Systematic reviews including this primary study

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Systematic review

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Effectiveness and safety of amantadine in parkinson disease-a meta-analysis

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Journal Chinese Pharmaceutical Journal
Year 2011
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OBJECTIVE: To evaluate the effectiveness and safety of amantadine in Parkinson’s disease. METHODS: Cochrane library, Pubmed database, Embase database, ISI database, CBM database, CNKI database, VIP database, Articles Database in computer were searched. Randomized controlled trials (RCT), systematic review (SR) or Meta analysis of amantadine vs placebo in Parkinson´s disease were selected, then quality evaluation and Meta-analysis were performed. The conclusions of the included SR and Metaanalysis were taken into consideration. RESULTS: There were 9 RCTs of amantadine vs placebo in treating parkinson´s disease. The result showed that the efficacy of amantadine was better than placebo [RR 0. 14, 95% CI (0. 06, 0. 29), P ＜ 0. 000 01]. Amantadine was better than placebo to improve parkinson's symptoms [RR － 3. 21, 95% CI (－ 5. 88􀈤－ 0. 54), P = 0. 02]. When it comes to ADR, there was no significant difference between amantadine and placebo

Systematic review

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Amantadine in Parkinson's disease

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Journal Cochrane Database of Systematic Reviews
Year 2003
Links Pubmed DOI PubMed Central
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Background: Although levodopa is the most common drug prescribed to relieve the symptoms of Parkinson's disease it is associated with motor and psychiatric side-effects. Consequently, interest has turned to alternative drugs with improved side-effect profiles to replace or augment levodopa. Amantadine, originally used as an antiviral drug, has been shown to improve the symptoms of Parkinson's disease. Objectives: To compare the efficacy and safety of amantadine therapy (monotherapy or adjuvant therapy) versus placebo in treating people with Parkinson's disease. Search methods: Electronic searches of The Cochrane Controlled Trials Register (The Cochrane Library Issue 3, 2001), MEDLINE (1966-2001), EMBASE (1974-2001), SCISEARCH (1974-2001), BIOSIS (1993-2001), GEROLIT (1979-2001), OLDMEDLINE (1957-1965), LILACS (1982-2001), MedCarib (17th Century - 2001), PASCAL (1973-2001), JICST-EPLUS (1985-2001), RUSSMED (1973-2001), DISSERTATION ABSTRACTS (2000-2001), SIGLE (1980-2001), ISI-ISTP (1990-2001), Aslib Index to Theses (2001), Clinicaltrials.gov (2001), metaRegister of Controlled Trials (2001), NIDRR (2001) and NRR (2001) were conducted. Grey literature was hand searched and the reference lists of identified studies and reviews examined. The manufacturers of amantadine were contacted. Selection criteria: Randomised controlled trials comparing amantadine with placebo in the treatment of patients with a clinical diagnosis of idiopathic Parkinson's disease. Data collection and analysis: Data was abstracted independently by NC and KD onto standardised forms and disagreements were resolved by discussion. Main results: Six randomised controlled trials were found comparing amantadine monotherapy or adjuvant therapy with placebo in the treatment of idiopathic Parkinson's disease. Five examined amantadine as adjuvant therapy with optimal levels of levodopa or anticholinergics and one examined amantadine as an adjuvant therapy with minimum tolerated levels of anticholinergics or as a monotherapy. Five were double-blind cross-over studies and one was a double-blind parallel group study. In total they examined 215 patients. The parallel group study allowed the randomisation codes to be broken and allowed patients in the placebo group to then receive amantadine. This could have led to bias. One study did not present the results of the placebo arm of the trial, hence we could not determine the difference between the two treatment groups. Two cross-over studies presented the results of the combined data from both treatment and placebo arms. The risk of carry-over effect into the second arm meant that these results could not be analysed. The final two studies presented at least some of their data from the end of the first arm of the trials. However only means were given, without standard deviations, so we could not determine the statistical significance of any difference between the amantadine and placebo groups. Although the authors did report on the side-effects from amantadine (such as livido recticularis, dry mouth and blurred vision), they state that none of them were severe. Authors' conclusions: A considerable amount of evidence on the effectiveness of amantadine has accrued from non-controlled trials, often in patients with Parkinsonian conditions other than idiopathic Parkinson's disease. However, rigorous analysis of the six randomised controlled trials of amantadine reveals insufficient evidence of its efficacy and safety in the treatment of idiopathic Parkinson's disease. Copyright © 2010 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.