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Parkinson's Disease View Time: 60 mins

touchROUNDTABLE The clinical evidence for opicapone across the duration of PD

Watch leading experts discuss the clinical evidence for opicapone across the duration of PD.

Prof. Olivier Rascol

University Hospital of Toulouse & University of Toulouse, Toulouse, France

CHAIR

Panelists:
Prof. Peter Jenner, Prof. Joaquim Ferreira
 
Discussion open and introduction

Prof. Rascol provides an overview of the progression of clinical symptoms associated with PD, in addition to the current treatment options including the place of COMT inhibitors.

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The biology of levodopa and the role of COMT inhibitors in levodopa pharmacokinetics

Prof. Jenner describes the challenges in delivering levodopa to the brain, and the pharmacological properties of COMT inhibitors and their effect on levodopa concentrations.

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Differentiating COMT inhibitors and the clinical development of opicapone for fluctuating Parkinson’s disease

Prof. Ferreira presents key results from clinical trials investigating the effect of opicapone on motor fluctuations, along with how these results compare with other PD treatments.

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The role of opicapone in the treatment of early motor fluctuations

The panel discuss usual approaches to treating patients with early-stage motor fluctuations, and how a recent analysis and an ongoing trial may change COMT inhibitor positioning in the treatment of PD.

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The role of opicapone in the treatment of non-motor symptoms

The panel discuss the impact of non-motor symptoms on patients with PD, and the potential role of COMT inhibitors in managing these symptoms based on previous and ongoing clinical trials.

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Conclusions and close

Prof. Rascol provides a summary of the demonstrated efficacy and safety of opicapone in PD, including in patients with recently diagnosed motor fluctuations and non-motor fluctuations.

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Learning Objectives & Overview
Overview

In Parkinson’s disease, the once-daily COMT inhibitor, opicapone, increases the bioavailability of levodopa, decreasing motor fluctuations.1–3 In this activity, leading experts discuss the challenges in delivering levodopa to the brain, key results from clinical trials investigating the effect of opicapone on motor fluctuations, and ongoing trials assessing opicapone in early-stage motor fluctuations, and non-motor symptoms.

Learning Objectives

After watching this activity, participants should be better able to:

  • Discuss the clinical trials examining the effects of opicapone in treating patients with PD and motor fluctuations, their key results and implications.
  • Describe the clinical studies investigating the early intervention with COMT inhibitors in patients with early motor fluctuations, and their results.
  • Understand the potential of opicapone to treat non-motor symptoms, including the design of ongoing trials investigating these outcomes.
Faculty & Disclosures
Prof. Olivier Rascol

University Hospital of Toulouse & University of Toulouse, Toulouse, France

Has participated in clinical trials sponsored by Bial and have received honoraria for consultancy and advisory boards from Bial; has acted as a scientific advisor for drug companies developing antiparkinsonian medications (Abbott, Abbvie, Acorda, Adamas, Affiris, Biogen, Britannia, Cynapsus, Denali Pharmaceuticals, Impax, Lundbeck, Merck, Neuroderm, Novartis, Orian Pharma, Osmotica, Oxford-Biomedica, Prexton, Servier, Sunovion, TEVA, UCB, Zambon) and has received unrestricted scientific grants from academic non-profit entities (Toulouse University Hospital, French Health Ministry, MJFox Foundation, France-Parkinson, European Commission EU FP7, and Horizon 2020).

Prof. Peter Jenner

King’s College London, London, UK

Has received honoraria for consultancy and advisory boards from AbbVie, Adamas, Bial, Britannia Pharmaceuticals, FP Pharmaceuticals, Kyowa Kirin, Roche, UCB, Worldwide Clinical Trials, Zambon, Chiesi Pharmaceuticals, and Profile Pharma.

