Objective:
To evaluate the effect of opicapone (OPC) 50 mg versus entacapone (ENT) on levodopa short duration response (SDR).
Background: OPC, a once-daily catechol-O-methyltransferase inhibitor, was shown to be effective for end-of-dose motor-fluctuations in Parkinson’s disease (PD) patients in two large multinational trials (BIPARK-I and II) [1, 2].
Method:
Home-diary data from OPC 50 mg and ENT BIPARK-I [1] patients with wearing-OFF were analyzed. Patients’ 24-h diary data were stratified per daily hour. Asleep and ON/OFF fluctuations were characterized and depicted by daily hour. Stylized profile of plasma levodopa following standard oral 100/25 mg dosing was used. Levodopa SDR was defined as the ON-time fluctuation daily pattern.
Results:
A total of 235 patients were included in the analysis. For both treatments, at baseline and endpoint, the majority of asleep-time (>50%/h) was within 11pm to 6am and the proportions of patients taking levodopa per daily-hour were comparable (Figures 1A, 1B and 2A, 2B). As expected, for both treatments at baseline, levodopa SDR roughly paralleled the stylized levodopa concentrations [3] (inset Figures 1C, 2C) fitted to the proportion of patients taking levodopa per daily-hour (Figures 1C, 2C). For ENT, at baseline and endpoint, 4 OFF/ON transition periods were apparent (in line with a higher proportion of patients [>25%] taking levodopa; Figures 2A, 2C and 2D), suggesting a mild influence of ENT on the levodopa SDR. For OPC 50 mg, at baseline, 5 OFF/ON transition periods were apparent (in line with a higher proportion of patients [>25%] taking levodopa; Figures 1A, 1B and 1C). At endpoint, despite comparable proportions of patients taking levodopa per daily-hour, only 3 OFF/ON transition periods were apparent (Figure 1D), suggesting a relevant impact of OPC 50 mg on the levodopa SDR.
Conclusion:
OPC enhances the magnitude of levodopa SDR, most likely due to its more potent and long-lasting catechol-O-methyltransferase inhibition, compared with ENT.
References: 1. Ferreira JJ, et al. Lancet Neurol. 2016;15:154–65. 2. Lees AJ, et al. JAMA Neurol. 2017;74:197–206. 3. Albin RL, et al. Ann Neurol. 2017;82:4–19.
To cite this abstract in AMA style:
P. LeWitt, J. Ferreira, G. Ebersbach, E. Tolosa, G. Liang, R. Loureiro, D. Magalhães, J.F Rocha, P. Soares-da-Silva. Effect of opicapone and entacapone on levodopa short duration response [abstract]. Mov Disord. 2020; 35 (suppl 1). https://www.mdsabstracts.org/abstract/effect-of-opicapone-and-entacapone-on-levodopa-short-duration-response/. Accessed May 17, 2025.« Back to MDS Virtual Congress 2020
MDS Abstracts - https://www.mdsabstracts.org/abstract/effect-of-opicapone-and-entacapone-on-levodopa-short-duration-response/