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Amantadine for COVID-19 treatment (ACT study): a randomized, double-blinded, placebo-controlled clinical trial

N. Weis, Signe Bollerup, John D. Sund, Jakob Borg Glamann, C. Vinten, Louise R. Jensen, Christoffer Sejling, T. Kledal et al.

Clinical Microbiology and Infection, 2023

242 participants · 14 citations

Abstract

Objectives The COVID-19 pandemic has revealed a severe need for effective antiviral treatment. The objectives of this study were to assess if preemptive treatment with amantadine for COVID-19 in non-hospitalized persons ≥40 years or adults with comorbidities was able to prevent disease progression and hospitalization. Primary outcomes were clinical status on day 14. Methods Between 9th June 2021 and 27th January 2022, this randomized, double-blinded, placebo-controlled, single-center clinical trial included 242 subjects with a follow-up period of 90 days. Subjects were randomized 1:1 to either amantadine 100 mg or placebo twice daily for five days. The inclusion criteria were confirmed SARS-CoV-2 infection and at least one of (i) age ≥ 40 years, age ≥ 18 years (ii) and at least one comorbidity, or - (iii) and BMI ≥ 30. The study protocol was published at www.clinicaltrials.gov (unique protocol #02032021) and at www.clinicaltrialregister.eu (EudraCT-number 2021-001177-22). Results With 121 participants in each arm, we found no difference in the primary endpoint with 82 participants in the amantadine arm, and 92 participants in the placebo arm with no limitations to activities, respectively, and 25 and 37 with limitations to activities in the amantadine arm and the placebo arm respectively. No participants in either group were admitted to hospital or died. The Odds Ratio of having state severity increased by 1 in the amantadine group versus placebo was 1.8 (Confidence Interval…

How strong is the evidence?

Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design. Reported size: 242 participants or records.

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