Objective: To assess the efficacy of opicapone 50 mg, compared to an additional 100 mg dose of levodopa, in reducing OFF-time in Parkinson’s disease (PD) patients experiencing the first signs of motor fluctuations, using different levodopa dosing regimens and levodopa equivalent daily dosages (LEDDs).
Background: Opicapone was shown to be effective in reducing OFF-time in patients with PD and early motor fluctuations.
Method: The ADOPTION clinical program included two 4-week, randomised (1:1), open-label studies in South Korea and Europe. PD patients with early wearing-off received opicapone 50 mg or an increased dose of levodopa (increased by 100 mg/day) as add-on to standard levodopa therapy. In this exploratory post-hoc analysis, change from baseline in absolute OFF-time (primary endpoint) was evaluated in four subgroups: patients receiving ≤400 mg/day of levodopa (low-dose group) and those receiving >400–≤600 mg/day of levodopa (moderate-dose group) at baseline; and patients with an LEDD of ≤550 mg/day and an LEDD of >550 mg/day at baseline.
Results: OFF-time reduction was consistently greater with opicapone 50 mg than with the increased levodopa dose [figure 1]. In the low-dose group, mean (95% confidence interval) OFF-time reduction was -60.12 (-85.77, -34.47) minutes with opicapone versus -40.40 (-64.98, -15.83) minutes with increased levodopa. In the moderate-dose group, OFF-time reduction was -66.27 (-86.37, -46.18) minutes with opicapone versus -24.91 (-55.22, 5.4) minutes with increased levodopa. Similar results were observed when considering LEDDs. While opicapone maintained a consistent effect across levodopa dose ranges and LEDDs, the additional 100 mg levodopa dose showed a lower magnitude of efficacy.
Conclusion: Opicapone consistently reduced OFF-time by ~1 hour independently from the total levodopa dose or LEDD at baseline, and was more efficacious than an increased levodopa dose, suggesting that it is an effective strategy for managing early motor fluctuations in PD patients.
Figure 1
To cite this abstract in AMA style:
J. Ferreira, JY. Lee, HI. Ma, B. Jeon, W. Poewe, A. Antonini, F. Stocchi, D. Rodrigues, M. Fonseca, H. Brigas, J. Holenz, O. Rascol. Effectiveness of Opicapone Added to Different Levodopa Doses and LEDDs in Parkinson’s Disease: Post-Hoc Analysis of the ADOPTION Trials [abstract]. Mov Disord. 2025; 40 (suppl 1). https://www.mdsabstracts.org/abstract/effectiveness-of-opicapone-added-to-different-levodopa-doses-and-ledds-in-parkinsons-disease-post-hoc-analysis-of-the-adoption-trials/. Accessed October 5, 2025.« Back to 2025 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/effectiveness-of-opicapone-added-to-different-levodopa-doses-and-ledds-in-parkinsons-disease-post-hoc-analysis-of-the-adoption-trials/