Session Information
Date: Monday, September 23, 2019
Session Title: Clinical Trials, Pharmacology and Treatment
Session Time: 1:45pm-3:15pm
Location: Agora 3 West, Level 3
Objective: The aim of the study is to evaluate opicapone in an heterogeneous patient population, reflecting daily clinical practice.
Background: Opicapone is a new COMT-inhibitor indicated for motor fluctuations in Parkinson’s disease (PD). In previous pivotal trials, opicapone effectively reduced time in the off state and increased time in the on state without troublesome dyskinesia. However, little is known about efficacy and safety in real clinical practice.
Method: We conducted a retrospective study of patients with advanced PD treated with opicapone (June 2017-June 2018) in our Movement Disorders Unit at Ramón y Cajal Hospital in Madrid. Clinical, efficacy and safety variables were analysed. Off-duration was assessed with UPDRS-IV scale.
Results: We included 30 patients, 50% male, mean age 71±13 years, median disease duration of 11 years (3-25), and Hoehn-and-Yahr scale of 3 (1.5-4). Patients were on treatment with levodopa (100%), dopamine agonists (46.7%), MAO-inhibitors (36.7%), amantadine (6.7%), DBS (13.3%) or continuous levodopa-carbidopa intestinal infusion (16.7%). Eight patients (26.7%) were on treatment with a different COMT-inhibitor. Mean follow-up was 3.6 months (1.2-6.1). Before opicapone, 16 patients (53.5%) had off-periods lasting 25-50% of the day and seven patients (23.3%) 50-75% of the day. This time was reduced to 20% and 6.7% respectively (p>0.05). The levodopa equivalent daily dose (LEDD) pre-treatment and post-treatment did not differ significantly (1171.4±671.8mg vs 1133.5±509.5mg, p=0.32). Fifteen patients had non-disabling dyskinesias before treatment, while on opicapone, despite an increase in the duration of dyskinesias (13.3% of patients), no patient with worsening of disabling dyskinesia was registered. Off-time dystonia was reported in three patients (10%) pre-treatment and in none post-treatment. Eight patients discontinued treatment: 3 due to inefficacy, and 5 due to dopaminergic adverse events.
Conclusion: In our one year experience, opicapone was effective in the treatment of motor fluctuations of PD, even in a cohort of complex advanced patients, without significant worsening of dyskinesia and allowing maintenance of LEDD.
To cite this abstract in AMA style:
JB. Paredes, J. Poles, V. Hristova, S. Madrona, S. Argos, P. Torre, JL. Moreno, I. Moreno, JC. Castrillo, A. Canovas. First year of Opicapone for Advanced Parkinson Disease: real-life experience in a single Movement Disorders Unit [abstract]. Mov Disord. 2019; 34 (suppl 2). https://www.mdsabstracts.org/abstract/first-year-of-opicapone-for-advanced-parkinson-disease-real-life-experience-in-a-single-movement-disorders-unit/. Accessed June 14, 2025.« Back to 2019 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/first-year-of-opicapone-for-advanced-parkinson-disease-real-life-experience-in-a-single-movement-disorders-unit/