The preclinical discovery and development of opicapone for the treatment of Parkinson's disease

Expert Opin Drug Discov. 2020 Sep;15(9):993-1004. doi: 10.1080/17460441.2020.1767580. Epub 2020 May 26.

Abstract

Introduction: Opicapone (OPC) is a well-established catechol-O-methyltransferase (COMT) inhibitor that is approved for the treatment of Parkinson's disease (PD) associated with L-DOPA/L-amino acid decarboxylase inhibitor (DDI) therapy allowing for prolonged activity due to a more continuous supply of L-DOPA in the brain. Thus, OPC decreases fluctuation in L-DOPA plasma levels and favors more constant central dopaminergic receptor stimulation, thus improving PD symptomatology.

Areas covered: This review evaluates the preclinical development, pharmacology, pharmacokinetics and safety profile of OPC. Data was extracted from published preclinical and clinical studies published on PUBMED and SCOPUS (Search period: 2000-2019). Clinical and post-marketing data are also evaluated.

Expert opinion: OPC is a third generation COMT inhibitor with a novel structure. It has an efficacy and tolerability superior to its predecessors, tolcapone (TOL) and entacapone (ENT). It also provides a safe and simplified drug regimen that allows neurologists to individually adjust the existing daily administration of L-DOPA. OPC is indicated as an adjunctive therapy to L-DOPA/DDI in patients with PD and end-of-dose motor fluctuations who cannot be stabilized on those combinations.

Keywords: Opicapone; Parkinson’s disease; dyskinesia; entacapone; tolcapone.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Animals
  • Antiparkinson Agents / administration & dosage
  • Antiparkinson Agents / adverse effects
  • Antiparkinson Agents / pharmacology
  • Catechol O-Methyltransferase Inhibitors / administration & dosage*
  • Catechol O-Methyltransferase Inhibitors / adverse effects
  • Catechol O-Methyltransferase Inhibitors / pharmacology
  • Drug Development
  • Drug Evaluation, Preclinical
  • Humans
  • Levodopa / metabolism
  • Oxadiazoles / administration & dosage*
  • Oxadiazoles / adverse effects
  • Oxadiazoles / pharmacology
  • Parkinson Disease / drug therapy*
  • Parkinson Disease / physiopathology

Substances

  • Antiparkinson Agents
  • Catechol O-Methyltransferase Inhibitors
  • Oxadiazoles
  • Levodopa
  • opicapone