Ongentys Approved in Japan to Help Treat Parkinson’s ‘Off’ Periods

[dlkeller]

Ongentys (opicapone) was recently approved by the FDA as an oral,add-on daily treatment for Parkinson’s patients experiencing off periods while on levodopa. Ongentys increases the amount of levodopa reaching the brain by blocking an enzyme called catechol-o-methyltransferase (COMT),that breaks down levodopa in the blood.  Ongentys was found to be superior to placebo in reducing “off” periods — times when the beneficial effects of levodopa wear off before a new dose can be taken.

I already take COMTAN (entacapone), a generic COMT-blocking drug. Has Ongentys been compared directly to Comtan in any clinical trials? Is there any reason to believe Ongentys may be more effective at reducing off time, without increasing troublesome dyskinesias? I take Rytary plus Comtan six times per day, and I would welcome replacing those 6 Comtan tablets with a single Ongentys pill, if the symptomatic benefits are equal or better, and the price of Ongentys is not prohibitive compared to Comtan.

[dlkeller]

Answer to my own question above: Ongentys (opicapone) is significantly better than Comtan (entacapone) for reducing motor fluctuations, as found in a number of clinical trials that tested the two medications directly against each other, head-to-head. They both work the same way, by inhibiting an enzyme called “COMT” (acronym for catechol-o-methyltransferase) that breaks down dopamine in the brain, which prolongs the effect of levodopa. However, Comtan only provides benefit for a few hours, but Ongentys has a long half-life in the brain, so it can be taken once a day and provides smooth predictable benefits all day, compared to Comtan, with its short half life, which has a fluctuating level throughout the day due to the need to redose every few hours. My neurologist switched me from Comtan to Ongentys and I immediately noticed that my motor fluctuations reduced, and my medication regimen is easier because I don’t have to wonder whether an OFF period was due to low levels of levodopa or low levels of Comtan. In summary, Ongentys does the same job as Comtan, but does it more smoothly and predictably, which I estimate has gained me about an hour per day of ON time without dyskinesias, on the average. Ongentys is not generic and was not on my formulary, but it is covered by my Medicare Part D (Blue Shield of CA Enhanced Coverage Part D Plan) with prior authorization.