National Hospital Organization, Sendai-Nishitaga Hospital, Sendai, Japan.
Department of Cognitive & Motor Aging, Tohoku University, Graduate School of Medicine, Sendai, Japan.
Mov Disord. 2021 Feb;36(2):415-423. doi: 10.1002/mds.28322. Epub 2020 Oct 19.
This placebo-controlled, randomized study evaluated the efficacy and safety of opicapone 25-mg and 50-mg tablets in Japanese levodopa-treated patients with Parkinson's disease and motor fluctuations.
Japanese adults (n = 437, age 39-83 years) with Parkinson's disease (United Kingdom Parkinson's Disease Society criteria) received opicapone 25-mg (n = 145), opicapone 50-mg (n = 145), or placebo (n = 147) tablets over the double-blind treatment period (14-15 weeks). The primary efficacy assessment was change in OFF-time; secondary efficacy assessments included OFF/ON-time responders (≥1 hour change from baseline), total ON-time, ON-time with and without troublesome dyskinesia, and Unified Parkinson's Disease Rating Scale.
The least squares mean (standard error) change in OFF-time from baseline to the last visit was -0.42 (0.21) hour for the placebo group, -1.16 (0.22) hour for the opicapone 25 mg group, and -1.04 (0.21) hour for the opicapone 50 mg group. The percentage of ON-time responders, changes in total ON-time/ON-time without troublesome dyskinesia, and Unified Parkinson's Disease Rating Scale II (at OFF) all showed statistically significant improvements versus placebo for both opicapone tablet doses (P < 0.05). Unified Parkinson's Disease Rating Scale III (at ON) was improved versus placebo in patients who received opicapone 50 mg (P < 0.05). Adverse events were more common in patients treated with opicapone 25 mg (60.0%) or opicapone 50 mg (54.5%) versus placebo (48.3%). The most commonly reported adverse event was dyskinesia (placebo, 2.7%; opicapone 25 mg, 9.0%; opicapone 50 mg, 12.4%).
In Japanese patients, both opicapone 25 and 50 mg were significantly more effective than placebo with no dose-dependent difference in efficacy, and both doses were well tolerated. © 2020 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
本安慰剂对照、随机研究评估了在左旋多巴治疗的日本帕金森病伴运动波动患者中,opicapone 25mg 和 50mg 片剂的疗效和安全性。
日本成年患者(n=437,年龄 39-83 岁)符合英国帕金森病协会标准,接受 opicapone 25mg(n=145)、opicapone 50mg(n=145)或安慰剂(n=147)治疗,治疗期为 14-15 周。主要疗效评估指标为关期时间变化;次要疗效评估指标包括关期/开期应答者(较基线改善≥1 小时)、总开期时间、开期时间(伴或不伴运动障碍)和统一帕金森病评定量表。
安慰剂组、opicapone 25mg 组和 opicapone 50mg 组自基线至最后一次访视的关期时间较基线的最小二乘均数(标准误)变化分别为-0.42(0.21)小时、-1.16(0.22)小时和-1.04(0.21)小时。与安慰剂组相比,两种剂量的 opicapone 均能显著提高开期时间应答率、总开期时间/无运动障碍的开期时间以及统一帕金森病评定量表Ⅱ(关期)评分(P<0.05)。在接受 opicapone 50mg 治疗的患者中,统一帕金森病评定量表Ⅲ(开期)评分较安慰剂组改善(P<0.05)。与安慰剂组(48.3%)相比,接受 opicapone 25mg(60.0%)或 opicapone 50mg(54.5%)治疗的患者中,不良反应更常见。最常见的不良反应是运动障碍(安慰剂组 2.7%,opicapone 25mg 组 9.0%,opicapone 50mg 组 12.4%)。
在日本患者中,opicapone 25mg 和 50mg 均显著优于安慰剂,且疗效无剂量依赖性差异,两种剂量均具有良好的耐受性。