2026-04-14T06:58:48Zhttps://recercat.cat/oai/request

oai:recercat.cat:11351/141312026-02-13T10:31:39Zcom_2072_451669com_2072_378040col_2072_451670

Real-World Use of COMT Inhibitors in the Management of Patients with Parkinson’s Disease in Spain Who Present Early Motor Fluctuations: Interim Results from the REONPARK Study López-Manzanares, Lydia Garcia-Caldentey, Juan Mata Álvarez-Santullano Mata Alvarez-Santullano, Marina Vilas, Dolores Herreros Rodríguez , Jaime Solano Vila, Berta [López-Manzanares L] Unidad de Trastornos de Movimiento, Servicio de Neurología, Hospital Universitario de La Princesa, Madrid, Spain. [García Caldentey J] Servei de Neurologia, Hospital Quirónsalud Palmaplanas i Clínica Rotger, Palma de Mallorca, Spain. [Mata Álvarez-Santullano M] Servicio de Neurología, Hospital Universitario Infanta Sofía, Madrid, Spain. [Vilas Rolán D] Servei de Neurologia, Universitat Hospital Germans Trias i Pujol, Barcelona, Spain. [Herreros-Rodríguez J] Unidad de Trastornos de Movimiento, Servicio de Neurología, Hospital Universitario Infanta Leonor, Madrid, Spain. [Solano Vila B] l Servei de Neurologia, Hospital Universitari de Girona Doctor Josep Trueta, Hospital de Santa Caterina de Salt (IAS), Girona, Spain Institut d'Assistència Sanitària Parkinson, Malaltia de Inhibidors enzimàtics Trastorns motors DISEASES::Nervous System Diseases::Central Nervous System Diseases::Brain Diseases::Basal Ganglia Diseases::Parkinsonian Disorders::Parkinson Disease CHEMICALS AND DRUGS::Chemical Actions and Uses::Pharmacologic Actions::Molecular Mechanisms of Pharmacological Action::Enzyme Inhibitors::Catechol O-Methyltransferase Inhibitors ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Diagnosis::Prognosis::Treatment Outcome PSYCHIATRY AND PSYCHOLOGY::Mental Disorders::Neurodevelopmental Disorders::Motor Skills Disorders ENFERMEDADES::enfermedades del sistema nervioso::enfermedades del sistema nervioso::enfermedades del sistema nervioso::enfermedades neurodegenerativas::enfermedad de Parkinson COMPUESTOS QUÍMICOS Y DROGAS::acciones y usos químicos::acciones farmacológicas::mecanismos moleculares de acción farmacológica::inhibidores enzimáticos::inhibidores de catecol-O-metiltransferasa PSIQUIATRÍA Y PSICOLOGÍA::trastornos mentales::trastornos del desarrollo neurológico::trastornos de las habilidades motoras COMT-inhibitors; Early fluctuations; Parkinson’s disease Inhibidors COMT; Malaltia de Parkinson; Fluctuacions motores Inhibidores COMT; Enfermedad de Parkinson; Fluctuaciones motoras Objective: We aimed to analyze the real-world use of COMT inhibitors associated with levodopa in patients with Parkinson’s disease (PD) who present early fluctuations and to explore whether early COMT inhibition optimizes treatment outcomes. Methods: REONPARK is an ongoing 2-year prospective observational study. We included patients diagnosed with PD who presented signs of end-of-dose motor fluctuations for <2 years and started COMT inhibitors according to clinical practice. Outcomes included the clinician and patient global impression of change (CGI-C, PGI-C), the Movement Disorder Society-sponsored revision of the Unified Parkinson’s Disease Rating Scale (MDS-UPDRS), the Parkinson’s Disease Questionnaire-8 (PDQ-8), Non-Motor Symptoms Scale (NMSS), 19-Symptom Wearing-off Questionnaire (WOQ-19), and safety. We present a pre-planned interim analysis (cut-off date 3 July 2023) of patients who completed the first 3 months of follow-up. Results: Seventy patients were analyzed (mean levodopa dose at inclusion 484.8 mg; duration of motor fluctuations 0.6 years). In all cases, COMT inhibition was initiated with opicapone, and 81% maintained a stable levodopa dose at 3 months. After 3 months of treatment with opicapone, 73.5% and 62.8% of patients improved on CGI-C and PGI-C, respectively. MDS-UPDRS scores improved significantly with a mean change from baseline of −3.3 ± 7.7 (p < 0.001) for Part III and −1.3 ± 1.7 (p < 0.001) for Part IV. The mean OFF time decreased from 3.7 ± 2.6 h at baseline to 2.2 ± 2.3 h, and 20.6% of patients no longer experienced OFF periods. Patients experiencing no impact of fluctuations increased from 10% to 45.6%. Conclusions: In PD patients with early fluctuations, three months of opicapone reduced the OFF time and improved functional outcomes, suggesting potential benefits in the early stages. This research was funded by Laboratorios Bial S.A. 2025-12-03T12:44:19Z 2025-12-03T12:44:19Z 2025-05-21 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion López-Manzanares L, García Caldentey J, Mata Álvarez-Santullano M, Vilas Rolán D, Herreros-Rodríguez J, Solano Vila B, et al. Real-World Use of COMT Inhibitors in the Management of Patients with Parkinson’s Disease in Spain Who Present Early Motor Fluctuations: Interim Results from the REONPARK Study. Brain Sci. 2025;15(5):532. 2076-3425 http://hdl.handle.net/11351/14131 10.3390/brainsci15050532 41300256 eng Brain Sciences;15(5) https://doi.org/10.3390/brainsci15050532 Attribution-ShareAlike 4.0 International http://creativecommons.org/licenses/by-sa/4.0/ info:eu-repo/semantics/openAccess application/pdf application/pdf MDPI Scientia