Abstract Details

New treatments, such as the COMT inhibitor opicapone, can reduce burdensome OFF-time between levodopa/carbidopa (LD/CD) doses. However, little is known about patients’ preferences for the potential benefits and adverse events of these adjunctive medications.

To quantify the preferences of adults with Parkinson’s disease (PD) for features of oral adjunctive PD treatments.

United States adults (aged 30+years) with self-reported PD, currently treated with LD/CD, with OFF-episodes were recruited through the Michael J. Fox Foundation for Parkinson’s Research for an online discrete-choice experiment survey. Respondents selected among experimentally designed profiles for hypothetical adjunctive PD treatments that varied in efficacy (minutes of additional ON-time), potential side effects (troublesome dyskinesia, risk of diarrhea or of change in urine/sweat/saliva color), and dosing frequency or the option “No additional medicine.” Data were analyzed with random-parameters logit models.

480 adults completed the survey (average age 67 years, 69% diagnosed for 5+ years). The results indicate that respondents would require ≥60 additional minutes of daily ON-time to accept either a 40% risk of change in urine/sweat/saliva color or to accept 10 additional minutes with troublesome dyskinesia daily. Respondents would require 40 additional minutes of daily ON-time to accept a 10% risk of diarrhea and 22 additional minutes of daily ON-time to switch from one additional pill each day to one pill with each LD/CD dose. On average, respondents preferred an adjunctive PD medication over no additional medication. When presented with medication profiles similar to opicapone and entacapone, 59% of respondents selected a profile similar to opicapone, 11% a profile similar to entacapone, and 29% chose no additional medication.

Patients with PD expressed interest in adjunctive treatment and were willing to accept reduced ON-time to avoid treatment-related side effects. Physicians should work to accommodate patient preferences in selecting adjunctive treatment.