Objective: To evaluate baseline predictors and longitudinal impact of amantadine use in Parkinson’s disease (PD).

Background: There is preclinical data that amantadine has neuroprotective properties, however to date, few studies have assessed impact of long-term use on PD progression, particularly on cognition, gait and quality of life (QoL).

Methods: Data were obtained from the NPF-QII database, an observational prospective longitudinal study, conducted at 21 NPF sites, with all PD patients eligible for enrollment. Data included demographics, comorbid conditions, PD stage/diagnosis, other treatments, and clinical outcomes. QoL was measured by PDQ39. The baseline characteristics were compared for amantadine users versus nonusers. To assess the longitudinal difference in trajectories between amantadine users and nonusers, a generalized linear mixed model was used to regress each clinical outcome on the time-dependent “amantadine use” variable while adjusting for age, disease duration, Hoehn and Yahr (HY) stage, and initial score of outcome of interest.

Results: 7484 patients were included in the baseline dataset. Amantadine users were more likely to be younger, have earlier age of PD diagnosis, higher HY stage, motor fluctuations, be treated with levodopa, have better cognition, and have fewer comorbid conditions. 4622 patients with more than one clinic visit were included in the longitudinal analysis. The mean follow-up was 2.39 (SD 1.09) years, range 0.06 – 5.08. Amantadine users had 0.398s shorter Timed up and Go times (t = -3.173, P = 0.0015). There was no difference in longitudinal trajectories for users versus nonusers in cognition or total PDQ39. Amantadine users had significantly worse communication, stigma, and ADL PDQ-39subscores.

Conclusions: Our data suggest long term beneficial effect of amantadine on objective measures of gait (as measured by TUG), no negative impact on cognition but worsening of certain QoL metrics without a significant decrease in overall QoL score. These results support further testing of amantadine for gait in PD in a randomized controlled trial.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/utilization-and-longitudinal-impact-of-amantadine-use-in-parkinsons-disease-national-parkinson-foundation-npf-qii-registry/