sort="Byrne, E Jane" uniqKey="Byrne E" first="E. Jane" last="Byrne">E. Jane Byrne</name>
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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a">Rivastigmine for dementia associated with Parkinson's disease</title>
<author><name sortKey="Emre, Murat" sort="Emre, Murat" uniqKey="Emre M" first="Murat" last="Emre">Murat Emre</name>
<affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Istanbul Faculty of Medicine, Istanbul University</s1>
<s2>Istanbul</s2>
<s3>TUR</s3>
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<author><name sortKey="Aarsland, Dag" sort="Aarsland, Dag" uniqKey="Aarsland D" first="Dag" last="Aarsland">Dag Aarsland</name>
<affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Rogaland Central Hospital</s1>
<s2>Stavanger</s2>
<s3>NOR</s3>
<sZ>2 aut.</sZ>
</inist:fA14>
<country>Norvège</country>
</affiliation>
<affiliation wicri:level="1"><inist:fA14 i1="03"><s1>School of Medicine, University of Bergen</s1>
<s2>Bergen</s2>
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<author><name sortKey="Albanese, Albeao" sort="Albanese, Albeao" uniqKey="Albanese A" first="Albeao" last="Albanese">Albeao Albanese</name>
<affiliation wicri:level="1"><inist:fA14 i1="04"><s1>Istituto Nazionale Neurologico Carlo Besta and Università Cattolica</s1>
<s2>Milan</s2>
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</inist:fA14>
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<author><name sortKey="Byrne, E Jane" sort="Byrne, E Jane" uniqKey="Byrne E" first="E. Jane" last="Byrne">E. Jane Byrne</name>
<affiliation wicri:level="1"><inist:fA14 i1="05"><s1>University of Manchester</s1>
<s2>Manchester</s2>
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<author><name sortKey="Deuschl, Gunther" sort="Deuschl, Gunther" uniqKey="Deuschl G" first="Günther" last="Deuschl">Günther Deuschl</name>
<affiliation wicri:level="1"><inist:fA14 i1="06"><s1>Christian-Albrechts-Universität Kiel</s1>
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<author><name sortKey="De Deyn, Peter P" sort="De Deyn, Peter P" uniqKey="De Deyn P" first="Peter P." last="De Deyn">Peter P. De Deyn</name>
<affiliation wicri:level="1"><inist:fA14 i1="07"><s1>Middelheim Hospital, Zeikenhuis Netwerk Antwerpen, and the Born-Bunge Foundation, University of Antwerp</s1>
<s2>Wilrijk-Antwerp</s2>
<s3>BEL</s3>
<sZ>6 aut.</sZ>
</inist:fA14>
<country>Belgique</country>
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<author><name sortKey="Durif, Franck" sort="Durif, Franck" uniqKey="Durif F" first="Franck" last="Durif">Franck Durif</name>
<affiliation wicri:level="1"><inist:fA14 i1="08"><s1>Centre Hospitalier Universitaire Clermont-Ferrand</s1>
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<s3>FRA</s3>
<sZ>7 aut.</sZ>
</inist:fA14>
<country>France</country>
</affiliation>
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<author><name sortKey="Kulisevsky, Jaime" sort="Kulisevsky, Jaime" uniqKey="Kulisevsky J" first="Jaime" last="Kulisevsky">Jaime Kulisevsky</name>
