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SYSTEMATIC REVIEW article

Front. Neurol.
Sec. Neurotrauma
Volume 15 - 2024 | doi: 10.3389/fneur.2024.1444623
This article is part of the Research Topic Assessment and Treatment Interventions for Traumatic Brain Injury View all 20 articles

Use of Amantadine in Traumatic Brain Injury: An Updated Meta-Analysis of Randomized Controlled Trials

Provisionally accepted
João Félix João Félix *Luísa Mendes Araújo Luísa Mendes Araújo *Antonio Henriques Antonio Henriques Ana Pereira Ana Pereira Saul Carneiro Saul Carneiro
  • Federal University of Pará, Belém, Brazil

The final, formatted version of the article will be published soon.

    Introduction: Amantadine has been shown to accelerate cognitive and functional brain recovery after cerebrovascular accidents. However, the efficacy of this drug in TBI patients remains poorly defined. Methods: We performed a systematic review and meta-analysis of randomized trials (RCTs) evaluating the effects of amantadine in TBI patients. The Cochrane, Embase, and PubMed databases were systematically searched for trials published up to March 24, 2024. Data from previous RCTs were extracted and quality assessed according to Cochrane recommendations. Means and standard deviations with 95% confidence intervals were aggregated across studies. The primary outcomes assessed were Glasgow Coma Scale (GCS), Mini Mental State Examination (MMSE) and the Disability Rating Scale (DRS). Results: From 1292 database results, 6 studies with 426 patients were included, of which 205 received amantadine (48.12%). The Glasgow Coma Scale score on day 7 (MD 1.50; 95% CI 0.08-2.92; p=0.038; I²=68%) was significantly higher in patients treated with amantadine than those treated with placebo. The Mini Mental State Examination (MD 3.23; 95% CI 0.53-5.94; p=0.019; I²=0%) was also better in patients treated with amantadine. No significant differences in Disability Rating Scale, day 3 GCS, Glasgow Outcome Scale (GOS), length of hospital stay, or duration of mechanical ventilation were observed between amantadine and placebo groups. Conclusions: In our analysis, TBI patients benefit from the use of amantadine in the day 7 GCS score and show better results in the MMSE test, but placebo patients benefit from not using amantadine in the DRS between weeks 3 and 4. No other statistically significant results were found related to the use of this medication.

    Keywords: Amantadine, Traumatic Brain Injury, neurotrauma, Meta-analysis, placebo

    Received: 05 Jun 2024; Accepted: 31 Dec 2024.

    Copyright: © 2024 Félix, Araújo, Henriques, Pereira and Carneiro. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    João Félix, Federal University of Pará, Belém, Brazil
    Luísa Mendes Araújo, Federal University of Pará, Belém, Brazil

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.