Effectiveness and safety of opicapone in Parkinson’s disease patients with motor fluctuations: the OPTIPARK open-label study

Background The efficacy and safety of opicapone, a once-daily catechol-O-methyltransferase inhibitor, have been established in two large randomized, placebo-controlled, multinational pivotal trials. Still, clinical evidence from routine practice is needed to complement the data from the pivotal trials. Methods OPTIPARK (NCT02847442) was a prospective, open-label, single-arm trial conducted in Germany and the UK under clinical practice conditions. Patients with Parkinson’s disease and motor fluctuations were treated with opicapone 50 mg for 3 (Germany) or 6 (UK) months in addition to their current levodopa and other antiparkinsonian treatments. The primary endpoint was the Clinician’s Global Impression of Change (CGI-C) after 3 months. Secondary assessments included Patient Global Impressions of Change (PGI-C), the Unified Parkinson’s Disease Rating Scale (UPDRS), Parkinson’s Disease Questionnaire (PDQ-8), and the Non-Motor Symptoms Scale (NMSS). Safety assessments included evaluation of treatment-emergent adverse events (TEAEs) and serious adverse events (SAEs). Results Of the 506 patients enrolled, 495 (97.8%) took at least one dose of opicapone. Of these, 393 (79.4%) patients completed 3 months of treatment. Overall, 71.3 and 76.9% of patients experienced any improvement on CGI-C and PGI-C after 3 months, respectively (full analysis set). At 6 months, for UK subgroup only (n = 95), 85.3% of patients were judged by investigators as improved since commencing treatment. UPDRS scores at 3 months showed statistically significant improvements in activities of daily living during OFF (mean ± SD change from baseline: − 3.0 ± 4.6, p < 0.0001) and motor scores during ON (− 4.6 ± 8.1, p < 0.0001). The mean ± SD improvements of − 3.4 ± 12.8 points for PDQ-8 and -6.8 ± 19.7 points for NMSS were statistically significant versus baseline (both p < 0.0001). Most of TEAEs (94.8% of events) were of mild or moderate intensity. TEAEs considered to be at least possibly related to opicapone were reported for 45.1% of patients, with dyskinesia (11.5%) and dry mouth (6.5%) being the most frequently reported. Serious TEAEs considered at least possibly related to opicapone were reported for 1.4% of patients. Conclusions Opicapone 50 mg was effective and generally well-tolerated in PD patients with motor fluctuations treated in clinical practice. Trial registration Registered in July 2016 at clinicaltrials.gov (NCT02847442)

Immunogenic Cross-Reactivity between Goose and Muscovy Duck Parvoviruses: Evaluation of Cross-Protection Provided by Mono- or Bivalent Vaccine

To investigate the immunogenic cross reactivity between goose parvovirus (GPV) and Muscovy duck parvovirus (MDPV), cross-neutralization was carried out with serum samples collected from birds after infection with one of the two waterfowl parvoviruses. The significantly higher virus neutralization titer obtained against the homologous virus than against the heterologous one suggests important differences between the GPV and MDPV antigenic make up that affects the induced protective virus-neutralizing antibody specificity. This was further confirmed by cross-protection studies carried out in waterfowl parvovirus antibody-free Muscovy ducks immunized at one day of age with whole-virus inactivated oil-emulsion vaccines containing either GPV or MDPV as a monovalent vaccine, or both viruses as a bivalent vaccine. Protection against the clinical disease (growth retardation and feathering disorders) provided by the monovalent vaccine was complete against homologous virus challenge at 2 weeks post-vaccination, while the protection against the heterologous virus challenge was significantly lower (p < 0.001). Only the bivalent vaccine containing both goose and Muscovy duck parvoviruses in an inactivated form protected the birds (90–100%) against both waterfowl parvoviruses that can cause disease in Muscovy ducks. Both the cross-neutralization and cross-protection results indicated that adequate protection in Muscovy ducks against the two waterfowl parvoviruses could be achieved only with a vaccine containing both goose and Muscovy duck parvoviruses. Our results showed that the inactivated vaccine applied at one day of age could induce fast immunity (by 2 weeks post-vaccination), providing complete clinical protection in maternal antibody-free birds. It was also demonstrated that day-old vaccination of ducks with maternal antibodies with bivalent vaccine induced active immunity, resulting in 90 to 100% protection by 3 weeks of age, after the decline of maternal antibodies. A booster vaccination administered at 3 weeks of age following the day-old vaccination resulted in a strong and durable immunity against the clinical disease during the susceptible age of the birds