Objective: The aim of this clinical observation was to verify the sparing of levodopa in patients affected by Parkinson’s disease who already started safinamide treatment for at least 1-year as add-on therapy to levodopa, and who were prescribed opicapone for treating the reappearance of motor fluctuations.

Background: Safinamide is a monoaminoxidase B inhibitor approved as adjunctive treatment to levodopa for treating fluctuating motor symptoms in patients affected by Parkinson’s disease (PD); more recently, opicapone has been approved as a Catechol-O-methyl transferase inhibitor for treating motor fluctuations in PD patients already treated by levodopa. Since both drugs have different effects and can be used for sparing levodopa in PD patients, it is important to evaluate in clinical practive the possible combination of these two drugs on motor symptoms.

Method: This is a clinical observation of a group of 12 patients affected by mild to moderate PD who started safinamide treatment for at least 1 year and who were prescribed opicapone for controlling the reappearance of motor fluctuations. We evaluated in all patients before starting opicapone and after 4 months of treatment the Hoen and Yahr stage (H&Y) and the Unified Parkinson’s Disease Rating Scale (UPDRS) III and IV scores.

Results: Twelve patients were included in this observation. The addiction of opicapone to safinamide improved H&Y stage (2.04±0.33 vs 1.92±0.19) and reduced the UPDRS III (20.58±2.02 vs 19.33±1.82) and IV scores (2.33±0.49 vs 0.91±0.66). We did not observe worsening of dyskinesia in all the patients evaluated, who reported at the follow-up visit the beneficial effect of opicapone added to safinamide mainteining stable levodopa doses.

Conclusion: In this preliminary clinical observation, we documented the beneficial effects of the combination of opicapone and safinamide in patients affected by mild to moderate PD under levodopa treatment and complaining for early motor fluctuation. Further studies with more patients are needed to confirm this observation.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/opicapone-added-to-safinamide-in-patients-affected-by-parkinsons-disease-for-better-controlling-motor-fluctuations/