Parkinson's Disease (Disorder)Phase 3NCT03670953
A Study to Evaluate the Safety and Efficacy of IPX203 in Parkinson's Disease Participants With Motor Fluctuations
A Phase 3 study testing IR CD-LD and IPX203 ER CD-LD in people with Parkinson's Disease (Disorder), run by Impax Laboratories, LLC at 108 sites in 8 countries.
Trial summary
To evaluate the safety and efficacy of IPX203 (carbidopa and levodopa) extended-release capsules (IPX203 ER CD-LD) in comparison to immediate release (IR) CD-LD in the treatment of CD-LD-experienced participants with Parkinson's disease (PD) who have motor fluctuations. Read more about this study
- Who is it for?
- Ages 40 years and older
- Conditions the study is for
- Parkinson's Disease (Disorder)
- What is being tested?
- IR CD-LD and IPX203 ER CD-LD
- Type of treatment
- Pill or oral medicine
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 630 participants
- Where
- 108 sitesin 8 countries
- Study dates
- 6 Nov 2018to 15 Jun 2021
- Phase
- Phase 3
- Are there results?
- Yes, posted in the registrySummary in the doctors' view
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 40 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Male or female participants diagnosed at age ≥ 40 years with PD, consistent with the United Kingdom Parkinson's Disease Society Brain Bank Diagnostic Criteria and who are being treated with stable regimens of CD-LD but experiencing motor fluctuations.
- Able to provide written informed consent prior to the conduct of any study-specific procedures.
- Female participants of childbearing potential must have a negative urine pregnancy test at Screening Visit.
- Negative urine screen for drugs of abuse and negative alcohol breath test at Screening.
- Hoehn and Yahr Stages 1, 2, 3, or 4 in the "On" state (part of Movement Disorders Society version of the Unified Parkinson's Disease Rating Scale [MDS-UPDRS] Part III)
- Agrees to use a medically acceptable method of contraception throughout the study and for 6 weeks after completing the study. Medically acceptable methods of contraception that may be used by the participant and/or partner include but are not limited to: abstinence, oral contraception, NuvaRing or transdermal systems, diaphragm with vaginal spermicide, intrauterine device, condom and partner using vaginal spermicide, surgical sterilization (6 months), progestin implant or injection, or postmenopausal female (no menstrual period for ˃ 2 years) or vasectomy (˃ 6 months).
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- Montreal Cognitive Assessment (MoCA) score ≥ 24 at Screening Visit in "On" state.
- Able to differentiate "On" state from "Off" state as determined by at least 75% concordance with a trained rater in "On/Off" ratings for 8 ratings over a 4-hour training period. The concordance must include at least 1 "On" and 1 "Off" rating and must be achieved within two 4-hour training sessions.
- Able and willing to comply with the protocol, including completion of diaries and availability for all study visits.
- Responsive to CD-LD therapy and currently being treated on a stable regimen with CD-LD for at least 4 weeks prior to Visit 1.
- At Screening, the participant has predictable "Off" periods.
Who cannot join
- Received any investigational medications within 30 days or 5 times the half-life, whichever is longer, prior to Visit 1.
- Female participants who are currently breastfeeding or lactating.
- Had prior neurosurgical treatment for PD or if such procedure is planned or anticipated during the study period.
- Allergic to any excipient in the study drugs.
- History of medical conditions or of a prior surgical procedure that would interfere with LD absorption, such as gastrectomy, proximal small-bowel resection, or bariatric surgery.
- History of upper gastrointestinal hemorrhage in participants with peptic ulcer disease within the past 5 years.
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- History of glaucoma with intraocular pressures that are elevated despite appropriate medical management.
- History of seizure or epilepsy and experienced at least 1 seizure during the past 12 months or has not been compliant with medically recommended therapy or visits.
- History of myocardial infarction with residual atrial, nodal, or ventricular arrhythmias that are not controlled with medical and/or surgical interventions. A recent (≤ 12 months) history of myocardial infarction with secondary arrhythmias is exclusionary regardless of the therapeutic control.
- History of neuroleptic malignant syndrome or of nontraumatic rhabdomyolysis.
- Liver enzyme values ≥ 2.5 times the upper limit of normal; or history of severe hepatic impairment.
- Serum creatinine level ≥ 1.75 times the upper limit of normal; or requires dialysis at the time of Screening.
