Parkinson's disease (PD) is one of the most common neurodegenerative disorders, characterized by motor symptoms in addition to non-motor symptoms that significantly impact the quality of life. While levodopa remains the gold standard for PD treatment, chronic use is associated with motor complications, including the "wearing-off" phenomenon and dyskinesia. IPX203, a novel extended-release carbidopa-levodopa (CD-LD) formulation, combines immediate-release granules with extended-release effects to maintain therapeutic plasma levels longer, potentially improving motor symptom management for PD patients.

A computer literature search of PubMed, Scopus, Web of Science, Google Scholar, and Cochrane Library was conducted using relevant keywords. Records were screened for eligible studies and data were extracted and synthesized using Review Manager version 4.5 for Windows. 

Four RCTs with a total of 712 patients were eligible for the final analysis.  The mean difference (MD) of change in the main outcomes from baseline to endpoint favored IPX203 over IR CD-LD (UPDRS) (MD = -6.80, 95% CI: [-9.38, -4.23]; p < 0.00001).  change in the off time favored IPX203 over IR CD-LD after sensitivity analysis (MD = -2.42, 95% CI: [-3.12, -1.71]; P < 0.00001). The mean difference (MD) of change in the “ good on”  time  favored IPX203 over IR CD-LD after sensitivity analysis  (MD = 2.15, 95% CI: [1.45, 2.86]; P < 0.00001). None of the adverse events were significantly higher in the case of IPX203 compared to IR CD-LD.