Objective: To evaluate the effect of opicapone (OPC) 50 mg versus an additional 100 mg levodopa (L-DOPA) dose on the different daily OFF patterns in patients with Parkinson’s disease (PD) and early motor fluctuations.

Background: OPC was shown to be effective in reducing OFF-time in patients with PD and early motor fluctuations.

Method: The efficacy and safety of OPC 50 mg versus an additional 100 mg L-DOPA dose in patients with PD and early motor fluctuations treated with L-DOPA therapy were evaluated in the Korean ADOPTION study. The main endpoint was change from baseline to Week 4 in OFF-time. In this post-hoc analysis, home patient diaries were stratified based on OFF-time periods: OFF-fluctuations during awake time and OFF-fluctuations at any point of the day when OFF-time exceeded approximately 10% per hour.

Results: Data from 165 patients were analysed (OPC 50 mg, n=84; L-DOPA 100 mg, n=81). For both groups, at baseline, the asleep-time (>50% per hour) was between 10 pm–6 am [Figure 1] and OFF-time periods (over ~10% per hour) were identified between 4 am–9:30 am, 9:30 am–3 pm and 3 pm–8:30 pm [Figure 1]. The awake OFF-time periods were identified between 6 am–9:30 am, 9:30 am–3p m and 3 pm–10 pm [Figure 1]. The decrease in OFF-time was significantly greater with OPC 50 mg than L-DOPA 100 mg between 9:30 am–10 pm [Figure 2], which represent the awake-time periods when OFF-time has the greatest impact on patients. Reductions in early-morning OFF-time periods were reported in both the OPC 50 mg and the L-DOPA 100 mg groups, with a trend favouring OPC 50 mg [Figure 2].

Conclusion: In patients with PD and early motor fluctuations, treatment with OPC 50 mg led to a greater decrease in OFF-time than an additional 100 mg L-DOPA dose during all OFF-time periods, including morning OFF-time.

Figure 1

Figure 2

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MDS Abstracts - https://www.mdsabstracts.org/abstract/effect-of-opicapone-and-levodopa-on-the-different-daily-off-patterns-in-patients-with-parkinsons-disease-and-early-motor-fluctuations-findings-from-the-korean-adoption-study/