Objective: To assess effectiveness and safety profile of Opicapone in our cohort of patients with Parkinson’s disease (PD) who received this treatment.

Background: Opicapone is a new catechol‐O‐methyltransferase (COMT) inhibitor indicated as adjunct to levodopa (LD) therapy in patients with PD and motor fluctuations. It has been shown to reduce “off” time with few adverse effects (AE) and improve the quality of life of patients [1][2][3]. 

Method: We developed a retrospective study.  We selected PD patients treated with Opicapone between May of 2017 to November of 2021 from our Movement Disorders Unit.We analyzed clinical data from their basal appointment when Opicapone was prescribed, first follow-up and Opicapone discontinuation appointment. A subset of motor and non motor symptoms were collected. Besides we analyzed the presence of motor fluctuations, dyskinesias, Clinical Global Impression (CGI) and adverse events. Linear and logistic analyses were applied to quantitative and qualitative variables, respectively.

Results: We included 187 patients (110 male, mean age 66±10 years). Mean disease duration was 11±5.98 years. Mean time to the first follow-up was 3.9±2.98 months. Comparing to basal evaluation, we observed a significant reduction in the presence of motor fluctuations  at follow-up (90.7 vs 78.63%,  p=0.003) as well as an increase of “on” time (11.28 vs 12.45 hours, p=0.014) and a reduction of “off” time (4.9 vs 3.7 hours, p=0.011). There were no change in dyskinesias presence neither in non-motor symptoms. No significant change in LD total dose was observed (664.6±328.22 vs 639.92±297.91, p=0.49). According to CGI score, 56.25% of patients improved, 18.75% of patients remained stable and 25% of patients worsened. 27.27% patients discontinued opicapone because of AE, being the most frequent hallucinations (7.49%), anxiety (4.27%), and nausea (2.67%). Withdrawal occurred within a mean time of 9.59±9.14 months. 

Conclusion: Our findings were consistent with the literature, with an increase of “on” time and a reduction of motor fluctuations and “off” time associated to Opicapone treatment. In addition, more than a half of patients improved their situation according to their CGI score. No major adverse events were seeing in our cohort, considering a safe profile for this treatment.

References: 1. Fabbri M, Ferreira JJ, Lees A, Stocchi F, Poewe W, Tolosa E, et al. Opicapone for the treatment of Parkinson’s disease: A review of a new licensed medicine: Opicapone in The treatment of PD. Mov Disord. 2018 Oct;33(10):1528–39.
2. Ferreira JJ, Lees A, Rocha J-F, Poewe W, Rascol O, Soares- da-Silva P. Opicapone as an adjunct to levodopa in patients with Parkinson’s disease and end-of-dose motor fluctua- tions: a randomised, double-blind, controlled trial. Lancet Neurol. 2016;15(2):154–65.
3. Reichmann H, Lees A, Rocha J-F, Magalhães D, Soares-da-Silva P. Effectiveness and safety of opicapone in Parkinson’s disease patients with motor fluctuations: the OPTIPARK open-label study. Transl Neurodegener. 2020 Dec;9(1):9.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/opicapone-use-in-patients-with-parkinsons-disease-with-motor-fluctuations-experience-from-a-tertiary-center/