Objective: This study aimed to provide real-life entacapone use in French PD expert centers, focusing on temporal trends, therapeutic positioning, and treatment persistence.

Background: Optimizing dopaminergic therapy remains central to managing motor fluctuations in Parkinson’s disease (PD).  Among adjunctive-to-levodopa strategies, COMT-inhibitors, particularly entacapone, have played a key role for over two decades in managing motor fluctuations¹. Opicapone, as the latest class expansion, exhibits limited global reach, due to lack of reimbursement or modest market penetration in several regions, including Europe (France, Sweden, Iceland), the Americas (Canada, Argentina, Uruguay, Mexico, Brazil) and the APAC region (Thailand, India). Accordingly, entacapone remains widely used, yet contemporary real-world data on its long-term use and positioning are lacking beyond early post-marketing studies^2,3.

Method: We performed a retrospective, multicenter analysis of visit-level data from 27 French PD expert centers (2012-2025) within the NS-Park network⁴. Disease duration, motor fluctuations, L-dopa dosage, Hoehn & Yahr (H&Y) stage, and concomitant dopaminergic or device-assisted therapies were examined as predictors of Entacapone use. Temporal trends were modelled using logistic regression and mixed-effects models. Persistence was assessed with Kaplan–Meier analyses and exploratory time-dependent discontinuation models.

Results: Across 70254 visits from 25312 PD patients, entacapone use remained stable at ~15% of visits over more than a decade explored, exceeding 20% in high follow-up sub-cohorts (patients with ≥5 or ≥10 visits per year), consistent with more advanced disease (fig. 1). Entacapone prescription was associated with longer disease duration, motor fluctuations, a higher LEDD, and freezing of gait but not age or H&Y stage (fig. 2). Co-prescription with adjunctive dopaminergic and device-aided treatments was common, suggesting a preference for therapeutic continuity over replacement. Median treatment duration was approximately six years, with no consistent symptom worsening preceding discontinuation.

Conclusion: In French expert practice, entacapone retains a stable and durable role in advanced PD management. Its consistent use over time, alongside frequent combination with device-aided therapies, supports its continued relevance in real-world care.

Entacapone penetrance over years

Clinical correlates of entacapone use

References: 1. Poewe W. (2023). Catechol-O-methyltransferase inhibition with entacapone: Evidence from controlled clinical trials in Parkinson’s disease. European journal of neurology, 30 Suppl 2, 9–14. https://doi.org/10.1111/ene.15993
2. Larsen, J. P., Worm-Petersen, J., Sidén, A., Gordin, A., Reinikainen, K., Leinonen, M., & NOMESAFE Study Group (2003). The tolerability and efficacy of entacapone over 3 years in patients with Parkinson’s disease. European journal of neurology, 10(2), 137–146.https://doi.org/10.1046/j.1468-1331.2003.00559.x
3. Myllylä, V. V., Kultalahti, E. R., Haapaniemi, H., Leinonen, M., & FILOMEN Study Group (2001). Twelve-month safety of entacapone in patients with Parkinson’s disease. European journal of neurology, 8(1), 53–60. https://doi.org/10.1046/j.1468-1331.2001.00168.x
4. Mariani, L. L., Doulazmi, M., Chaigneau, V., Brefel-Courbon, C., Carrière, N., Danaila, T., Defebvre, L., Defer, G., Dellapina, E., Doé de Maindreville, A., Geny, C., Maltête, D., Meissner, W. G., Rascol, O., Thobois, S., Torny, F., Tranchant, C., Vidailhet, M., Corvol, J. C., Degos, B., … NS-Park/F-CRIN Network study group (2019). Descriptive analysis of the French NS-Park registry: Towards a nation-wide Parkinson’s disease cohort?. Parkinsonism & related disorders, 64, 226–234. https://doi.org/10.1016/j.parkreldis.2019.04.012

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MDS Abstracts - https://www.mdsabstracts.org/abstract/clinical-features-and-trajectories-related-to-entacapone-use-in-parkinsons-disease-insights-from-the-french-ns-park-cohort/