Patient-reported outcomes and experiences with COMT inhibitors in the management of motor fluctuations in Parkinson’s disease: a UK-based nested cross-sectional study

BACKGROUND: Motor fluctuations are a common complication in Parkinson's disease (PD), often managed with catechol-O-methyltransferase (COMT) inhibitors. We aimed to explore patient perspectives on their COMT inhibitor treatment and to evaluate and compare patient-reported outcomes and experiences with the COMT inhibitors opicapone and entacapone. METHODS: This UK-based cross-sectional study utilised anonymised, real-world data from the AccessPD registry. A convenience sample of 102 registry participants who had received either opicapone or entacapone. completed validated patient-reported outcome measures (PDQ-39 and, EQ-5D-5L) and an online survey assessing treatment experiences, preferences, and communication with healthcare providers. RESULTS: Survey responses highlighted that increased ON time and reduced OFF time were the most valued treatment attributes for COMT inhibitors, while hallucinations and dyskinesia were the least acceptable side effects. Only 25% of respondents recalled being informed about alternative treatment options prior to starting COMT inhibitor therapy. Communication from clinicians about the role of these drugs was inconsistent, with 27.5% of participants only rating it as 'fair/poor' and 58% reporting no follow-up after initiation. Patients' overall quality of life was generally reported as mild to moderately affected in both treatment groups. CONCLUSIONS: Survey findings underscore the heterogeneity of patient preferences and the need for improved clinician-patient communication and personalised care. Both COMT inhibitors should be considered in shared decision-making to optimise motor fluctuation management and quality of life in PD.