Eur J Neurol. 2023 Jul 25. doi: 10.1111/ene.15990. Online ahead of print.
ABSTRACT
INTRODUCTION: Motor fluctuations are a significant driver of healthcare resource utilization (HCRU) in people with Parkinson’s (PwP). A common management strategy is to include Catechol-O-methyl transferase (COMT) inhibition with either opicapone or entacapone in the levodopa regimen. However, to date, there has been a lack of head-to-head data comparing the two COMT inhibitors in real-world settings.
METHODS: In this retrospective cohort study, we assessed HCRU outcomes in PwP naïve to COMT inhibition via UK electronic healthcare records (Clinical Practice Research Datalink and Hospital Episodes Statistics databases, June 2016 to December 2019). HCRU outcomes were assessed before (baseline) and after COMT inhibitor prescription at 0-6 months, 7-12 months, and 13-18 months. Opicapone treated PwP were algorithm-matched (1:4) to entacapone-treated PwP.
RESULTS: By 6-months, treatment with opicapone resulted in 18.5% fewer neurology outpatient visits compared to entacapone treatment; this effect was maintained until the last follow-up (18-months). In the opicapone group, the mean levodopa equivalent daily dose (LEDD) decreased over the first year and then stabilised, whereas the entacapone-treated group showed an initial decrease in the first 6-months followed by a dose increase between 7-18-months. Neither COMT inhibitors had significant impact on sleep medication use.
CONCLUSIONS: This head-to-head study is the first to demonstrate using ‘real-world’ data that initiating COMT inhibition with opicapone is likely to decrease the need for post-treatment HCRU versus initiation of COMT inhibition with entacapone.
PMID:37489574 | DOI:10.1111/ene.15990