Prof. Joaquim Ferreira

Universidade De Lisboa, Lisboa & CNS – Campus Neurológico, Torres Vedras, Portugal

Has participated in clinical trials sponsored by Bial and have received honoraria for consultancy and advisory boards from Bial; has received grants from GlaxoSmithKline, Grunenthal, Fundação MSD (Portugal), TEVA, Allergan, Novartis, Medtronic and consultancy fees from GlaxoSmithKline, Novartis, TEVA, Lundbeck, Solvay, BIAL, Merck-Serono, Merz, Ipsen, Biogen, Acadia, Allergan, Abbvie, Sunovion Pharmaceuticals, Zambon, Neuroderm, and Affiris.

References
References
  1. Ferreira JJ, Lees A, Rocha JF, et al. Opicapone as an adjunct to levodopa in patients with Parkinson's disease and end-of-dose motor fluctuations: a randomised, double-blind, controlled trial. Lancet Neurol. 2016;15(2):154–65.
  2. Lees AJ, Ferreira J, Rascol O, et al. Opicapone as Adjunct to Levodopa Therapy in Patients With Parkinson Disease and Motor Fluctuations: A Randomized Clinical Trial. JAMA Neurol. 2017;74(2):197–206.
  3. European Medicines Agency. Ongentys Summary of Product Characteristics. 2022. Available at: https://www.ema.europa.eu/en/documents/product-information/ongentys-epar-product-information_en.pdf (Accessed January 2022).
  4. Almeida L, Rocha JF, Falcão A, et al. Pharmacokinetics, pharmacodynamics and tolerability of opicapone, a novel catechol-O-methyltransferase inhibitor, in healthy subjects: prediction of slow enzyme-inhibitor complex dissociation of a short-living and very long-acting inhibitor. Clin Pharmacokinet. 2013;52(2):139–51.
  5. Bonifacio MJ, Palma PN, Almeida L, et al. Catechol-O-methyltransferase and its inhibitors in Parkinson's disease. CNS Drug Reviews. 2007;13:352–379.
  6. Chaudhuri KR, Odin P, Ferreira J, et al. Opicapone OCEAN study in Parkinson’s: design of a randomized double-blind placebo-controlled trial. Eur J Neurol. 2021;28(Suppl 1):753–921(EPO-744).
  7. Costa R, Trenkwalder C, Ferreira J, et al. Opicapone OASIS study in Parkinson’s: design of an open-label, single-arm, pilot trial. Eur J Neurol. 2021;28:(Suppl 1):753–921(EPO-300).
  8. Dingemanse J, Kleinbloesem CH, Zürcher G, et al. Pharmacodynamics of benserazide assessed by its effects on endogenous and exogenous levodopa pharmacokinetics. Br J Clin Pharmacol. 1997;44(1):41-8.
  9. GBD 2016 Parkinson’s Disease Collaborators. Global, regional, and national burden of Parkinson's disease, 1990-2016: a systematic analysis for the Global Burden of Disease Study 201. Lancet Neurol. 2018;17:939–53.
  10. Deane KH, Spieker S, Clarke CE. Catechol-O-methyltransferase inhibitors for levodopa-induced complications in Parkinson's disease. Cochrane Database Syst Rev. 2004;(4):CD004554.
  11. Ebersbach G, Poewe W, Ferreira J, et al. Efficacy of opicapone according to different levodopa daily intakes in Parkinson's disease patients with motor fluctuations. Mov Disord. 2021;36(suppl 1):S1-S599(abstract 380).
  12. Ehret R, Ferreira J, Stocchi F, et al. Switching from double-blind entacapone or placebo to open-label opicapone: UPDRS-II and III results of the 1-year extension BIPARK-I study. Mov Disord. 2018;33(Suppl 2):S1-S929(abstract 232).
  13. European Medicines Agency. Comtess Summary of Product Characteristics. 2022. Available at: https://www.ema.europa.eu/en/documents/product-information/comtess-epar-product-information_en.pdf (Accessed January 2022).
