The honeymoon’s over: what next for people with Parkinson’s?
Volume 8 Issue 2 December 2022, pages 42-51
Received; 21st November 2022; Accepted: 9th December 2022
CLAUDIA TRENKWALDER – Paracelsus-Elena Klinik, Kassel, Dept. Neurosurgery, University Medical Center Goettingen, Germany
STUART H. ISAACSON – Parkinson’s Disease and Movement Disorders Center of Boca Raton, Boca Raton, FL, USA
K RAY CHAUDHURI – Parkinson Foundation Centre of Excellence at King’s College Hospital and King’s College London, London, UK
The challenges of wearing-off in Parkinson’s disease (PD) were highlighted in a Bial-sponsored satellite symposium at the International Congress of Parkinson’s Disease and Movement Disorders (MDS) 2022. The symposium focused on both motor fluctuations and non-motor fluctuations (NMF), the latter often considered the hidden aspect of OFF-time. We discuss the role of the catechol-O-methyltransferase (COMT) inhibitor opicapone in the management of motor fluctuations, and also its emerging role in treating non-motor symptoms in patients with end-of-dose wearing-off. Particular consideration is given to pharmacokinetic and clinical data from the latest study on opicapone. These study results suggest that adding opicapone 50 mg to a stable levodopa regimen provides higher levodopa plasma bioavailability, while reducing levodopa plasma fluctuation levels, despite a concomitant 20% decrease in the total daily dose of levodopa. This is also associated with decreased OFF-time and increased ON-time, thus providing much-needed flexibility in tailoring treatment to the individual needs of patients with PD.
Keywords:PARKINSON’S DISEASE, COMT INHIBITORS, OPICAPONE, MOTOR FLUCTUATIONS, NON-MOTOR FLUCTUATIONS
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