Opicapone: A Review in Parkinson's Disease

Drugs. 2016 Sep;76(13):1293-1300. doi: 10.1007/s40265-016-0623-y.

Abstract

Oral opicapone (Ongentys(®)), a potent, third-generation, long-acting, peripheral catechol-O-methyltransferase (COMT) inhibitor, is approved as adjunctive treatment to levodopa (L-Dopa)/dopa-decarboxylase inhibitor (DDCI) therapy in adults with Parkinson's disease (PD) and end-of-dose motor fluctuations who cannot be stabilized on those combinations. In 14- to 15-week, double-blind, multinational trials and in 1-year, open-label extension studies in this patient population, opicapone was an effective and generally well tolerated adjunctive therapy to L-Dopa plus a DDCI and other PD therapy. During the double-blind phase, adjunctive opicapone 50 mg once daily provided significantly greater improvements in motor fluctuations than placebo, with these improvements noninferior to those with entacapone. These beneficial improvements in motor fluctuations with opicapone were maintained in patients who continued adjunctive opicapone during the extension studies, with patients who switched from placebo or entacapone to opicapone experiencing significant improvements in motor fluctuations during this year. No new unexpected safety concerns were identified after ≈1.4 years' treatment with opicapone, with no serious cases of hepatotoxicity reported in clinical trials. With its convenient once-daily regimen, oral opicapone is an emerging COMT inhibitor option for use as adjunctive therapy to L-Dopa/DDCI therapy in adults with PD and end-of dose motor fluctuations who cannot be stabilized on those combinations.

Publication types

  • Review

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antiparkinson Agents / therapeutic use*
  • Aromatic Amino Acid Decarboxylase Inhibitors / administration & dosage
  • Aromatic Amino Acid Decarboxylase Inhibitors / metabolism
  • Aromatic Amino Acid Decarboxylase Inhibitors / pharmacokinetics
  • Aromatic Amino Acid Decarboxylase Inhibitors / therapeutic use
  • Catechol O-Methyltransferase Inhibitors / administration & dosage
  • Catechol O-Methyltransferase Inhibitors / metabolism
  • Catechol O-Methyltransferase Inhibitors / pharmacokinetics
  • Catechol O-Methyltransferase Inhibitors / therapeutic use
  • Double-Blind Method
  • Drug Interactions
  • Drug Therapy, Combination
  • Humans
  • Levodopa / administration & dosage
  • Levodopa / metabolism
  • Levodopa / pharmacokinetics
  • Levodopa / therapeutic use
  • Middle Aged
  • Oxadiazoles / administration & dosage
  • Oxadiazoles / metabolism
  • Oxadiazoles / pharmacokinetics
  • Oxadiazoles / therapeutic use*
  • Parkinson Disease / drug therapy*

Substances

  • Antiparkinson Agents
  • Aromatic Amino Acid Decarboxylase Inhibitors
  • Catechol O-Methyltransferase Inhibitors
  • Oxadiazoles
  • Levodopa
  • opicapone