  14. European Medicines Agency. Tasmar Summary of Product Characteristics. 2022. Available at: https://www.ema.europa.eu/en/documents/product-information/tasmar-epar-product-information_mt.pdf (Accessed January 2022).
  15. Fabbri M, Ferreira JJ, Lees A, et al. Opicapone for the treatment of Parkinson's disease: A review of a new licensed medicine. Mov Disord. 2018;33:1528–39.
  16. Fabbri M, Rosa MM, Ferreira JJ. Adjunctive Therapies in Parkinson's Disease: How to Choose the Best Treatment Strategy Approach. Drugs Aging. 2018;35:1041–54.
  17. Fahn S. The history of dopamine and levodopa in the treatment of Parkinson's disease. Mov Disord. 2008;23:S497–S508.
  18. Fahn S, Poewe W. Levodopa: 50 years of a revolutionary drug for Parkinson disease. Mov Disord. 2015;30:1–3.
  19. Fahn S. The medical treatment of Parkinson disease from James Parkinson to George Cotzias. Mov Disord. 2015;30:4–18.
  20. Ferreira JJ, Katzenschlager R, Bloem BR, et al. Summary of the recommendations of the EFNS/MDS-ES review on therapeutic management of Parkinson's disease. Eur J Neurol. 2013;20:5–15.
  21. Ferreira JJ, Rocha JF, Falcão A, et al. Effect of opicapone on levodopa pharmacokinetics, catechol-O-methyltransferase activity and motor fluctuations in patients with Parkinson's disease. Eur J Neurol. 2015;22:815‒25; 11.
  22. Ferreira JJ, Lees AJ, Poewe W, et al. Effectiveness of opicapone and switching from entacapone in fluctuating Parkinson disease. Neurology. 2018;90(21):e1849–57.
  23. Ferreira J, Lees A, Poewe W, et al. Switching entacapone ‘non-responders’ to open-label opicapone: change in absolute OFF-time following the 1-year extension BIPARK-I study. Eur J Neurol. 2019;26(Suppl 1):112‒346(abstract EPR2061).
  24. Ferreira J, Poewe W, Antonini A, et al. Opicapone as First-Line Adjunctive Levodopa Treatment in Parkinson's Disease Patients with Motor Fluctuations: Findings from BIPARK-I and II Combined Post-Hoc Analysis. Mov Disord. 2020;35(suppl 1):S1-S70(abstract 999).
  25. Ferreira J, Poewe W, Rascol O, et al. Opicapone ADOPTION study in Parkinson’s: design of a randomized prospective, open-label exploratory trial. Eur J Neurol. 2021;28(Suppl 1):753–921(EPO-444).
  26. Gershanik OS. Improving L-dopa therapy: the development of enzyme inhibitors. Mov Disord. 2015;30:103–13.
  27. Hirsch L, Jette N, Frolkis A, et al. The Incidence of Parkinson's Disease: A Systematic Review and Meta-Analysis. Neuroepidemiology. 2016;46:292–300
  28. Krauß J, Bracher F. Pharmacokinetic Enhancers (Boosters)-Escort for Drugs against Degrading Enzymes and Beyond. Sci Pharm. 2018;86:E43.
  29. Kalia LV, Lang AV. Pharmacokinetic Enhancers (Boosters)-Escort for Drugs against Degrading Enzymes and Beyond. Lancet. 2015;386:896–912.
  30. Kim HJ, Jeon BS, Jenner P. Hallmarks of Treatment Aspects: Parkinson's Disease Throughout Centuries Including l-Dopa. Int J Neurobiol. 2017;132:295–343.
  31. Kiss L, Ferreira HS, Torrão L, et al. Discovery of a long-acting, peripherally selective inhibitor of catechol-O-methyltransferase. J Med Chem. 2010;53:3396–3411.
  32. Lees A, Ferreira JJ, Rocha JF, et al. Safety Profile of Opicapone in the Management of Parkinson's Disease. J Parkinsons Dis. 2019;9(4):733-740.
