What to do when the honeymoon wears off
Volume 7 Issue 2 January 2022, pages 19-27
Received 15th November 2021; Accepted 1st December 2021
Regina Katzenschlager – Department of Neurology and Karl Landsteiner Institute for Neuroimmunological and Neurodegenerative Disorders, Vienna, Austria
Joaquim J Ferreira – Faculty of Medicine, University of Lisbon, and CNS – Campus Neurológico, Torres Vedras, Lisbon, Portugal.
K Ray Chaudhuri – Parkinson’s Foundation Centre of Excellence at King’s College Hospital and King’s College London, London UK
We highlight key messages from a satellite symposium at the International Congress of Parkinson’s Disease and Movement Disorders (MDS) 2021, which reviewed the challenges of wearing-off in Parkinson’s disease (PD), focusing on both motor fluctuations and – what is often considered the hidden side of wearing-off – non-motor fluctuations (NMF). We consider the catechol-O-methyltransferase (COMT) inhibitor opicapone in the management of motor fluctuations, and consider evidence for a role for COMT inhibition in treating NMF, as well as presenting ongoing studies that may help to elucidate this further. The practicalities of adding opicapone 50 mg to a patient’s regimen to treat end-of-dose wearing-off are discussed by the faculty.
Keywords:PARKINSON’S DISEASE, COMT INHIBITORS, OPICAPONE, MOTOR FLUCTUATIONS, NON-MOTOR FLUCTUATIONS
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