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.

中文翻译：

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金刚烷胺在法国前瞻性 NS-Park 队列中的使用

客观的

评估帕金森病 (PD) 患者的金刚烷胺使用情况及相关因素。

背景

速释金刚烷胺被批准用于治疗帕金森病，并在临床实践中广泛用于治疗“左旋多巴引起的运动障碍（LID）”。其使用因国家和 PD 阶段而异。 NS-Park 前瞻性队列收集了 26 个法国 PD 专家中心跟踪的 PD 患者的特征。

方法

用于分析的变量包括人口统计学、运动和非运动 PD 症状和运动并发症 [运动波动 (MF)、LID)]、抗帕金森病药理学类别和左旋多巴每日等效剂量 (LEDD)。我们评估了：(i) 金刚烷胺使用流行率，并比较了金刚烷胺使用者与非使用者的临床特征（横断面分析）； (ii) 与金刚烷胺起始相关的因素（纵向分析）； (iii) 金刚烷胺对 LID、MF、冷漠、冲动控制障碍和步态冻结 (Fog) 的影响（纵向分析）。

结果

金刚烷胺使用率为 12.6%（1,585/12,542，中位剂量 = 200 mg）。金刚烷胺使用者明显更年轻，PD 症状更长、更严重，LEDD 更大，并且更频繁地使用设备辅助/手术治疗。与金刚烷胺起始独立相关的因素包括年龄较小、PD持续时间较长、LID、MF和FoG更频繁、LEDD更高和认知功能更好。 658 名服用金刚烷胺的患者中有 9 名在 12-18 个月后就诊时停止了服用（1.3%）。与从未使用过金刚烷胺的人相比，新使用金刚烷胺的人在 LID 和 MF 方面表现出更高的改善。

结论

法国 NS-Park 队列中约 12% 的帕金森病患者使用金刚烷胺，其中大多数是年龄较小且帕金森病较严重的患者。金刚烷胺起始治疗与随后 LID 和 MF 的减少相关。