<affiliation wicri:level="1"><inist:fA14 i1="09"><s1>Sant Pau Hospital</s1>
<s2>Barcelona</s2>
<s3>ESP</s3>
<sZ>8 aut.</sZ>
</inist:fA14>
<country>Espagne</country>
</affiliation>
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<author><name sortKey="Van Laar, Teus" sort="Van Laar, Teus" uniqKey="Van Laar T" first="Teus" last="Van Laar">Teus Van Laar</name>
<affiliation wicri:level="1"><inist:fA14 i1="10"><s1>Groningen University Hospital</s1>
<s2>Groningen</s2>
<s3>NLD</s3>
<sZ>9 aut.</sZ>
</inist:fA14>
<country>Pays-Bas</country>
</affiliation>
</author>
<author><name sortKey="Lees, Andrew" sort="Lees, Andrew" uniqKey="Lees A" first="Andrew" last="Lees">Andrew Lees</name>
<affiliation wicri:level="1"><inist:fA14 i1="11"><s1>Reta Lila Weston Institute for Neurological Studies, University College London</s1>
<s2>London</s2>
<s3>GBR</s3>
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<author><name sortKey="Poewe, Werner" sort="Poewe, Werner" uniqKey="Poewe W" first="Werner" last="Poewe">Werner Poewe</name>
<affiliation wicri:level="1"><inist:fA14 i1="12"><s1>Innsbruck Medical University</s1>
<s2>Innsbruck</s2>
<s3>AUT</s3>
<sZ>11 aut.</sZ>
</inist:fA14>
<country>Autriche</country>
</affiliation>
</author>
<author><name sortKey="Robillard, Alain" sort="Robillard, Alain" uniqKey="Robillard A" first="Alain" last="Robillard">Alain Robillard</name>
<affiliation wicri:level="1"><inist:fA14 i1="13"><s1>Hôpital Maisonneuve-Rosemont</s1>
<s2>Montreal</s2>
<s3>CAN</s3>
<sZ>12 aut.</sZ>
</inist:fA14>
<country>Canada</country>
</affiliation>
</author>
<author><name sortKey="Rosa, Mario M" sort="Rosa, Mario M" uniqKey="Rosa M" first="Mario M." last="Rosa">Mario M. Rosa</name>
<affiliation wicri:level="1"><inist:fA14 i1="14"><s1>Hospital de Santa Maria</s1>
<s2>Lisbon</s2>
<s3>PRT</s3>
<sZ>13 aut.</sZ>
</inist:fA14>
<country>Portugal</country>
</affiliation>
</author>
<author><name sortKey="Wolters, Erik" sort="Wolters, Erik" uniqKey="Wolters E" first="Erik" last="Wolters">Erik Wolters</name>
<affiliation wicri:level="1"><inist:fA14 i1="15"><s1>Research Institute for Neurosciences, Vrije Universiteit Medical Center</s1>
<s2>Amsterdam</s2>
<s3>NLD</s3>
<sZ>14 aut.</sZ>
</inist:fA14>
<country>Pays-Bas</country>
</affiliation>
</author>
<author><name sortKey="Quarg, Peter" sort="Quarg, Peter" uniqKey="Quarg P" first="Peter" last="Quarg">Peter Quarg</name>
<affiliation wicri:level="1"><inist:fA14 i1="16"><s1>Novartis Pharma</s1>
<s2>Basel</s2>
<s3>CHE</s3>
<sZ>15 aut.</sZ>
</inist:fA14>
<country>Suisse</country>
</affiliation>
</author>
<author><name sortKey="Tekin, Sibel" sort="Tekin, Sibel" uniqKey="Tekin S" first="Sibel" last="Tekin">Sibel Tekin</name>
<affiliation wicri:level="1"><inist:fA14 i1="17"><s1>Novartis Pharmaceuticals</s1>
<s2>East Hanover, N.J.</s2>
<s3>USA</s3>
<sZ>16 aut.</sZ>
<sZ>17 aut.</sZ>
</inist:fA14>
<country>États-Unis</country>
</affiliation>
</author>
