General Information

Ongentys (opicapone) is a catechol-O-methyltransferase (COMT) inhibitor. 

Ongentys is specifically indicated as adjunctive treatment to levodopa/carbidopa in patients with Parkinson’s disease (PD) experiencing “off” episodes.

Ongentys is supplied as capsules for oral administration. The recommended dosage of Ongentys is 50 mg administered orally once daily at bedtime. Patients should not eat food for 1 hour before and for at least 1 hour after intake of Ongentys. 

Mechanism of Action

Ongentys (opicapone) is a selective and reversible inhibitor of catechol-O-methyltransferase (COMT). COMT catalyzes the transfer of the methyl group of S-adenosyl-L-methionine to the phenolic group of substrates that contain a catechol structure.  Physiological substrates of COMT include DOPA, catecholamines (dopamine, norepinephrine, and epinephrine), and their hydroxylated metabolites.  When decarboxylation of levodopa is prevented by carbidopa, COMT becomes the major metabolizing enzyme for levodopa, catalyzing its metabolism to 3-methoxy-4-hydroxy-L-phenylalanine (3-OMD).

Side Effects

Adverse effects associated with the use of Ongentys may include, but are not limited to, the following:

• dyskinesia
• constipation
• blood creatine kinase increased
• hypotension/syncope
• weight decreased

Clinical Trial Results

The FDA approval of Ongentys was based on two multinational Phase III clinical studies, BIPARK-1 and BIPARK-2. In the BIPARK-1 trial, approximately 600 patients with Parkinson's disease and motor fluctuations received one of three doses of Ongentys (5 mg, 25 mg or 50 mg), placebo or 200 mg doses of the COMT inhibitor entacapone for 14 or 15 weeks. In the BIPARK-2 trial, approximately 400 patients received one of two doses of Ongentys (25 mg or 50 mg) or placebo for 14 or 15 weeks. Both studies included a one-year open-label extension. Data from both trials showed that Ongentys 50 mg significantly reduced "off" time from baseline to week 14 or 15 compared to placebo. "On" time without troublesome dyskinesia also increased from baseline to week 14 or 15 compared to placebo.