Objective: This post-hoc analysis evaluated the effectiveness of opicapone (OPC) in Parkinson’s disease (PD) patients with motor fluctuations (MF) according to baseline use of monoamine-oxidase-B inhibitors (MAO-Bi) and dopamine agonists (DA).

Background: OPC proved to be effective in treating end-of-dose MF in PD patients [1,2]. The OPTIPARK study evaluated OPC 50 mg in a heterogeneous population of patients treated in real-world conditions [3].

Method: OPTIPARK was a prospective, open-label, single-arm trial conducted in Germany and the UK. Patients with MF received OPC 50 mg in addition to current antiparkinsonian treatment. Primary efficacy 3-month endpoint was Clinician’s-Global-Impression-of-Change (CGI-C). Secondary efficacy endpoints included Patient’s-CGI-C (PGI-C), 8-item PD-Questionnaire (PDQ-8), Unified PD Rating Scale (UPDRS) and Non-Motor Symptoms Scale (NMSS). Safety assessments included evaluation of treatment-emergent adverse events (TEAEs). This post-hoc analysis evaluated the influence of baseline use of both MAO-Bi and DA in patients who completed the study for each outcome.

Results: Overall, 393 (82.4%) patients completed the 3-month endpoint (completers-set, Table 1). Of these, patients using MAO-Bi/DA at baseline experienced greater improvements on CGI-C and PGI-C, when compared to patients not using MAO-Bi/DA at baseline (Table 2). Except for NMSS, patients not using MAO-Bi/DA at baseline experienced greater improvements on UPDRS-II and III and quality-of-life (PDQ-8) (Table 3). Lower incidence of TEAEs considered at least possibly related to OPC were also reported for patients using MAO-Bi/DA at baseline (Table 3).

Conclusion: Overall, these findings indicate that patients may benefit from using OPC 50 mg with or without MAO-Bi/DA as adjunctive therapy to levodopa.

References: 1. Ferreira et al., Lancet Neurology 2016; 15(2):154-165. 2. Lees et al., JAMA Neurol. 2017; 74(2):197-206. 3. Reichmann et al., Transl Neurodegener. 2020;9(1):9

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