<author><name sortKey="Lane, Roger" sort="Lane, Roger" uniqKey="Lane R" first="Roger" last="Lane">Roger Lane</name>
<affiliation wicri:level="1"><inist:fA14 i1="17"><s1>Novartis Pharmaceuticals</s1>
<s2>East Hanover, N.J.</s2>
<s3>USA</s3>
<sZ>16 aut.</sZ>
<sZ>17 aut.</sZ>
</inist:fA14>
<country>États-Unis</country>
</affiliation>
</author>
</analytic>
<series><title level="j" type="main">The New England journal of medicine</title>
<title level="j" type="abbreviated">N. Engl. j. med.</title>
<idno type="ISSN">0028-4793</idno>
<imprint><date when="2004">2004</date>
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<seriesStmt><title level="j" type="main">The New England journal of medicine</title>
<title level="j" type="abbreviated">N. Engl. j. med.</title>
<idno type="ISSN">0028-4793</idno>
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<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Antialzheimer agent</term>
<term>Association</term>
<term>Dementia</term>
<term>Medicine</term>
<term>Nootropic agent</term>
<term>Parkinson disease</term>
<term>Psychotropic</term>
<term>Rivastigmine</term>
</keywords>
<keywords scheme="Pascal" xml:lang="fr"><term>Démence</term>
<term>Rivastigmine</term>
<term>Association</term>
<term>Parkinson maladie</term>
<term>Médecine</term>
<term>Psychotrope</term>
<term>Antialzheimer</term>
<term>Nootrope</term>
</keywords>
<keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Association</term>
<term>Médecine</term>
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<front><div type="abstract" xml:lang="en">BACKGROUND Cholinergic deficits are prominent in patients who have dementia associated with Parkinson's disease. We investigated the effects of the dual cholinesterase inhibitor rivastigmine in such patients. METHODS Patients in whom mild-to-moderate dementia developed at least 2 years after they received a clinical diagnosis of Parkinson's disease were randomly assigned to receive placebo or 3 to 12 mg of rivastigmine per day for 24 weeks. Primary efficacy variables were the scores for the cognitive subscale ofthe Alzheimer's Disease Assessment Scale (ADAS-cog) and Alzheimer's Disease Cooperative Study-Clinician's Global Impression of Change (ADCS-CGIC). Secondary clinical outcomes were the scores for the Alzheimer's Disease Cooperative Study-Activities of Daily Living, the 10-item Neuropsychiatric Inventory, the Mini-Mental State Examination, Cognitive Drug Research power of attention tests, the Verbal Fluency test, and the Ten Point Clock-Drawing test. RESULTS A total of 541 patients were enrolled, and 410 completed the study. The outcomes were better among patients treated with rivastigmine than among those who received placebo; however, the differences between these two groups were moderate and similar to those reported in trials of rivastigmine for Alzheimer's disease. Rivastigmine-treated patients had a mean improvement of2.1 points in the score for the 70-point ADAS-cog, from a baseline score of 23.8, as compared with a 0.7-point worsening in the placebo