Objective: The REONPARK study is an observational study conducted in Spain aiming to evaluate COMT inhibitors (iCOMT) effectiveness and tolerability in alleviating motor complications associated with L-dopa treatment in Parkinson’s disease (PD) patients with early motor fluctuations (signs of end-of-dose motor fluctuations within ≤2 years) in clinical practice.
Background: In PD, iCOMT usage extends the half-life of levodopa and reduces peak-trough variations, contributing to optimize the dose of levodopa and stabilize plasma levels [1]. Although evidence indicates comparable iCOMT efficacy in reducing off-time and increasing on-time in patients with recent or long-standing motor fluctuations, some studies suggest a benefit of earlier initiation of iCOMT [2-5]. The WOQ-19 has been recognized as a recommended diagnostic screening tool to detect the presence/absence of wearing-off symptoms in PD patients [6].
Method: This interim analysis describes the effectiveness of iCOMT in reducing wearing-off symptoms through WOQ-19 questionnaire after 12 months of treatment.
Results: In 89 evaluable patients (age [mean±SD] 64.6±10.2 years old; PD duration: 4.8±3.1 years; mean levodopa dose 463.8±191.7 mg/daily; onset of wearing-off 0.6 years; 98.9% initiating opicapone and 1.1% entacapone), the mean baseline total WOQ-19 score of 5.2±2.3 was significantly reduced to 3.3±2.6 after 12 months of iCOMT treatment (p<0.001). There was a reduction in most of the wearing-off symptoms, both motor and non-motor, with significant improvements observed in tremor, weakness, slowness of movement, reduced dexterity, numbness, cloudy mind, abdominal discomfort and difficulty getting out of the chair (p<0.05). (Figure 1)
Conclusion: Treatment with iCOMT (mainly opicapone) over 12 months was associated with a reduction of motor and non-motor wearing-off symptoms (based on WOQ-19) in real-world practice.
Figure 1
Table 1
References: 1. Jenner P. Expert Rev Neurother 2021(9):1019-1033.
2. Ebersbach GR, O; Ferreira, J; Costa, R. Rocha J.F , Magalhães, D; Soares-da-Silva, P. . Efficacy and Safety of Opicapone in Parkinson’s Disease Patients According to Duration of Motor Fluctuations: Post-Hoc Analysis of BIPARK-I and II. In: MDS Virtual Congress 2020.
3. Ferreira JJ, Lees A, Rocha JF, Poewe W, Rascol O, Soares-da-Silva P (2019) Long-term efficacy of opicapone in fluctuating Parkinson’s disease patients: a pooled analysis of data from two phase 3 clinical trials and their open-label extensions. Eur J Neurol 26(7):953-960.
4. Nissinen H, Kuoppamaki M, Leinonen M, Schapira AH (2009) Early versus delayed initiation of entacapone in levodopa-treated patients with Parkinson’s disease: a long-term, retrospective analysis. Eur J Neurol 16(12):1305-1311.
5. Rocha JF, Ebersbach G, Lees A et al (2021) The Added Benefit of Opicapone When Used Early in Parkinson’s Disease Patients With Levodopa-Induced Motor Fluctuations: A Post-hoc Analysis of BIPARK-I and -II. Front Neurol 12754016.
6. Antonini A, Martinez-Martn P, Chaudhuri RK, et al. Wearing-off scales in Parkinson´sdisease: critique and recommendations. Mov Disord 2011; 26:2169-75
To cite this abstract in AMA style:
L. López-Manzanares, M. Cerdán, I. Gaston, R. Vázquez, B. Vives, M. Carmona, M. Rodriguez-de Miguel, I. Tegel, D. Magalhāes, J. Holenz. Improvement of Wearing‑Off Symptoms After Initiation of COMT Inhibitors in Parkinson’s Disease patients with early motor fluctuations: Results from the 12 months interim analysis of REONPARK Study [abstract]. Mov Disord. 2026; 41 (suppl 1). https://www.mdsabstracts.org/abstract/improvement-of-wearing-off-symptoms-after-initiation-of-comt-inhibitors-in-parkinsons-disease-patients-with-early-motor-fluctuations-results-from-the-12-months-interim-analysis-of-re/. Accessed October 1, 2026.« Back to 2026 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/improvement-of-wearing-off-symptoms-after-initiation-of-comt-inhibitors-in-parkinsons-disease-patients-with-early-motor-fluctuations-results-from-the-12-months-interim-analysis-of-re/