Amantadine May Optimize Levodopa Regimen in Parkinson Disease Treatment

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Individual taking pill to aid with sleep.
Long-term adjunctive treatment with amantadine may enable the levodopa regimen to be optimized in patients with Parkinson experiencing motor complications.

The following article is part of conference coverage from the 2019 American Academy of Neurology Annual Meeting (AAN 2019) in Philadelphia, PA. Neurology Advisor’s staff will be reporting breaking news associated with research conducted by leading experts in neurology. Check back for the latest news from AAN 2019.

PHILADELPHIA, PA — Long-term adjunctive amantadine (Gocovri®, Adamas Pharmaceuticals) treatment for individuals with motor complications related to Parkinson disease may create better optimization in the levodopa regimen, according to research presented at the 2019 American Academy of Neurology Annual Meeting, held May 4-10, 2019, in Philadelphia, Pennsylvania.

This study included 223 participants with Parkinson disease, 129 (58%) of whom completed all 2 years of treatment. All medications were adjustable in this study. The safety and efficacy of amantadine was tested among individuals who increased, maintained, or decreased daily dosage of levodopa after completing the open-label EASE LID 2 study.

Among those who completed the study, there was a mean daily levodopa dosage of 695 mg, a mean disease duration of 11.8 years, and a mean score of 9.0 on MDS-UPDRS Part IV. Compared with baseline, the levodopa daily dose was increased among 30% (n=39) of participants with a mean change of +298 mg (range, 50-840), maintained among 54% (n=69), and decreased among 16% (n=21) with a mean change of -198 mg (range, -25 to -700). Between baseline and week 100, there was a mean observed change in MDS-UPDRS Part IV score of -1.7 among those who increased their daily levodopa dose, -2.6 among those who maintained, and -1.8 among those who decreased. All subgroups showed similar rates of adverse reactions to treatment.

The study researchers concluded, “These open label data suggest long-term adjunctive treatment with Gocovri may enable the levodopa regimen to be optimized in [Parkinson disease] patients experiencing motor complications.”

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Disclosure: Multiple authors disclosed affiliations with pharmaceutical companies. See the reference for complete disclosure information.

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Isaacson S, Hauser R, Pahwa R, et al. Changes to levodopa daily dose in Parkinson’s disease (PD) patients with dyskinesia while on Gocovri™ (amantadine) extended release capsules: a two-year phase 3 open label study analysis. Presented at: 2019 American Academy of Neurology Annual Meeting; May 4-10, 2019; Philadelphia, PA. Abstract P4.7-010.