Xadago (safinamide) vs Ongentys (opicapone)

Xadago (safinamide) is a reversible monoamine oxidase-B (MAO-B) inhibitor that can be used as an add-on treatment to levodopa/carbidopa in adults with Parkinson's disease experiencing "off" episodes. Ongentys (opicapone) is a third-generation, long-acting catechol-O-methyltransferase (COMT) inhibitor, also indicated as an adjunctive therapy to levodopa/carbidopa in patients with Parkinson's disease and motor fluctuations. When deciding between the two, it's important to consider their different mechanisms of action, potential side effects, and how they may interact with other medications you are taking, as well as consulting with a healthcare provider to tailor the choice to your specific medical history and treatment goals.

Difference between Xadago and Ongentys

Metric	Xadago (safinamide)	Ongentys (opicapone)
Generic name	Safinamide	Opicapone
Indications	As an add-on treatment to levodopa/carbidopa in patients with Parkinson's disease experiencing "off" episodes	As an adjunctive therapy to preparations of levodopa/DOPA decarboxylase inhibitors in adults with Parkinson's disease and end-of-dose motor fluctuations who cannot be stabilized on those combinations
Mechanism of action	MAO-B inhibitor and glutamate release inhibitor	COMT inhibitor
Brand names	Xadago	Ongentys
Administrative route	Oral	Oral
Side effects	Dyskinesia, insomnia, nausea, falls, and hypertension	Dyskinesia, constipation, blood pressure increase, weight decrease, and muscle spasms
Contraindications	Patients with severe liver impairment, patients with a history of pheochromocytoma or a known hypersensitivity to safinamide	Patients with tumor of the adrenal gland (pheochromocytoma), paraganglioma, or other catecholamine-secreting neoplasms; patients with a history of neuroleptic malignant syndrome and/or non-traumatic rhabdomyolysis; patients with a known hypersensitivity to opicapone
Drug class	MAO-B inhibitor	COMT inhibitor
Manufacturer	Newron Pharmaceuticals	Bial-Portela & Ca, S.A.

Efficacy

Xadago (Safinamide) Efficacy in Parkinson's Disease

Xadago (safinamide) is a medication approved for the treatment of Parkinson's disease as an add-on therapy to levodopa/carbidopa in patients experiencing "off" episodes. Safinamide works by inhibiting monoamine oxidase B (MAO-B) which breaks down dopamine in the brain, thereby increasing the levels of dopamine. In clinical trials, safinamide has shown efficacy in reducing "off" time in patients with Parkinson's disease who are already taking levodopa/carbidopa. Patients treated with safinamide experienced an improvement in motor function and a reduction in "off" time, which is the period when the effects of levodopa wear off and Parkinson's symptoms return.

Furthermore, safinamide has demonstrated a positive effect on dyskinesia, which is the involuntary movements that can occur with long-term levodopa use. It is important to note that while safinamide can be beneficial in managing symptoms of Parkinson's disease, it is not a cure for the condition and is most effective when used in conjunction with other Parkinson's medications.

Ongentys (Opicapone) Efficacy in Parkinson's Disease

Ongentys (opicapone) is another medication approved for the treatment of Parkinson's disease as an adjunctive therapy to levodopa/carbidopa in adults with "off" episodes. Opicapone is a catechol-O-methyltransferase (COMT) inhibitor that works by blocking the COMT enzyme, which breaks down levodopa in the periphery, thus prolonging its effect and increasing its availability in the brain. Clinical trials have shown that opicapone effectively reduces "off" time and increases "on" time without troublesome dyskinesia in patients with Parkinson's disease and motor fluctuations.

Patients receiving opicapone have reported significant improvements in motor symptoms and overall daily functioning. The efficacy of opicapone has been observed to be consistent across various doses, with the higher doses generally providing greater benefits. As with safinamide, opicapone is not a standalone treatment but is used to enhance the effects of levodopa/carbidopa and improve the quality of life for patients with Parkinson's disease.

Regulatory Agency Approvals

Xadago

European Medical Agency (EMA), European Union
Food and Drug Administration (FDA), USA
Health Canada
Therapeutic Goods Administration (TGA), Australia

Ongentys

European Medical Agency (EMA), European Union
Food and Drug Administration (FDA), USA
Pharmaceuticals and Medical Devices Agency (PMDA), Japan
Brazilian Health Regulatory Agency (Anvisa)

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