Opicapone in older people with Parkinson’s: real world evidence on side effects and tolerability

Opicapone is used alongside levodopa to help manage “wearing off”, when the effect of a levodopa dose starts to fade before the next dose is due. It works by slowing the breakdown of levodopa, helping it stay active for longer. A new study has looked at how opicapone was tolerated by older people with Parkinson’s in routine clinical practice. The researchers followed 101 people aged 65 and over who were taking the medication, with an average follow up of around 21 months. During this time, 49 people, or 48.5%, experienced at least one adverse event. This means that almost half of the people in the study had a side effect or other unwanted medical event recorded during follow up. Twenty nine people, or 28.7%, stopped taking opicapone. The reasons included adverse events as well as other reasons. Among the adverse events associated with stopping treatment, neuropsychiatric problems and cardiovascular or autonomic problems were particularly important. The study also found differences between age groups. People aged 75 and over generally had more advanced Parkinson’s and experienced adverse events more often. However, older age itself was not found to be the main factor associated with adverse events. Parkinson’s disease severity had a stronger association. These findings give a picture of what happens when opicapone is used in older people in everyday clinical care. They also add information about a group that can be underrepresented in clinical trials. However, the study has limitations. It was retrospective, meaning the researchers looked back at information already recorded in medical records. It included only 101 people and did not have a control group, so it cannot show how opicapone compares with another treatment. The researchers concluded that opicapone was generally well tolerated in this older Parkinson’s population. At the same time, the study provides useful numbers alongside that conclusion: 48.5% experienced an adverse event and 28.7% discontinued treatment during follow up. These figures do not by themselves tell us whether opicapone is suitable or unsuitable for an individual person. They provide information that doctors and people with Parkinson’s can consider when weighing the potential benefits and side effects of treatment.