Opicapone is a COMT inhibitor with a long duration of action due to a slow complex dissociation rate and high binding affinity. It is licensed in UK as an adjunctive therapy to preparations of levodopa/ DOPA decarboxylase inhibitors in adult patients with Parkinson's disease and end-of-dose motor fluctuations who cannot be stabilised on those combinations.
An editorial discusses the findings of the study, noting a few limitations:
• It was limited to patients with moderate Parkinson disease and thus it is unknown how effective a once-a-day opicapone dosage would be in late-stage disease with unpredictable off episodes and morning akinesia.
• Opicapone did not show a statistically significant improvement in any of the nonmotor symptoms assessed by different scales which may suggest no difference in the quality of life from the patient perspective.
• This research underscores the need for larger efficacy studies comparing entacapone and opicapone to make a more informed decision about the use of a specific COMT inhibitor.
The editorial suggests that once-a-day opicapone therapy could result in an easier and practical treatment approach for patients and clinicians.