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Opicapone: A third generation COMT inhibitor.

Jessica Greenwood1, Huy Pham1, Jose Rey1

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Clinical Parkinsonism & Related Disorders
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PubMed
Summary

Opicapone, a new COMT inhibitor, effectively treats Parkinson's motor fluctuations with once-daily dosing. It offers benefits over older treatments by reducing "off" time and improving patient care.

Keywords:
COMT inhibitorOpicaponeParkinson’s Disease

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Area of Science:

  • Pharmacology
  • Neurology
  • Drug Development

Background:

  • Parkinson's disease (PD) is a progressive neurodegenerative disorder.
  • Motor fluctuations, particularly end-of-dose (wearing-off) phenomena, significantly impact patient quality of life.
  • Catechol-O-methyl transferase (COMT) inhibitors are used as adjunct therapy to levodopa to manage PD motor symptoms.

Purpose of the Study:

  • To review the newly FDA-approved COMT inhibitor, opicapone, for managing end-of-motor fluctuations in adult Parkinson's patients.
  • To evaluate opicapone's efficacy, safety, and clinical relevance compared to existing treatments.

Main Methods:

  • Literature search of PubMed for studies on opicapone (BIA 9-1067, Ongentys) up to May 2020.
  • Review of relevant English-language clinical trials, drug monographs, and review articles.
  • Data synthesis from randomized clinical trials (BIPARK I and BIPARK II).

Main Results:

  • Opicapone (50 mg once daily) demonstrated non-inferiority to entacapone in reducing mean "off" time by approximately 50 minutes compared to placebo.
  • Common adverse events included dyskinesia, falls, insomnia, and elevated creatine phosphokinase.
  • Switching from entacapone to opicapone resulted in a mean reduction of "off" time by -39.3 minutes.

Conclusions:

  • Opicapone is a third-generation COMT inhibitor approved for Parkinson's disease motor fluctuations.
  • Its once-daily dosing, favorable tolerability, and lack of hepatic failure risk offer advantages over other COMT inhibitors.
  • Opicapone presents a valuable therapeutic option for patients experiencing end-of-motor fluctuations.