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There is a need for new therapeutic options to target this debilitating aspect of the disease. Cholinergic deficit has been shown to contribute to both gait and cognitive dysfunction seen in the condition. Potential benefits of using cholinesterase inhibitors were shown during a single centre phase 2 trial. The aim of this trial is to evaluate the effectiveness of a cholinesterase inhibitor on fall rate in people with idiopathic Parkinson\u2019s disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This is a multi-centre, double-blind, randomised placebo-controlled trial in 600 people with idiopathic Parkinson\u2019s disease (Hoehn and Yahr stages 1 to 4) with a history of a fall in the past year. Participants will be randomised to two groups, receiving either transdermal rivastigmine or identical placebo for 12\u2009months. The primary outcome is the fall rate over 12\u2009months follow-up. Secondary outcome measures, collected at baseline and 12\u2009months either face-to-face or via remote video\/telephone assessments, include gait and balance measures, neuropsychiatric indices, Parkinson\u2019s motor and non-motor symptoms, quality of life and cost-effectiveness.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>This trial will establish whether cholinesterase inhibitor therapy is effective in preventing falls in Parkinson\u2019s disease. If cost-effective, it will alter current management guidelines by offering a new therapeutic option in this high-risk population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration<\/jats:title>\n                    <jats:p>REC reference: 19\/SW\/0043.<\/jats:p>\n                    <jats:p>EudraCT: 2018\u2013003219-23.<\/jats:p>\n                    <jats:p>\n                      ISCRTN:\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/doi.org\/10.1186\/ISRCTN41639809\">41639809<\/jats:ext-link>\n                      (registered 16\/04\/2019).\n                    <\/jats:p>\n                    <jats:p>\n                      ClinicalTrials.gov Identifier:\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/clinicaltrials.gov\/ct2\/show\/NCT04226248?term=falls&amp;cond=Parkinson&amp;draw=2&amp;rank=4\">NCT04226248<\/jats:ext-link>\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Protocol at time of publication<\/jats:title>\n                    <jats:p>Version 7.0, 20th January 2021.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12883-021-02430-2","type":"journal-article","created":{"date-parts":[[2021,10,29]],"date-time":"2021-10-29T15:29:36Z","timestamp":1635521376000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["Cholinesterase inhibitor to prevent falls in Parkinson\u2019s disease (CHIEF-PD) trial: a phase 3 randomised, double-blind placebo-controlled trial of rivastigmine to prevent falls in Parkinson\u2019s disease"],"prefix":"10.1186","volume":"21","author":[{"given":"S.","family":"Neumann","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Taylor","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Bamford","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Metcalfe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D. 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