Integrated safety summary from Phase 3 clinical trials of IPX203, an extended-release carbidopa-levodopa formulation, in Parkinson disease
Hubert Fernandez1, Robert Hauser2, Vanessa Hinson3, Nirav Pavasia4, Eric Molho5, Leonid Zeitlin6, Hester Visser7, Richard D'Souza7
1Center for Neurological Restoration, Cleveland Clinic, 2Movement Disorders Center, 3MUSC, 4Neurology Consultants of Dallas, 5Parkinson's Disease & Movement Dis Ctr, 6Quartesian LLC, 7Amneal Pharmaceuticals
Objective:

To present the adverse event (AE) profile of IPX203 in the Phase 3 clinical trials in Parkinson disease (PD).

Background:

IPX203 is an investigational oral extended-release carbidopa-levodopa (CD-LD) designed to produce prolonged therapeutic LD plasma concentrations. IPX203 has shown improvement in “Good On” time compared to immediate-release CD-LD.

Design/Methods:

Safety data from a multi-center, double-blind, randomized, active-controlled Phase 3 study and an open-label extension Phase 3 study were combined and analyzed.

Results:

Safety population consisted of 630 patients with PD experiencing motor fluctuations, with a mean age of 66.5yrs (9.0), and mean duration of disease of 8.5yrs (4.9). The average total daily dose (TDD) of IPX203 was 1520.97 mg (±587.78); most subjects (83.0%) received IPX203 at an average TDD between 800 mg and <2400 mg of LD. The average daily dosing frequency of IPX203 was 3.08 times/day, the mean (range) treatment duration was 242.9 (2 to 553) days and person-years of exposure was 388.34. The majority, 385/584 (65.9%), were exposed to IPX203 for 6 months or longer, and 179 (30.7%) were exposed for 12 months or longer.

In the Phase 3 studies pool, 397 (67.4%) of IPX203 subjects experienced 1355 treatment-emergent AEs (TEAEs) (837 mild, 419 moderate, 99 severe). Of these, 205 (34.8%) experienced 471 TEAEs that were treatment-related. The most reported TEAEs were dyskinesia (10.7%), nausea (7.5%), fall (5.9%), and urinary tract infection (5.3%). The analysis of TEAEs by duration of exposure to study treatment showed that most IPX203 subjects (55.0%) experienced TEAEs (first onset) within the first 3 months. The occurrence of TEAEs remained stable over time.

Conclusions:

Considering the disease duration and presence of motor fluctuations in the PD cohort enrolled in our Phase 3 trials, IPX203 was generally safe and well tolerated; the safety profile was stable over time and consistent with the known effects of other LD formulations.

10.1212/WNL.0000000000203101