- Participant with a history of malignant melanoma or with a suspicious undiagnosed skin lesion which in the opinion of the investigator could be melanoma.
- History of drug or alcohol abuse within the 12 months prior to Screening.
- Received within 4 weeks of Screening or planning to take during participation in the clinical study:
- Any doses of a CR CD-LD apart from a single daily bedtime dose, any doses of Rytary, additional CD (eg, Lodosyn) or benserazide (eg, Serazide), or catechol-O-methyl transferase inhibitors (entacapone or tolcapone) or medications containing these inhibitors (Stalevo),
- Nonselective monoamine oxidase inhibitors (MAOI), apomorphine, or antidopaminergic agents, including antiemetics.
- Employees or family members of the investigator, study site, or sponsor.
- Participants who have previously participated in an IPX203 study.
- Participants who, in the opinion of the clinical investigator, should not participate in the study.
- Based on clinical assessment, participant does not adequately comprehend the terminology needed to complete the PD diary.
Trial locations and contacts
108 sites in 8 countries.
108 sites in 8 countries
United States56 sites
Albany Medical College (139)
Albany, New York, 12208
Inova Medical Group-Neurology I (147)
Alexandria, Virginia, 22311
Emory Brain Health Center (110)
Atlanta, Georgia, 30329
JEM Research Institute (136)
Atlantis, Florida, 33462
University of Colorado Hospital Anschutz Outpatient Pavilion (120)
Aurora, Colorado, 80045
Visionary Investigators Network (168)
Aventura, Florida, 33180
University of Miami-UHealth at Boca Raton (152)
Boca Raton, Florida, 33131
Parkinson's Disease and Movement Disorders Center of Boca Raton (121)
Boca Raton, Florida, 33486
Medical University of South Carolina (150)
Charleston, South Carolina, 29425
Northwestern Medical Group Neurology Clinic(145)
Chicago, Illinois, 60611
Ucgni (133)
Cincinnati, Ohio, 45219
University Hospitals Cleveland Medical Center (123)
Cleveland, Ohio, 44106
Cleveland Clinic (144)
Cleveland, Ohio, 44195
Neurology Consultants of Dallas, PA (108)
Dallas, Texas, 75251
University of Texas Southwestern Medical Center (143)
Dallas, Texas, 75390-9184
NeuroStudies.net, LLC (155)
Decatur, Georgia, 30033
Rocky Mountain Movement Disorders Center (116)
Englewood, Colorado, 80113
Quest Research Institute (103)
Farmington Hills, Michigan, 48334
Struthers Parkinson's Center (130)
Golden Valley, Minnesota, 55427
MD Clinical (111)
Hallandale, Florida, 33009
VCU Health - Neuroscience, Orthopaedic and Wellness Center (124)
Henrico, Virginia, 23233
Infinity Clinical Research (104)
Hollywood, Florida, 33024
Houston Methodist Neurological Institute/Movement Disorders Clinic (135)
Houston, Texas, 77030
Indiana University Health Neuroscience Center (164)
Indianapolis, Indiana, 46202
University of Florida Health Science Center(129)
Jacksonville, Florida, 32209
University of Kansas Medical Center (118)
Kansas City, Kansas, 66160
Booth Gardner Parkinson's Care Center (112)
Kirkland, Washington, 98034
Cleveland Clinic Lou Ruvo Center for Brain Health (142)
Las Vegas, Nevada, 89106
Roseman Medical Research Institute/Roseman Medical Group (154)
Las Vegas, Nevada, 89118
Clinical Trials, Inc. (113)
Little Rock, Arkansas, 72205
University of Arkansas for Medical Sciences (117)
Little Rock, Arkansas, 72205
