Evidence map›Paper›PMID 41724884›Full record

ReviewNeurology and therapy2026

Advancing the Treatment of Motor Fluctuations in Parkinson's Disease with a Next-Generation Levodopa/Carbidopa Formulation.

Fabrizio Stocchi, Mathias Knecht, Ivan Marjanovic, Achim Wach, Jaakko Kopra, Jaime Kulisevsky

Abstract readReview
In one paragraph

Review in Neurology and therapy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Fabrizio StocchiDepartment of Neurology, University San Raffaele Rome, Rome, Italy. fabrizio.stocchi@fastwebnet.it.ORCID http://orcid.org/0000-0002-5763-0033
Mathias KnechtZambon Biotech SA, Cadempino, Switzerland.
Ivan MarjanovicZambon Biotech SA, Cadempino, Switzerland.
Achim WachA Consulting, Dr Wach & Wach GbR, Weil am Rhein, Germany.
Jaakko KopraZambon Biotech SA, Cadempino, Switzerland.ORCID http://orcid.org/0000-0002-4872-3326
Jaime KulisevskySant Pau Hospital, Universitat Autònoma de Barcelona and CIBERNED, Barcelona, Spain.ORCID http://orcid.org/0000-0003-4870-1431

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

As of today, levodopa remains the cornerstone of symptomatic management in Parkinson's disease (PD). As PD progresses, the limitations of immediate-release (IR) levodopa/carbidopa, such as its short half-life and inconsistent absorption, result in unstable fluctuating levodopa plasma concentrations. These fluctuations contribute to motor complications including wearing off, delayed ON responses, and dyskinesias. To maintain symptom control, patients often require frequent dosing or, eventually, transition to device-aided therapies (DATs). Although effective, these therapies are invasive and require intensive clinical monitoring. IPX203, a next-generation modified-release (MR) levodopa/carbidopa formulation, may address these challenges. Approved by the US Food and Drug Administration (FDA) in 2024, IPX203 combines IR granules and extended-release (ER) pellets within a single capsule. IPX203 is designed to improve levodopa delivery and absorption, enhancing therapeutic benefit. It ensures both rapid onset and sustained levodopa plasma concentrations, minimising peak-to-trough fluctuations and reducing dosing frequency. The formulation delivers 100% of the carbidopa and 25% of the levodopa dose via IR granules, while the remaining 75% of levodopa is gradually released from ER pellets engineered with sustained release, mucoadhesive, and enteric coatings to optimise proximal small intestinal absorption. Clinical studies have shown that IPX203 significantly reduces OFF time, increases Good ON time, and improves motor symptom control compared with IR levodopa/carbidopa. It may also extend symptom relief into the following morning. This review outlines the pharmacological rationale and clinical evidence supporting IPX203 therapy, highlighting its potential to enhance motor control and improve patients' quality of life, thereby supporting a more personalised and sustained approach to PD management.

Indexed as

CarbidopaIPX203LevodopaModified-release formulationMotor fluctuationParkinson diseaseTreatment of fluctuations

Identifiers

PMID41724884
PMCPMC13172189

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.