Abstract:

Proceedings from the Bial satellite symposium at the MDS Congress 2023

Optimising levodopa therapy as part of the challenge of treating ‘wearing-off’ in Parkinson’s disease (PD) was the focus of a Bial-sponsored satellite symposium at the International Congress of Parkinson’s Disease and Movement Disorders (MDS) 2023. The symposium profiled the rational use of adjunctive therapy to levodopa early in the disease, when motor fluctuations start to occur. This review of the symposium discusses the role of the catechol-O-methyltransferase (COMT) inhibitor opicapone in the management of motor fluctuations in the context of improving the plasma profile and bioavailability of levodopa and how, from a clinical perspective, dual enzymatic inhibition (dopa-decarboxylase (DDC) and COMT) may be one strategy for maximising the effectiveness of this cornerstone therapy. Particular consideration is given to the pharmacokinetic and clinical results from the latest trials of opicapone (203 pharmacokinetic trial and OGT_001 trial in South Korea). These findings, together with the soon-to-be- available results from the ADOPTION trial, may help to guide clinical decision-making in the early use of opicapone as part of a dual inhibition strategy in patients with PD experiencing end-of-dose motor fluctuations.

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