Loma Linda University Health Care, Department of Neurology (137)
Loma Linda, California, 92354
Keck School of Medicine of USC/University of Southern California (106)
Los Angeles, California, 90033
Neurology Associates, P.A. (125)
Maitland, Florida, 32751
University of Miami (149)
Miami, Florida, 33136
Medical Professional Clinical Research Center, INC (163)
Miami, Florida, 33165
The Vanderbilt Clinic(158)
Nashville, Tennessee, 37232
Mount Sinai West-Department of Neurology(172)
New York, New York, 10019
Christiana Care Neurology Specialists (153)
Newark, Delaware, 19713
Hoag Memorial Hospital Presbyterian (134)
Newport Beach, California, 92663
SC3 Research - Pasadena (148)
Pasadena, California, 91105
Xenoscience, Inc. (102)
Phoenix, Arizona, 85004
St. Joseph's Hospital & Medical Center/ Barrow Neurological Institute (156)
Phoenix, Arizona, 85013
Parkinsons's Disease Treatment Center of Southwest Florida (131)
Port Charlotte, Florida, 33980
SC3 Research - Reseda (146)
Reseda, California, 91335
Inland Northwest Research (119)
Spokane, Washington, 99202
Washington University (109)
St Louis, Missouri, 63110
Infinity Clinical Research, LLC (105)
Sunrise, Florida, 33351
University of South Florida (114)
Tampa, Florida, 33613
University of Toledo, Gardner-McMaster Parkinson Center (122)
Toledo, Ohio, 43614
Movement Disorder Clinic of Oklahoma (115)
Tulsa, Oklahoma, 74136
Henry Ford West Bloomfield Hospital (100)
West Bloomfield, Michigan, 483222
Premiere Research Institute at Palm Beach Neurology (174)
West Palm Beach, Florida, 33407
Central DuPage Hospital (151)
Winfield, Illinois, 60190
Wake Forest Baptist Health Sciences (127)
Winston-Salem, North Carolina, 27157
Charter Research (166)
Winter Park, Florida, 32792
Spain15 sites
Hospital Universitario Quiron Dexeus (501)
Barcelona, 08028
Hospital Universitario Vall d' Hebron (505)
Barcelona, 08035
Hospitalaries Del Sagrat Cor De Jesus Hospital Sant Rafael (516)
Barcelona, 08035
Hospital Clinic de Barcelona (507)
Barcelona, 08036
Hospital De La Santa Creu i Sant Pau (502)
Barcelona, 08041
Policlinica Gipuzkoa, S.A.,(511)
Donostia / San Sebastian, Gipuzkoa, 20014
Hospital Genral Universitario de Elche (509)
Elche, Alicante, 03203
Hospital Universitario de la Princesa (508)
Madrid, 28006
Hospital Universitario Ramon y Cajal (500)
Madrid, 28034
Hospital Universitario Infanta Sofia (513)
Madrid, 28703
Clinica Universidad de Navarra (512)
Pamplona, Navarre, 31008
Hospital Universitari General de Catalunya (504)
Sant Cugat del Vallès, Barcelona, 08190
Hospital Universitario Virgen del Rocio (503)
Seville, 41013
Hospital Universitari Mutua Terrassa (506)
Terrassa, Barcelona, 08222
Hospital Universitario y politecnico La Fe (515)
Valencia, 46026
Germany8 sites
Kliniken Beelitz GmbH, Neurologisches Fachkrankenhaus fUr Bewegungsstorungen/Parkinson (300)
Beelitz-Heilstätten, Brandenburg, 14547
Dr. med. REINHARDT Ehret Neurologie Berlin Schlobstr. 29 (309)
Berlin, 12163
St. Josef-Hospital, Universitatsklinik fur Neurologie, Klinisches Forschungszentrum fur Neurodegeneration (301)
Bochum, North Rhine-Westphalia, 44791
Universitatsklinikum Carl Gustav Carus, Klinik und Poliklinik fur Neurologie (307)
Dresden, Saxony, 01307
Klinik Haag i. OB, Geriatric Hospital (305)
Haag in Oberbayern, Oberbayern (Upper Bavaria), 83527
Curiositas ad sanum, Studien und Beratungs GmbH(311)
