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Review
. 2022 Oct;93(10):1035-1045.
doi: 10.1007/s00115-021-01237-3. Epub 2022 Jan 19.

[Relevance of COMT inhibitors in the treatment of motor fluctuations]

[Article in German]
Wolfgang H Jost  1 , Carsten Buhmann  2 , Joseph Classen  3 , Karla Eggert  4 , Zacharias Kohl  5 , Tiago Outeiro  6 , Lars Tönges  7 , Dirk Woitalla  8 , Heinz Reichmann  9
Affiliations
Review

[Relevance of COMT inhibitors in the treatment of motor fluctuations]

[Article in German]
Wolfgang H Jost et al. Nervenarzt. 2022 Oct.

Abstract
in English, German

Catechol O‑methyltransferase (COMT) inhibitors have been established in the treatment of Parkinson's disease for more than 20 years. They are considered the medication of choice for treating motor fluctuations. The available COMT inhibitors, entacapone, opicapone and tolcapone, differ pharmacokinetically in terms of their half-lives with implications for the dose frequency, in their indication requirements and in their spectrum of side effects, including diarrhea and yellow discoloration of urine. Many patients with motor fluctuations are currently not treated with COMT inhibitors and are, therefore, unlikely to receive individually optimized drug treatment. This manuscript summarizes the results of a working group including several Parkinson's disease experts, in which the value of COMT inhibitors was critically discussed.

Seit über 20 Jahren haben sich die COMT(Catechol-O-Methyltransferase)-Hemmer in der Therapie des Parkinson-Syndroms etabliert. Sie gelten als Mittel der Wahl bei motorischen Fluktuationen. Die verfügbaren Substanzen Entacapon, Opicapon und Tolcapon unterscheiden sich pharmakokinetisch hinsichtlich ihrer Halbwertszeiten, mit Folgen für die Einnahmefrequenz, hinsichtlich ihrer Indikationsvoraussetzungen und ihres Nebenwirkungsspektrums, darunter Diarrhöen und eine Gelbverfärbung des Urins. Viele Patienten mit motorischen Fluktuationen werden aktuell nicht mit COMT-Hemmern behandelt und erhalten deshalb vermutlich keine individuell optimale medikamentöse Therapie. Das vorliegende Manuskript fasst die Ergebnisse eines Arbeitstreffens mehrerer Parkinson-Experten zusammen, in dem der Stellenwert der COMT-Hemmer kritisch diskutiert wurde.

Keywords: Entacapone; Motor fluctuations; Opicapone; Parkinson’s disease; Tolcapone.

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References

Literatur

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