The real-life effect of catechol-O-methyltransferase inhibition on non-motor symptoms in levodopa-treated Parkinson's disease: opicapone versus entacapone

J Neural Transm (Vienna). 2023 Jul;130(7):925-930. doi: 10.1007/s00702-023-02603-y. Epub 2023 Apr 10.

Abstract

Objective: To evaluate the long-term, real-life effects on non-motor symptoms (NMS) of opicapone compared to entacapone in levodopa-treated people with Parkinson's disease (PwP).

Methods: A retrospective data analysis, with pre- and post-opicapone initiation data of 17 PwP with motor fluctuations compared to a comparable group of 18 PwP introduced on entacapone. The primary outcome was changes in the NMS Scale (NMSS) total score after 1-year follow-up. Secondary outcomes included changes in the NMSS domains, and Parkinson's Disease Sleep Scale (PDSS) total and item scores after the same time span.

Results: Groups were comparable for baseline demographics and Parkinson's-related features (p ≥ 0.314) as well as duration of follow-up (1.33 ± 0.66 years for PwP on opicapone and 1.23 ± 0.49 years for those on entacapone; p = 0.858). PwP who were introduced on opicapone showed no changes in NMSS and PDSS total scores after 1 year (p = 0.605 and p = 0.507, respectively), whereas PwP who were introduced on entacapone showed significant worsening of NMSS and PDSS total scores at follow-up (p = 0.005 and p = 0.001, respectively). In neither group changes in individual NMSS domains from baseline to follow-up were observed (p ≥ 0.288 for entacapone and p ≥ 0.816 for opicapone, respectively). In PwP on entacapone significant worsening was seen in the distressing dreams, hallucinations, and limb numbness items of the PDSS (p ≤ 0.05).

Conclusions: Introduction of opicapone in real-life PwP with motor fluctuations seems to stabilise NMS burden and aspects of sleep dysfunction, in contrast to entacapone where there was a worsening of NMS burden and PDSS scores over 1 year follow-up.

Keywords: Catechol-O-methyltransferase; Entacapone; Non-motor symptoms; Opicapone; Parkinson’s disease; Sleep.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antiparkinson Agents / adverse effects
  • Catechol O-Methyltransferase
  • Catechol O-Methyltransferase Inhibitors / pharmacology
  • Catechol O-Methyltransferase Inhibitors / therapeutic use
  • Humans
  • Levodopa* / adverse effects
  • Nitriles
  • Parkinson Disease* / drug therapy
  • Retrospective Studies

Substances

  • Levodopa
  • Antiparkinson Agents
  • entacapone
  • opicapone
  • Catechol O-Methyltransferase
  • Catechol O-Methyltransferase Inhibitors
  • Nitriles