München, Bavaria, 80331
Klinikum rechts der lsar der TUM, Klinik und Poliklinik fur Neurologie (303)
München, Bavaria, 81675
Gemeinschaftspraxis Dr. med. Joachim Springub/ Wolfgang Schwarz, Studienzentrum Nord-West (306)
Westerstede, Lower Saxony, 26655
Italy8 sites
Centro Ricerca Parkinson San Raffaele Cassino (601)
Cassino, Italy/Frosinone/Lazio, 03043
Department "G.F. Ingrassia" Section of neuroscience-Policlinico "Vittorio Emanuele" (608)
Catania, Italy/Catania/Sicily, 95123
Universita G. D'annunzio CeSi Met (604)
Chieti, Italy/Chieti/Abbruzzo, 66100
Fondazione lstituto Neurologico Nazionale "C. Mondino" (606)
Pavia, Italy/Pavia/Lombardia, 27100
Azienda Ospedaliero-Universitaria Pisana (602)
Pisa, Italy/Pisa/Toscana, 56126
University of Rome Tor Vergata/Hospital Tor Vergata (605)
Roma, Italy/Roma/Lazio, 00133
IRCCS San Raffaele Pisana (600)
Roma, Italy/Roma/Lazio, 00163
Department of Neuroscience, Mental Health and Sensory System (NeSMOS), Sapienza University (603)
Roma, Italy/Roma/Lazio, 00189
Poland7 sites
Centrum Medyczne Neuromed (803)
Bydgoszcz, 85-163
Szpital Sw. Rozy (805)
Krakow, 30-394
Krakowska Akademia Neurologii Sp. z o.o.(802)
Krakow, 31-505
NZOZ Neuromed M. i M Nastaj Spolka Partnerska(800)
Lublin, 20-064
NZOZ Neuro-Kard Ilkowski i Partnerzy Spolka Partnerska Lekarzy (801)
Poznan, 61-853
Neuro-Care Sp. z o.o. sp. k.(804)
Siemianowice Śląskie, 41-100
Centrum Medyczne NeuroProtect (806)
Warsaw, 01-684
Czechia6 sites
Fakultni nemocnice u sv. Anny v Brne, I. neurologicka klinika (704)
Brno, 65691
Neurohk, s.r.o (701)
Choceň, 56501
Nemocnice Pardubickeho kraje, a.s., Pardubicka nemocnice, Neurologicka klinika (702)
Pardubice, 53203
Clintrial s.r.o. (703)
Prague, 10000
AXON Clinical, s.r.o. (700)
Prague, 15000
Neurologicka ordinace FORBELI s.r.o.(706)
Prague, 160 00
France5 sites
CHU de Clermont-Ferrand - Hopital Gabriel Montpied (404)
Clermont-Ferrand, 63003
CHU de Montpellier, Hopital Gui de Chauliac(405)
Montpellier, 34295
Centre Hospitalier Universitaire de Nice (400)
Nice, 06002
INSERM, Centre d'investigation Clinique 1402, CHU de Poitiers (402)
Poitiers, 86021
Centre d'Investigation Clinique 1436-CHU Purpan-Hopital Pierre Paul Riquet (403)
Toulouse, 31059
United Kingdom3 sites
Re:Cognition Health Ltd (202)
London, W1G9JF
Imperial College Healthcare NHS Trust (200)
London, W68RF
Re: Cognition Health Ltd(205)
Plymouth, Devon, PL68BT
About this study
Official title: A Randomized Controlled Study to Compare the Safety and Efficacy of IPX203 With Immediate-Release Carbidopa-Levodopa in Parkinson's Disease Patients With Motor Fluctuations
To evaluate the safety and efficacy of IPX203 (carbidopa and levodopa) extended-release capsules (IPX203 ER CD-LD) in comparison to immediate release (IR) CD-LD in the treatment of CD-LD-experienced participants with Parkinson's disease (PD) who have motor fluctuations.
Read the detailed description
This was a multicenter, randomized, double-blind, double-dummy, active-controlled, parallel-group study. The study consisted of a 3-week, open-label IR CD-LD dose adjustment period; a 4-week, open-label period for conversion to IPX203; followed by a 13-week double-blind treatment period with participants randomized in a 1:1 ratio, stratified by center, to receive either IPX203 (with matching IR CD-LD placebo) or IR CD-LD (with matching IPX203 placebo).
