Abstract Details

Title Retrospective Review of Amantadine Use in Progressive Supranuclear Palsy

Topic Movement Disorders

Presentation(s) P8 - Poster Session 8 (11:45 AM-12:45 PM)

Poster/Presentation
Number 5-009

Objective

To determine the efficacy and tolerability of amantadine therapy in Progressive supranuclear palsy (PSP).

Background PSP is one of the most common atypical parkinson disorders, resulting in progressive disability and early mortality. Although increasingly recognized, including varied phenotypic presentations of PSP, therapeutic options remain significantly limited and fraught with insufficient supporting data on efficacy. There are currently no approved therapies for PSP. Symptomatic drug treatment for PSP typically begins with trial of carbidopa-levodopa, but in most cases levodopa is poorly effective and provides only modest benefit. Multiple alternative medications have been tried in PSP, however, mainly in small studies with limited effects or benefit. Amantadine remains a primary alternative therapy with anecdotal benefit to gait and speech, but lacks evidence and risks adverse effects.

Design/Methods We describe a single center retrospective review from 2011 to 2022 of PSP cases treated with amantadine. Both the UF INFORM database and electronic records were queried to identify cases with clinical data, pre and post amantadine treatment with minimum window of 6 months. Data including demographics, dose, and treatment effects, including PSPRS, UPDRS, PSPQol, Beck Depression and Anxiety inventories were collected.

Results

Of over 350 PSP cases reviewed, 64 were treated with amantadine, and 42 (22 female) with adequate data. Mean age was 70.4 yrs, duration of symptoms 3.84 yrs, and treatment length 8.1 (±2.2) months. 30 participants reported no benefit or worsening of symptoms, whereas 5 indicated improvement, and 7 unclear. Mean change in total PSPRS or axia/gait subscore was not significantly different among these groups. Adverse effects included confusion/hallucinations (6), worsening gait/dizziness (3), and leg edema (1).

Conclusions While a small percentage of PSP patients tolerated and reported subjective benefit from amantadine, objectively, amantadine did not improve PSPRS scores and may worsen symptoms or cause adverse effects.

Authors/Disclosures
Nikolaus McFarland, MD, PhD, FAAN (University of Florida) PRESENTER	Dr. McFarland has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sutter Health. Dr. McFarland has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for ONO Pharmaceuticals. Dr. McFarland has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Ferrer. The institution of Dr. McFarland has received research support from NIH, Michael J. Fox Foundation, Huntington Disease Society for America, CurePSP, and Mission MSA.. Dr. McFarland has received publishing royalties from a publication relating to health care.
Ramsha Farrukh, MD	Dr. Farrukh has nothing to disclose.
	No disclosure on file

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