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Hepatotoxic profile of catechol-O-methyltransferase inhibitors in Parkinson's disease.
Expert Opin Drug Saf. 2003 May; 2(3):263-7.EO

Abstract

Entacapone and tolcapone are selective catechol-O-methyltransferase (COMT) inhibitors developed recently as adjuncts to levodopa for the treatment of Parkinson's disease (PD). They extend the duration of action of levodopa. As a result, they increase 'on' time, decrease 'off' time and improve motor scores in patients with motor fluctuations. Both benefits and main side effects are related to increased dopaminergic activity. This paper reviews the use of those COMT inhibitors in PD with particular focus on the issue of hepatotoxicity. Neither tolcapone nor entacapone caused hepatotoxicity in preclinical studies. However, in 1998, four patients who were using tolcapone presented with serious liver dysfunction; three of them died due to acute liver failure. Tolcapone is now known to have the potential to cause hepatotoxicity in clinical use and experimental studies. It is now recommended that tolcapone be administered only in patients with motor fluctuations who are no longer satisfactorily treated with other medications for PD. Routine liver monitoring is now mandatory with this agent. Entacapone has been described as a well-tolerated and safe drug in recent experimental studies, human clinical trials and postmarketing surveillance. It can be offered to any patient with motor fluctuations and routine liver monitoring is not required.

Authors+Show Affiliations

The Center for Parkinson's Disease and Other Movement Disorders, New York-Presbyterian Hospital, Columbia Presbyterian Medical Center, The Neurological Institute, 710 West 168th Street, Room 350, New York, NY 10032, USA. RBenabou@neuro.columbia.eduNo affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

12904105

Citation

Benabou, Reina, and Cheryl Waters. "Hepatotoxic Profile of catechol-O-methyltransferase Inhibitors in Parkinson's Disease." Expert Opinion On Drug Safety, vol. 2, no. 3, 2003, pp. 263-7.
Benabou R, Waters C. Hepatotoxic profile of catechol-O-methyltransferase inhibitors in Parkinson's disease. Expert Opin Drug Saf. 2003;2(3):263-7.
Benabou, R., & Waters, C. (2003). Hepatotoxic profile of catechol-O-methyltransferase inhibitors in Parkinson's disease. Expert Opinion On Drug Safety, 2(3), 263-7.
Benabou R, Waters C. Hepatotoxic Profile of catechol-O-methyltransferase Inhibitors in Parkinson's Disease. Expert Opin Drug Saf. 2003;2(3):263-7. PubMed PMID: 12904105.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Hepatotoxic profile of catechol-O-methyltransferase inhibitors in Parkinson's disease. AU - Benabou,Reina, AU - Waters,Cheryl, PY - 2003/8/9/pubmed PY - 2003/10/9/medline PY - 2003/8/9/entrez SP - 263 EP - 7 JF - Expert opinion on drug safety JO - Expert Opin Drug Saf VL - 2 IS - 3 N2 - Entacapone and tolcapone are selective catechol-O-methyltransferase (COMT) inhibitors developed recently as adjuncts to levodopa for the treatment of Parkinson's disease (PD). They extend the duration of action of levodopa. As a result, they increase 'on' time, decrease 'off' time and improve motor scores in patients with motor fluctuations. Both benefits and main side effects are related to increased dopaminergic activity. This paper reviews the use of those COMT inhibitors in PD with particular focus on the issue of hepatotoxicity. Neither tolcapone nor entacapone caused hepatotoxicity in preclinical studies. However, in 1998, four patients who were using tolcapone presented with serious liver dysfunction; three of them died due to acute liver failure. Tolcapone is now known to have the potential to cause hepatotoxicity in clinical use and experimental studies. It is now recommended that tolcapone be administered only in patients with motor fluctuations who are no longer satisfactorily treated with other medications for PD. Routine liver monitoring is now mandatory with this agent. Entacapone has been described as a well-tolerated and safe drug in recent experimental studies, human clinical trials and postmarketing surveillance. It can be offered to any patient with motor fluctuations and routine liver monitoring is not required. SN - 1474-0338 UR - https://www.unboundmedicine.com/medline/citation/12904105/Hepatotoxic_profile_of_catechol_O_methyltransferase_inhibitors_in_Parkinson's_disease_ L2 - https://www.tandfonline.com/doi/full/10.1517/14740338.2.3.263 DB - PRIME DP - Unbound Medicine ER -