Opicapone for the management of end-of-dose motor fluctuations in patients with Parkinson’s disease treated with L-DOPA

ABSTRACT

Introduction: Opicapone is a third generation, highly potent and effective catechol O‑methyltransferase (COMT) inhibitor that optimizes the pharmacokinetics and bioavailability of L-DOPA therapy.

Areas covered: In this review, the authors describe the preclinical and clinical development of opicapone. In PD patients with motor fluctuations, once daily opicapone administration was well-tolerated and consistently reduced OFF-time and increased ON-time without increasing the frequency of troublesome dyskinesia, and these benefits were maintained over at least a year of continued open-label therapy.

Expert commentary: With its convenient once-daily regimen, adjunct opicapone should be considered as an effective option for use in L-DOPA treated PD patients experiencing motor fluctuations.

KEYWORDS:

• Opicapone
• L-DOPA
• Parkinson’s disease
• wearing-off
• motor fluctuations
• COMT inhibition

Declaration of interest

A.J. Lees, J.J. Ferreira, W. Poewe, O. Rascol, H. Reichmann, F. Stocchi and E. Tolosa report personal fees for consultancy from BIAL and were all investigators in BIAL sponsored Phase III studies. A.J. Lees is funded by the Reta Lila Weston Institute of Neurological Studies, University College London, Institute of Neurology and reports consultancies for: Britannia Pharmaceuticals, BIAL Portela. He also reports grants and/or research support: from the PSP Association, Weston Trust, The Reta Lila Howard Foundation and honoraria from Britannia, UCB, Roche, Novartis, Boehringer Ingelheim, Lundbeck, GE Healthcare, Teva, GSK, Ipsen, Allergan, Orion, Bial, AbbVie Lucid, Nordiclnfu Care. J.J. Ferreira has held consultancy functions with GlaxoSmithKline, Novartis, TEVA, Lundbeck, Solvay, Abbott, BIAL, Merck-Serono, Merz, Ipsen, Biogen; has received lecture fees from Biogen and BIAL; has received grants from GlaxoSmithKline, Grunenthal, MSD, Allergan, Novartis, Fundação MSD (Portugal) and Teva; has been employed by Centro Hospitalar Lisboa Norte, Faculdade de Medicina de Lisboa. W. Poewe reports receiving consulting fees from AbbVie, Allergan, Astra Zeneca, BIA, Boehringer-Ingelheim, Boston Scientific, GlaxoSmithKline, Ipsen, Lundbeck, Medtronic, MSD, Merck-Serono, Merz Pharmaceuticals, Novartis, Orion Pharma, Teva, UCB and Zambon. O. Rascol reports receiving consulting fees from Abbvie, BIAL, Britannia, Lundbeck, Merck, Mundipharma, Sanofi, Servier, Teva, UCB, XénoPort, Zambon; and grant support from Agence Nationale de la Recherche (ANR), Boehringer Ingelheim, CHU de Toulouse, French Parkinson, GSK, INSERM-DHOS, Michael J Fox Foundation, Programme Hospitalier de Recherche Clinique, Recherche Clinique Translationnelle, UCB, Teva and Lundbeck. H. Reichmann reports acting on Advisory Boards, gave lectures and received research grants from Abbott, Abbvie, Bayer Health Care, BIAL, Boehringer/Ingelheim, Brittania, Cephalon, Desitin, GSK, Lundbeck, Medtronic, Merck-Serono, Novartis, Orion, Pfizer, TEVA, UCB Pharma, Valeant, and Zambon. F. Stocchi reports honoraria and consulting fees from GlaxoSmithKline, Boehringer Ingelheim, Lundbeck, Orion Novartis, Teva, Newron, Merck Serono, and Pfizer. E. Tolosa reports honoraria and consulting fees from BIAL, UCB, Boehringer Ingelheim, Novartis, Abbot, Medtronic, Solvay, GSK. Anita Chadha-Patel of ACP Clinical Communications Ltd (funded by BIAL) provided medical writing support (literature searching, referencing and editing) in the development of this report. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Additional information

Funding

Funding for this paper was provided by BIAL - Portela & Ca, S.A, who were not involved in the preparation of the paper, but who provided a full review of the article. No author received any remuneration for the preparation of this article.​​​​