Efficacy

Ongentys (Opicapone) for Parkinson's Disease

Ongentys, with the active ingredient opicapone, is a medication approved for the treatment of Parkinson's disease as an adjunctive therapy to levodopa/carbidopa in adults experiencing "off" episodes. "Off" episodes are periods when the patient's medications are not working well, causing an increase in Parkinson's symptoms like tremor and difficulty moving. Opicapone works as a catechol-O-methyltransferase (COMT) inhibitor, which prolongs the effect of levodopa by blocking the enzyme that breaks it down. This results in more consistent and prolonged dopamine levels in the brain, which can help to reduce the amount and length of "off" periods.

The efficacy of Ongentys in improving "off" time was demonstrated in clinical trials. Patients treated with opicapone experienced a significant reduction in "off" time compared to placebo, without a concomitant increase in troublesome dyskinesia (involuntary movements). This improvement in "off" time was associated with an increase in "on" time, the periods when levodopa is working well and symptoms are controlled, without worsening of involuntary movements.

Nuplazid (Pimavanserin) for Parkinson's Disease

Nuplazid, whose active ingredient is pimavanserin, is a medication specifically approved for the treatment of hallucinations and delusions associated with Parkinson's disease psychosis. Unlike traditional antipsychotics, pimavanserin does not block dopamine receptors, which is beneficial since Parkinson's disease patients require dopamine for motor control. Instead, pimavanserin acts as a selective serotonin inverse agonist and antagonist, preferentially targeting 5-HT2A receptors. This mechanism of action is thought to help alleviate the psychotic symptoms without exacerbating the motor symptoms of Parkinson's disease.

The efficacy of Nuplazid for the treatment of hallucinations and delusions in Parkinson's disease was established in a six-week clinical trial. Patients who received pimavanserin demonstrated a significant decrease in the frequency and severity of hallucinations and delusions without a significant worsening of primary motor symptoms when compared to placebo. This represents a significant advancement in the management of Parkinson's disease psychosis, as it provides an option that specifically addresses the complex balance between managing psychosis and maintaining motor function.