  33. Lees A, Ferreira J, Poewe W, et al. Mov Disord. 2020;35(suppl 1):S1-S70(abstract 1028).
  34. Lewitt PA. Levodopa for the treatment of Parkinson's disease. New Eng J Med. 2008;359(23):2468–76.
  35. LeWitt P. Levodopa therapy for Parkinson's disease: Pharmacokinetics and pharmacodynamics. Mov Disord. 2015;30:64–72.
  36. LeWitt P, Stocch F, Ferreira J, et al. Efficacy of Opicapone at Different Levodopa Regimens up to a Threshold of 600mg/Day Levodopa in Parkinson’s Disease Patients with Motor Fluctuations. Ann Neurol. 2020;88(suppl 25):S1-S280(abstract 490).
  37. Loewen G, LeWitt P, Olanow C, et al. Pharmacokinetics of Opicapone and Effect on COMT and Levodopa Pharmacokinetics in Patients with Parkinson's Disease. Mov Disord. 2019;34(Suppl S2):S1-S930(A143).
  38. Loewen G, LeWitt P, Olanow WC, et al. Pharmacokinetics of Opicapone and Effect on COMT and Levodopa Pharmacokinetics in Patients with Parkinson’s Disease. 2019. Available at: https://www.neurocrinemedical.com/wp-content/uploads/2019/06/OPC_1706_PK_2019-PSG-Poster.pdf (Accessed January 2022).
  39. National Institute for Health and Care Excellence. Parkinson’s disease in adults NICE guideline [NG71]. Available at: https://www.nice.org.uk/guidance/NG71 (Accessed January 2022).
  40. Oliveira C, Lees A, Ferreira J, et al. Evaluation of non-motor symptoms in opicapone treated Parkinson’s disease patients: results from a double-blind, randomized, placebo-controlled study and open-label extension. Eur J Neurol. 2015;22(Suppl 1): 120-482(abstract P1236).
  41. Poewe W, Seppi K, Tanner CM, et al. Parkinson disease. Nat Rev Dis Primers. 2017;3:17013.
  42. Pinder RM, Brogden RN, Sawyer PR, et al. Levodopa and decarboxylase inhibitors: a review of their clinical pharmacology and use in the treatment of parkinsonism. Drugs. 1976;11:329–377.
  43. Reichmann H, Lees A, Rocha JF, et al. Effectiveness and safety of opicapone in Parkinson's disease patients with motor fluctuations: the OPTIPARK open-label study. Transl Neurodegener. 2020;9:1–9.
  44. Rocha JF, Almeida L, Falcão A, et al. Opicapone: a short lived and very long acting novel catechol-O-methyltransferase inhibitor following multiple dose administration in healthy subjects. Br J Clin Pharmacol. 2013;76:763–7652.
  45. Rocha J, Falcão A, Santos A, et al. Effect of opicapone and entacapone upon levodopa pharmacokinetics during three daily levodopa administrations. Eur J Clin Pharmacol. 2014;70:1059–107.
  46. Rocha JF, Ebersbach G, Lees A, et al. The Added Benefit of Opicapone When Used Early in Parkinson's Disease Patients With Levodopa-Induced Motor Fluctuations: A Post-hoc Analysis of BIPARK-I and -II. Front Neurol. 2021;12:754016.
  47. Storch A, Schneider CB, Wolz M, et al. Nonmotor fluctuations in Parkinson disease: severity and correlation with motor complications. Neurology. 2013;80:800–9.
  48. Tayarani-Binazir KA. Behavioural investigation into whether L-DOPA, the current 'gold standard' pharmacotherapy for Parkinson’s disease can be improved by optimising its treatment strategies. 2014. Avaliable at: https://kclpure.kcl.ac.uk/portal/files/44453499/2014_Tayarani_Binazir_Kayhan_A_0104422_ethesis.pdf (Accessed January 2022).
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