Objective: To evaluate the efficacy and tolerability of opicapone in usual clinical practice in patients with Parkinson’s disease (PD).

Background: Opicapone is a recently approved catechol-O-methyl transferase (COMT) inhibitor with a potential improvement in efficacy and adverse effects profile with respect to previous COMT inhibitors.

Method: We conducted a retrospective study in patients with PD who started with opicapone under usual clinical practice. Clinical variables were collected 6 months after the start of the drug.

Results: 39 patients with PD were analyzed. 35 patients (89.7%) had advanced PD, among which 18 were on DBS. Only 4 patients (10.25%) presented early fluctuations. The average time of evolution of the disease was 9.5 years (RIC 6.87). 61.54% of patients showed a positive evaluation on the PGIC scale, presenting 15.38% “no change” and 23.08% a negative statement. There were no statistical differences in improvement in patients with DBS and non-DBS (p = 0.53). All patients with early fluctuations presented a positive evaluation. The mean LEDD dose was reduced by 56.17mg ([17.96-94.39], p = 0.005). The improvement in motor fluctuations was referred in 65.79% of patients. There was also an improvement in neuropsychiatric (n= 6/10), sensory (n=3/8) and dysautonomic (n=3/6) fluctuations.
58.97% of patients presented dyskinesias before starting opicapone. Amongst them, 65.22% showed no modification in dyskinesias and 26.09% presented a non-disabling worsening of them. There were no disabling dyskinesias in any patient.
12 patients (30.77%) experienced adverse effects: dizziness (n = 5), new onset dyskinesias (n = 4), orthostatic hypotension (n = 3), drowsiness (n = 2), gastrointestinal intolerance (n = 1), visual hallucinations (n = 1), impulsivity (n = 1) and headache (n = 1). Patients presenting with hallucinations and impulsivity had a previous history of psychosis and impulse control disorder, respectively. The suspension of the drug occurred in 30.77% (n = 12), being the main reason a lack of efficacy in 5 patients and a disabling adverse effect in 7 patients.

Conclusion: Opicapone is an effective drug with a good safety profile in advanced and early-fluctuating PD. It is also useful as an adjuvant therapy in patients treated with DBS who keep with fluctuations. Opicapone also improved non-motor fluctuations in half of the patients.

« Back to MDS Virtual Congress 2020

MDS Abstracts - https://www.mdsabstracts.org/abstract/efficacy-and-tolerability-of-opicapone-in-parkinsons-disease-in-usual-clinical-practice/