Decision Making Prac cum
Opicapone (OngentysTM) is a catechol-O-methyltransferase (COMT) inhibitor
that is indicated as an adjunc ve treatment to levodopa/carbidopa in pa ents with Parkinson's
disease experiencing "o " episodes. Opicapone is a selec ve, reversible COMT inhibitor that
works by preven ng COMT from metabolizing levodopa and producing the metabolite (3-OMD).
3-OMD is thought to compete with levodopa to cross the blood brain barrier. Opicapone works
to prevent metabolism of levodopa resul ng in increased concentra ons of levodopa and
decreased concentra ons of 3-OMD. Dosing for opicapone is 50mg capsule by mouth at
bed me daily. Pa ents with moderate hepa c impairment should use a 25-mg capsule due to
increased exposure. Pa ents should not eat food for 1 hour before and at least 1 hour a er
taking opicapone. Pa ents with Parkinson's disease are impacted by this drug. Opicapone can
worsen caused by the e ect of levodopa wearing o .2
Opicapone is not available in a generic formula on. The current cash price for
OngentysTM is $24.60 per capsule (both 25 mg and 50 mg).3 For a one-month prescrip on,
using GoodRx, the pa ent price would be ~$670.4 Entacapone is available in a generic
Entacapone is typically dosed 4 mes daily, with a max dose of 1600mg daily. 5 For a one.
month prescrip on of entacapone using GoodRx, the cash price would be ~$63 - $200.6
In a randomized, double-blind, placebo-controlled, and ac ve-controlled trial,
with Parkinson's disease and motor uctua ons. The study compared once daily opicapone
doses of 5, 25, and 50 mg to placebo as well as an ac ve comparator, entacapone 200 mg with
each levodopa dose. The primary endpoint measured was change from baseline in absolute
o - me. Results showed that opicapone 50 mg resulted in a sta s cally signi cant 116.8-
minute (14-0; -144.2 to -89.4) reduc on in o me compared to placebo. Opicapone was non-
inferior to entacapone which showed a -96.3 min (13.4; -122-6 to -70-0)
reduc on in o
me.' According to this data, opicapone o ers a non-inferior op on for
reducing o
me in pa ents with Parkinson's compared to entacapone.
In regard to humanis c outcomes, opicapone is a favorable op on as adjunct therapy
to levodopa/carbidopa for pa ents with Parkinson's disease. Although opicapone is more
expensive than entacapone per month, other bene ts of opicapone make it a favorable
op on. Opicapone o ers other bene ts over entacapone in regard to humanis c outcomes.
Both opicapone and entacapone are available in oral dosage forms - opicapone as oral
capsules and entacapone as oral tablets. Both agents o er an easily administered dosage form
as they come in oral dosage forms. The opicapone dosing o ers a more convenient regimen
compared to entacapone. Opicapone is dosed once daily at bed me, whereas entacapone is
dosed mul ple mes a day with each dose of levodopa/carbidopa (up to eight mes daily).1,
In clinical studies, opicapon