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)

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

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.

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.

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.