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Opicapone as adjunct to levodopa in treated Parkinson's disease without motor complications: A randomized clinical trial

Lookup NU author(s): Professor Camille CarrollORCiD

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This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


Abstract

© 2024 The Author(s). European Journal of Neurology published by John Wiley & Sons Ltd on behalf of European Academy of Neurology.Background: Catechol-O-methyl transferase (COMT) inhibitors are routinely used to manage motor fluctuations in Parkinson's disease (PD). We assessed the effect of opicapone on motor symptom severity in levodopa-treated patients without motor complications. Methods: This was a randomized, double-blind, 24-week, placebo-controlled study of opicapone 50 mg as adjunct to levodopa (NCT04978597). Levodopa-treated patients without motor complications were randomized to 24 weeks of double-blind treatment with adjunct opicapone 50 mg or matching placebo. The primary efficacy endpoint was the mean change from baseline to week 24 in Movement Disorder Society-Unified Parkinson's Disease Rating Scale Part III (MDS-UPDRS-III) total score. Results: A total of 355 patients were randomized (opicapone 50 mg n = 177, placebo n = 178) and 322 (91%) completed the double-blind period. The adjusted mean [95% CI] change from baseline to week 24 in MDS-UPDRS-III subscore was −6.5 [−7.9, −5.2] in the opicapone group versus −4.3 [−5.7, 3.0] in the placebo group resulting in a significant difference of −2.2 [−3.9, −0.5] favoring opicapone (p = 0.010). There was no difference in the incidence of patients who developed motor complications (5.5% with opicapone vs. 9.8% with placebo) and the incidence of adverse events considered related to study medication was similar between groups (opicapone 10.2% vs. placebo 13.5%). Conclusions: Treatment with once-daily adjunct opicapone was well tolerated, improved motor severity, and did not induce the development of motor complications. These results support the clinical usefulness of opicapone in the management of PD patients without motor complications.


Publication metadata

Author(s): Ferreira JJ, Rascol O, Stocchi F, Antonini A, Moreira J, Castilla-Fernandez G, Rocha J-F, Holenz J, Poewe W, Marechal E, Bergmans B, De Weweire M, Manolova-Mancheva T, Bosilkov A, Haralanov L, Milanov I, Ikonomov R, Kirilov K, Naydenov V, Izmailov A, Traykov L, Balaz M, Pazdera L, Bajacek M, Skoda O, Bartlova L, Talab R, Hort J, Valis M, Ehler E, Rascol O, Drapier S, Defebvre L, Thobois S, Castelnovo G, Toenges L, Krause P, Falkenburger B, Schwarz J, Klostermann F, Schnitzler A, Volonte MA, Tessitore A, Barone P, Colosimo C, Buonaura GC, Centonze D, De Pandis MF, Vacca L, Antonini A, Trzebinska-Frydrychowska E, Siuda J, Machowski J, Ilkowski J, Nastaj M, Rudzinska-Bar M, Kasprzyk-Galon K, Grudniak M, Ferreira JJ, Gago MF, Mendes A, Dedic SK, Svetel M, Knezevic Z, Jovic J, Rivera PM, Cristobal GL, Martinez EB, Ballestero TD, Serra FV, Krupinski J, Pons NC, Garriga MC, Morales EA, Vara JH, Cakmur R, Hanagasi H, Uslu F, Dogu O, Elibol B, Carroll C, Walker R, Ledingham D, Sammler E, Marshall V, Pasiura I, Buchakchyiska N, Dziak L, Moskovko S, Sanotskyy Y, Kozyolkin O, Slobodin T

Publication type: Article

Publication status: Published

Journal: European Journal of Neurology

Year: 2025

Volume: 32

Issue: 1

Print publication date: 10/01/2025

Online publication date: 10/01/2025

Acceptance date: 11/07/2024

Date deposited: 11/02/2025

ISSN (print): 1351-5101

ISSN (electronic): 1468-1331

Publisher: John Wiley and Sons Inc

URL: https://doi.org/10.1111/ene.16420

DOI: 10.1111/ene.16420

Data Access Statement: The data that support the findings of this study are available from the corresponding author upon reasonable request.

PubMed id: 39790009


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