group, from a baseline score of 24.3 (P<0.001). Clinically meaningful improvements in the scores for the ADCS-CGIC were observed in 19.8 percent of patients in the rivastigmine group and 14.5 percent ofthose in the placebo group, and clinically meaningful worsening was observed in 13.0 percent and 23.1 percent, respectively (mean score at 24 weeks, 3.8 and 4.3, respectively; P=0.007). Significantly better outcomes were seen with rivastigmine with respect to all secondary efficacy variables. The most frequent adverse events were nausea (affecting 29.0 percent of patients in the rivastigmine group and 11.2 percent of those in the placebo group, P<0.001), vomiting (16.6 and 1.7 percent, P<0.001), and tremor (10.2 and 3.9 percent, P=:0.01). CONCLUSIONS In this placebo-controlled study, rivastigmine was associated with moderate improvements in dementia associated with Parkinson's disease but also with higher rates of nausea, vomiting, and tremor.</div>
</front>
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<fA08 i1="01" i2="1" l="ENG"><s1>Rivastigmine for dementia associated with Parkinson's disease</s1>
</fA08>
<fA11 i1="01" i2="1"><s1>EMRE (Murat)</s1>
</fA11>
<fA11 i1="02" i2="1"><s1>AARSLAND (Dag)</s1>
</fA11>
<fA11 i1="03" i2="1"><s1>ALBANESE (Albeao)</s1>
</fA11>
<fA11 i1="04" i2="1"><s1>BYRNE (E. Jane)</s1>
</fA11>
<fA11 i1="05" i2="1"><s1>DEUSCHL (Günther)</s1>
</fA11>
<fA11 i1="06" i2="1"><s1>DE DEYN (Peter P.)</s1>
</fA11>
<fA11 i1="07" i2="1"><s1>DURIF (Franck)</s1>
</fA11>
<fA11 i1="08" i2="1"><s1>KULISEVSKY (Jaime)</s1>
</fA11>
<fA11 i1="09" i2="1"><s1>VAN LAAR (Teus)</s1>
</fA11>
<fA11 i1="10" i2="1"><s1>LEES (Andrew)</s1>
</fA11>
<fA11 i1="11" i2="1"><s1>POEWE (Werner)</s1>
</fA11>
<fA11 i1="12" i2="1"><s1>ROBILLARD (Alain)</s1>
</fA11>
<fA11 i1="13" i2="1"><s1>ROSA (Mario M.)</s1>
</fA11>
<fA11 i1="14" i2="1"><s1>WOLTERS (Erik)</s1>
</fA11>
<fA11 i1="15" i2="1"><s1>QUARG (Peter)</s1>
</fA11>
<fA11 i1="16" i2="1"><s1>TEKIN (Sibel)</s1>
</fA11>
<fA11 i1="17" i2="1"><s1>LANE (Roger)</s1>
</fA11>
<fA14 i1="01"><s1>Istanbul Faculty of Medicine, Istanbul University</s1>
<s2>Istanbul</s2>
<s3>TUR</s3>
<sZ>1 aut.</sZ>
</fA14>
<fA14 i1="02"><s1>Rogaland Central Hospital</s1>
<s2>Stavanger</s2>
<s3>NOR</s3>
<sZ>2 aut.</sZ>
</fA14>
<fA14 i1="03"><s1>School of Medicine, University of Bergen</s1>
<s2>Bergen</s2>
<s3>NOR</s3>
<sZ>2 aut.</sZ>
</fA14>
<fA14 i1="04"><s1>Istituto Nazionale Neurologico Carlo Besta and Università Cattolica</s1>
<s2>Milan</s2>
<s3>ITA</s3>
<sZ>3 aut.</sZ>
</fA14>
<fA14 i1="05"><s1>University of Manchester</s1>
<s2>Manchester</s2>
<s3>GBR</s3>
<sZ>4 aut.</sZ>
</fA14>
<fA14 i1="06"><s1>Christian-Albrechts-Universität Kiel</s1>
<s2>Kiel</s2>
<s3>DEU</s3>
<sZ>5 aut.</sZ>
</fA14>
<fA14 i1="07"><s1>Middelheim Hospital, Zeikenhuis Netwerk Antwerpen, and the Born-Bunge Foundation, University of Antwerp</s1>
<s2>Wilrijk-Antwerp</s2>
<s3>BEL</s3>
<sZ>6 aut.</sZ>
</fA14>
<fA14 i1="08"><s1>Centre Hospitalier Universitaire Clermont-Ferrand</s1>
