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Opicapone: A Review in Parkinson’s Disease

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Abstract

Oral opicapone (Ongentys®), a potent third-generation, peripheral catechol-O-methyltransferase (COMT) inhibitor, is approved as adjunctive therapy to preparations of levodopa/dopa-decarboxylase inhibitor (L-dopa/DDCI) in adults with Parkinson’s disease (PD) and end-of dose (EoD) motor fluctuations. In pivotal global trials (BIPARK 1 and BIPARK 2; 14–15 weeks’ duration), open-label extensions (OLEs) of BIPARK, and in the real-world setting (OPTIPARK; 3–6 months), opicapone 50 mg once daily was an effective and generally well tolerated adjunctive therapy to L-dopa/DDCI plus other PD therapy in adults with PD and EoD motor fluctuations. Adjunctive opicapone provided better efficacy than placebo for improvements in ON- and OFF-state time and fulfilled noninferiority to adjunctive entacapone for improvements in OFF time in BIPARK 1. These beneficial effects of adjunctive opicapone on motor fluctuations were maintained during 1 year of treatment in OLE studies. Given its efficacy and safety profile, adjunctive opicapone remains an important option in the management of adults with PD and EoD motor fluctuations who cannot be stabilized on preparations of L-dopa/DDCI.

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Acknowledgements

During the peer review process, the manufacturer of the agent under review was also offered an opportunity to review this article. Changes resulting from comments received were made on the basis of scientific and editorial merit.

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    Lesley J. Scott

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Lesley Scott is a salaried employee of Adis International Ltd/Springer Nature, and declares no relevant conflicts of interest. All authors contributed to the review and are responsible for the article content.

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The manuscript was reviewed by: A. Antonini, Parkinson’s Disease & Movement Disorders Unit, IRCCS Hospital San Camillo, and 1st Neurology Clinic, Padua University Hospital, Venice, Italy; F. Brugger, Klinik für Neurologie, Kantonsspital St. Gallen, St Gallen, Switzerland; P. J. Garcia Ruiz, Department of Neurology, Fundacion Jimenez Diaz, Madrid, Spain; S. Grill, Parkinson’s Disease & Movement Disorders Center of Maryland, Elkridge, MD, USA; K. Jellinger, Institute of Clinical Neurobiology, Vienna, Austria.

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Scott, L.J. Opicapone: A Review in Parkinson’s Disease. CNS Drugs 35, 121–131 (2021). https://doi.org/10.1007/s40263-020-00778-6

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