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Eur J Neurol. 2019 Jul;26(7):953-960. doi: 10.1111/ene.13914. Epub 2019 Mar 25.

Long-term efficacy of opicapone in fluctuating Parkinson's disease patients: a pooled analysis of data from two phase 3 clinical trials and their open-label extensions.

Author information

1
Faculty of Medicine, Instituto de Medicina Molecular, University of Lisbon, Lisbon, Torres Vedras, Portugal.
2
CNS - Campus Neurológico Sénior, Torres Vedras, Portugal.
3
Reta Lila Weston Institute, University College London, London, UK.
4
Department of Research and Development, BIAL - Portela & Ca SA, S. Mamede do Coronado, Portugal.
5
Department of Neurology, Medical University Innsbruck, Innsbruck, Austria.
6
Clinical Investigation Centre CIC1436, Departments of Clinical Pharmacology and Neurosciences, NS-Park/FCRIN Network, University Hospital of Toulouse, INSERM, University Toulouse 3, Toulouse, France.
7
Department of Pharmacology and Therapeutics, Faculty of Medicine, University Porto, Porto, Portugal.
8
Center for Drug Discovery and Innovative Medicines, MedInUP, University Porto, Porto, Portugal.

Abstract

BACKGROUND AND PURPOSE:

The aim was to evaluate the efficacy of the catechol-O-methyltransferase inhibitor opicapone (25 and 50 mg) as adjunct therapy to levodopa in a pooled population of Parkinson's disease patients who participated in the pivotal double-blind trials of opicapone and their 1-year open-label extensions.

METHODS:

Data (placebo, opicapone 25 mg and opicapone 50 mg) from the BIPARK-1 and BIPARK-2 double-blind and open-label studies were combined. The studies had similar designs, eligibility criteria and assessment methods. The primary efficacy variable in both double-blind studies was the change from baseline in absolute OFF time based on patient diaries.

RESULTS:

Double-blind treatment with opicapone (25 and 50 mg) significantly reduced absolute daily OFF time from a baseline of 6.1-6.6 h. The mean (and 95% confidence interval) treatment effect versus placebo was -35.1 (-62.1, -8.2) min (P = 0.0106) for the 25 mg dose and -58.1 (-84.5, -31.7) min (P < 0.0001) for the 50 mg dose. Reductions in OFF time were mirrored by significant increases in ON time without troublesome dyskinesia (P < 0.05 and P < 0.0001 for the 25 and 50 mg doses, respectively). No significant differences were observed for ON time with troublesome dyskinesia. Patient diary results from the open-label phase indicated a maintenance of effect for patients previously treated with opicapone 50 mg. The group previously treated with the 25 mg dose benefitted with further optimization of therapy during the open-label phase, whilst switching from placebo to opicapone led to significant reductions in OFF time and increased ON time.

CONCLUSIONS:

Over at least 1 year of open-label therapy, opicapone consistently reduced OFF time and increased ON time without increasing the frequency of troublesome dyskinesia.

KEYWORDS:

OFF time; Parkinson's disease; motor fluctuations; opicapone

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