Amantadine for dyskinesias in Parkinson's disease: a randomized controlled trial
Hideyuki Sawada, Tomoko Oeda, Sadako Kuno, Masahiro Nomoto, Kenji Yamamoto, Mitsutoshi Yamamoto, Kinya Hisanaga, Takashi Kawamura, Amantadine Study Group, Hasegawa Kazuko, Yutaka Naito, Tetsuya Maeda, Keiko Kamakura, Masaru Yoshioka, Ken-ichi Fujimoto, Tokio Shimomura, Hideyuki Sawada, Tomoko Oeda, Sadako Kuno, Masahiro Nomoto, Kenji Yamamoto, Mitsutoshi Yamamoto, Kinya Hisanaga, Takashi Kawamura, Amantadine Study Group, Hasegawa Kazuko, Yutaka Naito, Tetsuya Maeda, Keiko Kamakura, Masaru Yoshioka, Ken-ichi Fujimoto, Tokio Shimomura
Abstract
Background: Dyskinesias are some of the major motor complications that impair quality of life for patients with Parkinson's disease. The purpose of the present study was to investigate the efficacy of amantadine in Parkinson's disease patients suffering from dyskinesias.
Methods: In this multi-center, double-blind, randomized, placebo-controlled, cross-over trial, 36 patients with Parkinson's disease and dyskinesias were randomized, and 62 interventions, which included amantadine (300 mg/day) or placebo treatment for 27 days, were analyzed. At 15 days after washout, the treatments were crossed over. The primary outcome measure was the changes in the Rush Dyskinesia Rating Scale (RDRS) during each treatment period. The secondary outcome measures were changes in the Unified Parkinson's Disease Rating Scale part IVa (UPDRS-IVa, dyskinesias), part IVb (motor fluctuations), and part III (motor function).
Results: RDRS improved in 64% and 16% of patients treated with amantadine or placebo, respectively, with significant differences between treatments. The adjusted odds-ratio for improvement by amantadine was 6.7 (95% confidence interval, 1.4 to 31.5). UPDRS-IVa was improved to a significantly greater degree in amantadine-treated patients [mean (SD) of 1.83 (1.56)] compared with placebo-treated patients [0.03 (1.51)]. However, there were no significant effects on UPDRS-IVb or III scores.
Conclusions: Results from the present study demonstrated that amantadine exhibited efficacious effects against dyskinesias in 60-70% of patients.
Trial registration: UMIN Clinical Trial Registry UMIN000000780.
Conflict of interest statement
Competing Interests: Dr. Sawada is funded by the grants-in-aid from the National Hospital Organization and received honoraria for lectures from Novartis Pharma, GlaxoSmithKline and Boehringer Ingelheim.
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Source: PubMed