Efficacy and Safety of Extended-release Carbidopa Levodopa (IPX203) versus Immediate-release Carbidopa Levodopa in the Management of Parkinson’s Disease: A Systematic Review
Hasen Aljadani1, Khaled Barwais2, Abdalmajeed Alqsair2, Faisal Alharbi2, Harith Alharith2, Abdullah Fallatah2, Mumen Halabi2, Alqassem Hakami3
1King saud bin abdulaziz university, 2King Saud bin Abdulaziz University for Health Sciences, 3King Saud bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center
Objective:

This study aims to evaluate the efficacy and safety of IPX203 compared to the immediate-release carbidopa-levodopa in managing advanced Parkinson’s disease (PD)

Background:

PD is a chronic neurodegenerative movement disorder that most commonly affects the elderly. IPX203 is a newly approved oral carbidopa-levodopa formulation designed to extend the effect of therapy and reduce complications seen with the standard immediate-release form. The immediate-release carbidopa-levodopa formulation remains the current standard but has a short duration of action

Design/Methods:

This systematic review followed PRISMA guidelines and was registered in PROSPERO. A comprehensive search of PubMed/Medline, the Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science, ScienceDirect, Scopus, and Embase identified randomized controlled trials (RCTs) comparing IPX203 with immediate-release carbidopa-levodopa. Two independent reviewers screened the RCTs, extracted data, and assessed bias, with conflicts resolved by a third investigator. The primary outcome compared changes from baseline in “Good On-time” (periods of effective symptom control with minimal dyskinesia) and “Off-time” (periods when medication effects wear off and symptoms return) between immediate-release carbidopa-levodopa and IPX203. Secondary outcomes included Movement Disorder Society Unified Parkinson’s Disease Rating Scale Part III scores and adverse events.


Results:

A total of 466 studies were screened resulted in three RCTs with 560 participants included in the review. IPX203 generally demonstrated a significant increase in “Good On-time” hours and a reduction in “Off-time” compared immediate-release carbidopa-levodopa. MDS-UPDRS Part III scores showed greater motor function improvement with IPX203. The incidence of adverse events between the two arms was comparable.

Conclusions:

IPX203 increased “Good On-time” and reduced “Off-time” more than immediate-release carbidopa-levodopa, with improved motor function (MDS-UPDRS III) and a comparable safety profile. Findings suggest its potential use in managing motor fluctuations in advanced Parkinson’s disease.

10.1212/WNL.0000000000217155
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