<s2>Clermont-Ferrand</s2>
<s3>FRA</s3>
<sZ>7 aut.</sZ>
</fA14>
<fA14 i1="09"><s1>Sant Pau Hospital</s1>
<s2>Barcelona</s2>
<s3>ESP</s3>
<sZ>8 aut.</sZ>
</fA14>
<fA14 i1="10"><s1>Groningen University Hospital</s1>
<s2>Groningen</s2>
<s3>NLD</s3>
<sZ>9 aut.</sZ>
</fA14>
<fA14 i1="11"><s1>Reta Lila Weston Institute for Neurological Studies, University College London</s1>
<s2>London</s2>
<s3>GBR</s3>
<sZ>10 aut.</sZ>
</fA14>
<fA14 i1="12"><s1>Innsbruck Medical University</s1>
<s2>Innsbruck</s2>
<s3>AUT</s3>
<sZ>11 aut.</sZ>
</fA14>
<fA14 i1="13"><s1>Hôpital Maisonneuve-Rosemont</s1>
<s2>Montreal</s2>
<s3>CAN</s3>
<sZ>12 aut.</sZ>
</fA14>
<fA14 i1="14"><s1>Hospital de Santa Maria</s1>
<s2>Lisbon</s2>
<s3>PRT</s3>
<sZ>13 aut.</sZ>
</fA14>
<fA14 i1="15"><s1>Research Institute for Neurosciences, Vrije Universiteit Medical Center</s1>
<s2>Amsterdam</s2>
<s3>NLD</s3>
<sZ>14 aut.</sZ>
</fA14>
<fA14 i1="16"><s1>Novartis Pharma</s1>
<s2>Basel</s2>
<s3>CHE</s3>
<sZ>15 aut.</sZ>
</fA14>
<fA14 i1="17"><s1>Novartis Pharmaceuticals</s1>
<s2>East Hanover, N.J.</s2>
<s3>USA</s3>
<sZ>16 aut.</sZ>
<sZ>17 aut.</sZ>
</fA14>
<fA20><s1>2509-2518</s1>
</fA20>
<fA21><s1>2004</s1>
</fA21>
<fA23 i1="01"><s0>ENG</s0>
</fA23>
<fA43 i1="01"><s1>INIST</s1>
<s2>6013</s2>
<s5>354000121136360050</s5>
</fA43>
<fA44><s0>0000</s0>
<s1>© 2005 INIST-CNRS. All rights reserved.</s1>
</fA44>
<fA45><s0>31 ref.</s0>
</fA45>
<fA47 i1="01" i2="1"><s0>05-0025297</s0>
</fA47>
<fA60><s1>P</s1>
</fA60>
<fA61><s0>A</s0>
</fA61>
<fA64 i1="01" i2="1"><s0>The New England journal of medicine</s0>
</fA64>
<fA66 i1="01"><s0>USA</s0>
</fA66>
<fC01 i1="01" l="ENG"><s0>BACKGROUND Cholinergic deficits are prominent in patients who have dementia associated with Parkinson's disease. We investigated the effects of the dual cholinesterase inhibitor rivastigmine in such patients. METHODS Patients in whom mild-to-moderate dementia developed at least 2 years after they received a clinical diagnosis of Parkinson's disease were randomly assigned to receive placebo or 3 to 12 mg of rivastigmine per day for 24 weeks. Primary efficacy variables were the scores for the cognitive subscale ofthe Alzheimer's Disease Assessment Scale (ADAS-cog) and Alzheimer's Disease Cooperative Study-Clinician's Global Impression of Change (ADCS-CGIC). Secondary clinical outcomes were the scores for the Alzheimer's Disease Cooperative Study-Activities of Daily Living, the 10-item Neuropsychiatric Inventory, the Mini-Mental State Examination, Cognitive Drug Research power of attention tests, the Verbal Fluency test, and the Ten Point Clock-Drawing test. RESULTS A total of 541 patients were enrolled, and 410 completed the study. The outcomes were better among patients treated with rivastigmine than among those who received placebo; however, the differences between these two groups were moderate and similar to those reported in trials of rivastigmine for Alzheimer's disease. Rivastigmine-treated patients had a mean improvement of2.1 points in the score for the 