Objective: Our study aims to assess the effect of an add-on treatment with catechol-O-methyl transferase (COMT) inhibitor, opicapone, on the plasmatic levels of homocysteine (HCY) in patients with Parkinson’s disease (PD) treated with levodopa-carbidopa intestinal gel/carbidopa-levodopa enteral suspension (LCIG/CLES).
Background: Levodopa-carbidopa intestinal gel/carbidopa-levodopa enteral suspension (LCIG/CLES) is an effective Device-Aided Therapy in fluctuating patients with advanced PD. Long-term treatment with relatively high doses of levodopa is connected with the elevation of homocysteine (HCY) plasmatic levels. We have previously proved that add-on treatment with COMT inhibitor tolcapone reduced LCIG/CLES daily dose and decreased HCY levels [1]. Opicapone shares similar effectiveness compared to tolcapone, with a much lower risk of hepatotoxicity [2]. It has been successfully used together with LCIG/CLES [3].
Method: In this pilot study, we examined the levels of HCY in patients treated with LCIG/CLES before and 12 weeks after add-on treatment with opicapone.
Results: Until the deadline for abstract submission, we obtained data from three patients with advanced PD, in whom three-month treatment with opicapone and an adequately reduced dose of LCIG/CLES led to an average 43% reduction in HCY levels (Figure 1).
Conclusion: Opicapone might have the potential to reduce HCY plasmatic levels in patients with advanced PD treated by LCIG/CLES, probably by decreased peripheral conversion of levodopa to 3-O-methyldopa and, thus, also possibility to reduce the daily dose of LCIG/CLES.
The change in homocysteine levels (in μmol/l)
References: [1] Valkovič P, Minár M, Matejička P, Gmitterová K, Boleková V, Košutzká Z. Tolcapone improves outcomes in patients with Parkinson disease treated by levodopa/carbidopa intestinal gel: A pilot study. Medicine (Baltimore). 2022 Aug 12;101(32):e29526. doi: 10.1097/MD.0000000000029526. PMID: 35960120; PMCID: PMC9371526.
[2] Rodrigues FB, Ferreira JJ. Opicapone for the treatment of Parkinson’s disease. Expert Opin Pharmacother. 2017 Mar;18(4):445-453. doi: 10.1080/14656566.2017.1294683. Epub 2017 Feb 22. PMID: 28234566.
[3] Leta V, van Wamelen DJ, Sauerbier A, Jones S, Parry M, Rizos A, Chaudhuri KR. Opicapone and Levodopa-Carbidopa Intestinal Gel Infusion: The Way Forward Towards Cost Savings for Healthcare Systems? J Parkinsons Dis. 2020;10(4):1535-1539. doi: 10.3233/JPD-202022. PMID: 32597817.
To cite this abstract in AMA style:
M. Minar, I. Straka, Z. Kosutzka, Z. Andre. Opicapone Reduces Homocysteine Levels in Patients with Parkinson’s Disease Treated with Levodopa Gel Infusion [abstract]. Mov Disord. 2024; 39 (suppl 1). https://www.mdsabstracts.org/abstract/opicapone-reduces-homocysteine-levels-in-patients-with-parkinsons-disease-treated-with-levodopa-gel-infusion/. Accessed November 21, 2024.« Back to 2024 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/opicapone-reduces-homocysteine-levels-in-patients-with-parkinsons-disease-treated-with-levodopa-gel-infusion/