Since 2016, opicapone (OPC), a potent third-generation, long-acting, once-daily, peripheral catechol-O-methyltransferase inhibitor, is approved as an add-on to levodopa in Parkinson's disease patients with motor fluctuations. OPC 50 mg has showed to be able in reducing OFF time by an average of about 60 min daily compared with placebo, to further reduce OFF-time of about 39 min, when switched from ENT to OPC and to be safe. These beneficial effects of OPC were maintained for 1 year. Recently, several post hoc analysis and few pilot observational open-label studies, have suggested its efficacy and wider applicability for different phenotypes of motor complications and for Parkinson's disease stages. Here we review OPC applicability and perspectives, in the light of the more recently published analysis.
Keywords: COMT inhibitor; Parkinson’s disease; advanced stage; motor fluctuations; opicapone.
Lay abstract Opicapone (OPC) is a recently marketed drug for treatment of Parkinson’s disease. It has been approved in Europe in 2016 and it is currently available in several countries, including Italy, Germany, Portugal, Spain, UK, Japan and US. The clinical indication of OPC is the presence of ‘OFF-period’, that means moments during which anti-parkinsonian medications are not doing effect and tremor or slowness are coming out. OPC is used in co-administration with levodopa, at night, once a daily. OPC does not slow the progression of the disease but can reduce of 1 h/day the ‘OFF periods’. It is well tolerated. It can be taken in concomitant with other anti-parkinsonian medications, but it can be required to readapt the dose of levodopa.