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Is Ongentys better than Comtan?

Medically reviewed by Philip Thornton, DipPharm. Last updated on Sep 18, 2023.

Official answer

by Drugs.com

  • Ongentys is taken once daily, while Comtan needs to be taken up to eight times a day

  • Ongentys is better at preventing early-morning off symptoms than Comtan

  • Patients treated with Ongentys take less time than those treated with Comtan to achieve on-status following their first dose of levodopa in the morning

  • Ongentys is better than Comtan across a range of measures in people with Parkinson’s disease who have recently started experiencing fluctuating motor symptoms

Ongentys (opicapone) and Comtan (entacapone) are both catechol-O-methyltransferase (COMT) inhibitors used to help people with Parkinson’s disease who are experiencing ‘off’ episodes (periods of time when their symptoms recur) while being treated with levodopa/carbidopa. According to the results of clinical trials Ongentys is better than Comtan.

Results from the phase III BIPARK-1 trial showed that Ongentys was non-inferior to Comtan in terms of reducing time spent in an off state. Ongentys, however, only needed to be taken once daily at bedtime, compared with Comtran which needs to be taken up to eight times a day alongside levodopa. The simplified dosing regimen of Ongentys enables doctors to more easily tailor existing daily levodopa regimens to better suit the needs of the patient.

Ongentys is also better at preventing early-morning off symptoms compared with Comtan. More patients with Parkinson’s disease treated with Ongentys woke up in an on-status compared with patients treated with Comtan, according to further analysis of data from the BIPARK-1 trial. Patients treated with Ongentys also had a greater decrease in the time it took to achieve on-status following their first dose of levodopa in the morning, compared with patients treated with Comtan.

In a separate analysis, treatment with Ongentys also provided added benefit over that seen with Comtan in people with Parkinson’s disease who had recently started experiencing motor fluctuations. Treatment with Ongentys resulted in greater off-time reductions (-124 min vs -81.1 min) and on-time increases (+131.2 min vs +85.5 min) compared with Comtan treatment. A higher proportion of patients treated with Ongentys were also considered to be off-time responders (66% vs 57.8%) and on-time responders (66% vs 51.1%) compared with patients treated with Comtan. Results from the Clinical Global Impression of Change (CGI-C, 74% vs 51.1%) and Patient Global Impression of Change (PGI-C, 74% vs 51.1%) survey tools also showed a higher proportion of patients improved while on Ongentys compared with Comtan.

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References
  • Food and Drug Administration (FDA). Comtan. [Accessed September 29, 2021]. Available from: https://www.accessdata.fda.gov/drugsatfda_docs/label/2016/020796s026lbl.pdf.
  • Food and Drug Administration (FDA). Ongentys. [Accessed September 29, 2021]. Available from: https://www.accessdata.fda.gov/drugsatfda_docs/label/2020/212489s000lbl.pdf.
  • Ferreira JJ, Lees A, Rocha JF, et al. Opicapone as an adjunct to levodopa in patients with Parkinson's disease and end-of-dose motor fluctuations: a randomised, double-blind, controlled trial. Lancet Neurol. 2016;15(2):154-165. doi:10.1016/S1474-4422(15)00336-1.
  • Lees AJ, Ferreira J, Rascol O, et al. Opicapone as Adjunct to Levodopa Therapy in Patients With Parkinson Disease and Motor Fluctuations: A Randomized Clinical Trial. JAMA Neurol. 2017;74(2):197-206. doi:10.1001/jamaneurol.2016.4703.
  • A. Videnovic, W. Poewe, A. Lees, J. Ferreira, O. Klepitskaya, R. Loureiro, D. Magalhães, J.F Rocha, P. Soares-da-Silva. Effect of opicapone and entacapone on early morning-OFF pattern in Parkinson’s disease patients with motor fluctuations [abstract]. Mov Disord. 2020; 35 (suppl 1).
  • A. Lees, J. Ferreira, W. Poewe, H. Gama, D. Magalhães, J.F Rocha, P. Soares-da-Silva. Efficacy and safety/tolerability of opicapone in catechol-O-methyltransferase inhibitor-naïve Parkinson’s disease patients recently diagnosed with motor fluctuations [abstract]. Mov Disord. 2020; 35 (suppl 1).

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