Objective: Evaluation of the acute efficacy and tolerability of Opicapone.

Background: Opicapone is a Catechol-O-Methyltransferase (COMT) inhibitor for the treatment of patients with idiopathic Parkinson’s Disease with motor fluctuations. The major studies on opicapone do not differentiate reactions occurring within the first days of treatment.

Methods: 88 patients with idiopathic Parkinson’s Disease with motor fluctuations were newly administered the COMT inhibitor opicapone during inpatient treatment at a specialized Parkinson’s Disease clinic. Acute efficacy (measured by Clinical Global Impression of change, CGI-c) and tolerability were assessed 3 days after starting treatment.

Results: After 3 days of treatment, 67% of the patients showed an improvement in the CGI-c score. Improvements occurred most often in patients which were exposed to a COMT-I for the first time (60.7 %), compared to those who were switched from entacapone (44.2 %) or tolcapone (37,5 %). The most common side effect was the emergence of, or increased, hyperkinesia (6.8 %) or hallucinations (14.7 %). The observed adverse reactions can be linked to the increased bioavailability of levodopa. Substance-specific side effects described for other COMT inhibitors (urine discolouration, diarrhea) were not observed.

Conclusions: Positive effects can be observed within in the first days of treatment with opicapone. Patients at risk for hyperkinesia or hallucinations should be carefully monitored for possible adverse events.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/acute-efficacy-and-tolerability-of-the-comt-inhibitor-opicapone/