Abstract:

The challenges of wearing-off in Parkinson’s disease (PD) were highlighted in a Bial-sponsored satellite symposium at the International Congress of Parkinson’s Disease and Movement Disorders (MDS) 2022. The symposium focused on both motor fluctuations and non-motor fluctuations (NMF), the latter often considered the hidden aspect of OFF-time. We discuss the role of the catechol-O-methyltransferase (COMT) inhibitor opicapone in the management of motor fluctuations, and also its emerging role in treating non-motor symptoms in patients with end-of-dose wearing-off. Particular consideration is given to pharmacokinetic and clinical data from the latest study on opicapone. These study results suggest that adding opicapone 50 mg to a stable levodopa regimen provides higher levodopa plasma bioavailability, while reducing levodopa plasma fluctuation levels, despite a concomitant 20% decrease in the total daily dose of levodopa. This is also associated with decreased OFF-time and increased ON-time, thus providing much-needed flexibility in tailoring treatment to the individual needs of patients with PD.

Keywords:

PARKINSON’S DISEASE, COMT INHIBITORS, OPICAPONE, MOTOR FLUCTUATIONS, NON-MOTOR FLUCTUATIONS