70-point ADAS-cog, from a baseline score of 23.8, as compared with a 0.7-point worsening in the placebo group, from a baseline score of 24.3 (P<0.001). Clinically meaningful improvements in the scores for the ADCS-CGIC were observed in 19.8 percent of patients in the rivastigmine group and 14.5 percent ofthose in the placebo group, and clinically meaningful worsening was observed in 13.0 percent and 23.1 percent, respectively (mean score at 24 weeks, 3.8 and 4.3, respectively; P=0.007). Significantly better outcomes were seen with rivastigmine with respect to all secondary efficacy variables. The most frequent adverse events were nausea (affecting 29.0 percent of patients in the rivastigmine group and 11.2 percent of those in the placebo group, P<0.001), vomiting (16.6 and 1.7 percent, P<0.001), and tremor (10.2 and 3.9 percent, P=:0.01). CONCLUSIONS In this placebo-controlled study, rivastigmine was associated with moderate improvements in dementia associated with Parkinson's disease but also with higher rates of nausea, vomiting, and tremor.</s0>
</fC01>
<fC02 i1="01" i2="X"><s0>002B01</s0>
</fC02>
<fC02 i1="02" i2="X"><s0>002B17G</s0>
</fC02>
<fC03 i1="01" i2="X" l="FRE"><s0>Démence</s0>
<s5>01</s5>
</fC03>
<fC03 i1="01" i2="X" l="ENG"><s0>Dementia</s0>
<s5>01</s5>
</fC03>
<fC03 i1="01" i2="X" l="SPA"><s0>Demencia</s0>
<s5>01</s5>
</fC03>
<fC03 i1="02" i2="X" l="FRE"><s0>Rivastigmine</s0>
<s2>NK</s2>
<s2>FR</s2>
<s5>02</s5>
</fC03>
<fC03 i1="02" i2="X" l="ENG"><s0>Rivastigmine</s0>
<s2>NK</s2>
<s2>FR</s2>
<s5>02</s5>
</fC03>
<fC03 i1="02" i2="X" l="SPA"><s0>Rivastigmina</s0>
<s2>NK</s2>
<s2>FR</s2>
<s5>02</s5>
</fC03>
<fC03 i1="03" i2="X" l="FRE"><s0>Association</s0>
<s5>03</s5>
</fC03>
<fC03 i1="03" i2="X" l="ENG"><s0>Association</s0>
<s5>03</s5>
</fC03>
<fC03 i1="03" i2="X" l="SPA"><s0>Asociación</s0>
<s5>03</s5>
</fC03>
<fC03 i1="04" i2="X" l="FRE"><s0>Parkinson maladie</s0>
<s5>04</s5>
</fC03>
<fC03 i1="04" i2="X" l="ENG"><s0>Parkinson disease</s0>
<s5>04</s5>
</fC03>
<fC03 i1="04" i2="X" l="SPA"><s0>Parkinson enfermedad</s0>
<s5>04</s5>
</fC03>
<fC03 i1="05" i2="X" l="FRE"><s0>Médecine</s0>
<s5>05</s5>
</fC03>
<fC03 i1="05" i2="X" l="ENG"><s0>Medicine</s0>
<s5>05</s5>
</fC03>
<fC03 i1="05" i2="X" l="SPA"><s0>Medicina</s0>
<s5>05</s5>
</fC03>
<fC03 i1="06" i2="X" l="FRE"><s0>Psychotrope</s0>
<s2>FX</s2>
<s5>25</s5>
</fC03>
<fC03 i1="06" i2="X" l="ENG"><s0>Psychotropic</s0>
<s2>FX</s2>
<s5>25</s5>
</fC03>
<fC03 i1="06" i2="X" l="SPA"><s0>Psicotropo</s0>
<s2>FX</s2>
<s5>25</s5>
</fC03>
<fC03 i1="07" i2="X" l="FRE"><s0>Antialzheimer</s0>
<s2>FR</s2>
<s5>26</s5>
</fC03>
<fC03 i1="07" i2="X" l="ENG"><s0>Antialzheimer agent</s0>
<s2>FR</s2>
<s5>26</s5>
</fC03>
<fC03 i1="07" i2="X" l="SPA"><s0>Antialzheimer</s0>
<s2>FR</s2>
<s5>26</s5>
</fC03>
<fC03 i1="08" i2="X" l="FRE"><s0>Nootrope</s0>
<s5>27</s5>
</fC03>
<fC03 i1="08" i2="X" l="ENG"><s0>Nootropic agent</s0>
<s5>27</s5>
</fC03>
<fC03 i1="08" i2="X" l="SPA"><s0>Nootropo</s0>
<s5>27</s5>
</fC03>
