Amantadine use in the French prospective NS-Park cohort

• Published in: Journal of Neural Transmission Vol. 131; no. 7; pp. 799 - 811
• Main Authors: Fabbri, Margherita, Rousseau, Vanessa, Corvol, Jean-Christophe, Sommet, Agnès, Tubach, Florence, De Rycke, Yann, Bertille, Nathalie, Selvarasa, Yajiththa, Carvalho, Stephanie, Chaigneau, Véronique, Brefel-Courbon, Christine, Ory-Magne, Fabienne, Tessier, Samuel, Tir, Melissa, Bereau, Matthieu, Meissner, Wassilios G., Thiriez, Claire, Marques, Ana, Remy, Philippe, Schneider, Vincent, Moro, Elena, Defebvre, Luc, Houeto, Jean Luc, Prange, Stephane, Eusebio, Alexandre, Geny, Christian, Frismand, Solène, Damier, Philippe, Reuther, Caroline Giordana, Castelnovo, Giovanni, Benatru, Isabelle, De Maindreville, Anne Doe, Drapier, Sophie, Maltête, David, Lagha-Boukbiza, Ouhaid, Rascol, Olivier
• Format: Journal Article
• Language: English
• Published: Vienna Springer Vienna 01.07.2024; Springer Verlag
• Subjects: Aged; Amantadine - adverse effects; Amantadine - therapeutic use; Antiparkinson Agents - administration & dosage; Antiparkinson Agents - adverse effects; Antiparkinson Agents - therapeutic use; Cohort Studies; Cross-Sectional Studies; Dyskinesia, Drug-Induced - epidemiology; Dyskinesia, Drug-Induced - etiology; Female; France - epidemiology; Human health and pathology; Humans; Levodopa - administration & dosage; Levodopa - adverse effects; Life Sciences; Longitudinal Studies; Male; Medicine; Medicine & Public Health; Middle Aged; Neurology; Neurology and Preclinical Neurological Studies - Original Article; Neurosciences; Parkinson Disease - drug therapy; Parkinson Disease - epidemiology; Prospective Studies; Psychiatry; France; Amantadine; NS-Park; Motor complications; Parkinson’s disease; Parkinson's disease
• ISSN: 0300-9564; 1435-1463; 1435-1463
• DOI: 10.1007/s00702-024-02772-4

Objective To assess amantadine use and associated factors in the patients with Parkinson’s disease (PD). Background Immediate-release amantadine is approved for the treatment of PD and is largely used in clinical practice to treat “levodopa-induced dyskinesia (LIDs). Its use varies according to countries and PD stages. The prospective NS-Park cohort collects features of PD patients followed by 26 French PD Expert Centres. Methods Variables used for the analyses included demographics, motor and non-motor PD symptoms and motor complications [motor fluctuations (MFs), LIDs)], antiparkinsonian pharmacological classes and levodopa equivalent daily dose (LEDD). We evaluated: (i) prevalence of amantadine use and compared clinical features of amantadine users vs. non-users (cross-sectional analysis); (ii) factors associated with amantadine initiation (longitudinal analysis); (iii) amantadine effect on LIDs, MFs, apathy, impulse control disorders and freezing of gait (Fog) (longitudinal analysis). Results Amantadine use prevalence was 12.6% (1,585/12,542, median dose = 200 mg). Amantadine users were significantly younger, with longer and more severe PD symptoms, greater LEDD and more frequent use of device-aided/surgical treatment. Factors independently associated with amantadine initiation were younger age, longer PD duration, more frequent LIDs, MFs and FoG, higher LEDD and better cognitive function. 9 of the 658 patients on amantadine had stopped it at the following visit, after 12–18 months (1.3%). New users of amantadine presented a higher improvement in LIDs and MF compared to amantadine never users. Conclusions About 12% of PD patients within the French NS-Park cohort used amantadine, mostly those with younger age and more severe PD. Amantadine initiation was associated with a subsequent reduction in LIDs and MFs.