<fC07 i1="01" i2="X" l="FRE"><s0>Acetylcholinesterase</s0>
<s2>FE</s2>
<s5>37</s5>
</fC07>
<fC07 i1="01" i2="X" l="ENG"><s0>Acetylcholinesterase</s0>
<s2>FE</s2>
<s5>37</s5>
</fC07>
<fC07 i1="01" i2="X" l="SPA"><s0>Acetylcholinesterase</s0>
<s2>FE</s2>
<s5>37</s5>
</fC07>
<fC07 i1="02" i2="X" l="FRE"><s0>Carboxylic ester hydrolases</s0>
<s2>FE</s2>
</fC07>
<fC07 i1="02" i2="X" l="ENG"><s0>Carboxylic ester hydrolases</s0>
<s2>FE</s2>
</fC07>
<fC07 i1="02" i2="X" l="SPA"><s0>Carboxylic ester hydrolases</s0>
<s2>FE</s2>
</fC07>
<fC07 i1="03" i2="X" l="FRE"><s0>Esterases</s0>
<s2>FE</s2>
</fC07>
<fC07 i1="03" i2="X" l="ENG"><s0>Esterases</s0>
<s2>FE</s2>
</fC07>
<fC07 i1="03" i2="X" l="SPA"><s0>Esterases</s0>
<s2>FE</s2>
</fC07>
<fC07 i1="04" i2="X" l="FRE"><s0>Hydrolases</s0>
<s2>FE</s2>
</fC07>
<fC07 i1="04" i2="X" l="ENG"><s0>Hydrolases</s0>
<s2>FE</s2>
</fC07>
<fC07 i1="04" i2="X" l="SPA"><s0>Hydrolases</s0>
<s2>FE</s2>
</fC07>
<fC07 i1="05" i2="X" l="FRE"><s0>Enzyme</s0>
<s2>FE</s2>
</fC07>
<fC07 i1="05" i2="X" l="ENG"><s0>Enzyme</s0>
<s2>FE</s2>
</fC07>
<fC07 i1="05" i2="X" l="SPA"><s0>Enzima</s0>
<s2>FE</s2>
</fC07>
<fC07 i1="06" i2="X" l="FRE"><s0>Anticholinestérasique</s0>
<s5>38</s5>
</fC07>
<fC07 i1="06" i2="X" l="ENG"><s0>Anticholinesterase agent</s0>
<s5>38</s5>
</fC07>
<fC07 i1="06" i2="X" l="SPA"><s0>Anticolinesterasa agente</s0>
<s5>38</s5>
</fC07>
<fC07 i1="07" i2="X" l="FRE"><s0>Inhibiteur enzyme</s0>
<s5>39</s5>
</fC07>
<fC07 i1="07" i2="X" l="ENG"><s0>Enzyme inhibitor</s0>
<s5>39</s5>
</fC07>
<fC07 i1="07" i2="X" l="SPA"><s0>Inhibidor enzima</s0>
<s5>39</s5>
</fC07>
<fC07 i1="08" i2="X" l="FRE"><s0>Encéphale pathologie</s0>
<s5>40</s5>
</fC07>
<fC07 i1="08" i2="X" l="ENG"><s0>Cerebral disorder</s0>
<s5>40</s5>
</fC07>
<fC07 i1="08" i2="X" l="SPA"><s0>Encéfalo patología</s0>
<s5>40</s5>
</fC07>
<fC07 i1="09" i2="X" l="FRE"><s0>Extrapyramidal syndrome</s0>
<s5>41</s5>
</fC07>
<fC07 i1="09" i2="X" l="ENG"><s0>Extrapyramidal syndrome</s0>
<s5>41</s5>
</fC07>
<fC07 i1="09" i2="X" l="SPA"><s0>Extrapiramidal síndrome</s0>
<s5>41</s5>
</fC07>
<fC07 i1="10" i2="X" l="FRE"><s0>Maladie dégénérative</s0>
<s5>42</s5>
</fC07>
<fC07 i1="10" i2="X" l="ENG"><s0>Degenerative disease</s0>
<s5>42</s5>
</fC07>
<fC07 i1="10" i2="X" l="SPA"><s0>Enfermedad degenerativa</s0>
<s5>42</s5>
</fC07>
<fC07 i1="11" i2="X" l="FRE"><s0>Système nerveux central pathologie</s0>
<s5>43</s5>
</fC07>
<fC07 i1="11" i2="X" l="ENG"><s0>Central nervous system disease</s0>
<s5>43</s5>
</fC07>
<fC07 i1="11" i2="X" l="SPA"><s0>Sistema nervosio central patología</s0>
<s5>43</s5>
</fC07>
<fC07 i1="12" i2="X" l="FRE"><s0>Système nerveux pathologie</s0>
<s5>45</s5>
</fC07>
<fC07 i1="12" i2="X" l="ENG"><s0>Nervous system diseases</s0>
<s5>45</s5>
</fC07>
<fC07 i1="12" i2="X" l="SPA"><s0>Sistema nervioso patología</s0>
<s5>45</s5>
</fC07>
<fN21><s1>010</s1>
</fN21>
<fN44 i1="01"><s1>OTO</s1>
</fN44>
<fN82><s1>OTO</s1>
</fN82>
</pA>
</standard>
</inist>
</record>
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