- Conditions
- Parkinson's Disease (Disorder)
- Being tested
- IR CD-LD, IPX203 ER CD-LD, Placebo Matching IPX203, Placebo Matching IR CD-LD
- Keywords
- Idiopathic Parkinson's Disease, Lewy Body Parkinson's Disease, Paralysis Agitans, Primary Parkinsonism
- Medical subject headings
- Parkinson Disease
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
IR CD-LDDrug
Also called Generic for Sinemet tablets
Active comparator - IR CD-LD
IPX203 ER CD-LDDrug
Investigational formulation - ER CD-LD
Placebo Matching IPX203Other
Double dummy placebo capsules
Placebo Matching IR CD-LDOther
Double dummy placebo tablets
| Study group | Role | What they receive |
|---|---|---|
| IR CD-LD - Dose Adjustment | Active comparator | Participants started on the same dose as the pre-study dosing regimen of IR CD-LD and then received dose adjusted IR CD-LD tablets daily orally, for a period of 3 weeks. If the participant was taking controlled release carbidopa-levodopa (CR CD-LD), the CR CD-LD was discontinued and substituted with a 1:1 milligram-equivalent dose of IR CD-LD. Receives: Drug: IR CD-LD |
| IPX203 - Dose Conversion | Experimental | Participants received extended release (ER) CD-LD (IPX203) capsules orally, every 6 - 12 hours for a period of 4 weeks at a dose based on their most frequent stable dose of IR CD-LD in dose adjustment period. Participant with most frequent stable dose of 25-100 milligrams (mg) IR CD-LD received 70 - 280 mg IPX203 thrice daily (TID); >25-100 - 37.5-150 mg IR CD-LD received 105-420 mg IPX203 TID; >37.5-150 - 50-200 mg IR CD-LD received 140-560 mg IPX203 TID; >50 - 200 mg IR CD-LD received 175-700 mg IPX203 TID. Participants who received a daily total dose of less than 125-500 mg IR CD-LD in dose adjustment received IPX203 every 12 hours. After initial dose conversion from IR CD-LD to IPX203 as per above mentioned dose conversion schedule, the dose of IPX203 could be further adjusted during the 4 week dose conversion period. Receives: Drug: IPX203 ER CD-LD |
| IPX203 - Double-Blind Maintenance | Experimental | Participants received IPX203 capsules orally, every 6 - 12 hours for 13 weeks at a stable dose established at the end of dose conversion period along with placebo matched to IR CD-LD. Receives: Drug: IPX203 ER CD-LD; Other: Placebo Matching IPX203 |
| IR CD-LD - Double -Blind Maintenance | Active comparator | Participants received IR CD-LD tablets daily orally, for 13 weeks at a stable dose established at the end of dose adjustment period along with placebo matched to IPX203. Receives: Drug: IR CD-LD; Other: Placebo Matching IR CD-LD |
What is being measured
The primary outcome is the main question the study is designed to answer.
Mean Change From Baseline in "Good on" Time Per Day at Week 20/Early Termination (ET)
"Good on" time was derived from the 3-day PD Diaries. For each day, "Good on" time was calculated by adding the number of half-hour intervals in which either an "On" without dyskinesia or "On" with nontroublesome dyskinesia was checked.
Baseline was defined as data obtained from PD Diary collected over 3 days prior to Week 7/Randomization.
Least square mean (LSM), standard error (SE), confidence interval (CI), Mixed model repeated measures (MMRM), Change from baseline (CFB).
Measured: Baseline (Week 7) and Week 20/ET
Secondary outcomes (4)
Change From Baseline in "Off" Time Per Day at Week 20/ET
"Off" time was derived from the 3-day PD Diaries. For each day, "Off" time was calculated by adding the number of half-hour intervals in which the Status "Off" was checked. Baseline was defined as data obtained from PD Diary collected over 3 days prior to Week 7/Randomization.
Measured: Baseline (Week 7) and Week 20/ET
Percentage of Participants With Either "Much Improved" or "Very Much Improved" in Patient Global Impression of Change (PGI-C) Scores at Week 20/ET
The Patient Global Impression of Change (PGIC) is self assessment questionnaire which was used by participants to compare his/her condition on a 7-point scale ranging from 1-Very Much Worse, 2-Much Worse, 3-Minimally Worse, 4-No Change, 5-Minimally Improved, 6-Much Improved, 7-Very Much Improved. Percentage of participants with either "Much Improved" or "Very Much Improved" was reported.
Measured: Week 20/ET
Change From Baseline in The Movement Disorders Society Version of the Unified Parkinson's Disease Rating Scale (MDS-UPDRS) Part III at Week 20/ET
MDS-UPDRS is a multimodal scale assessing impairment and disability consisting of 4 parts. (Part I; 13 items) non-motor experiences of daily living, (Part II; 13 items) motor experiences of daily living completed by the participants, (Part III; 34 items) motor examination of PD and was administered by the rater, and (Part IV; 6 items) motor complication integrates participant-derived information with the rater's clinical observations and judgements and is completed by the rater. For each question a numeric score was assigned between 0-4, where 0 = Normal, 1 = Slight, 2 = Mild, 3 = Moderate, 4 = Severe. MDS-UPDRS Total Score equals the sum of Parts I, II, and III and IV (Range 0-234). Part III score ranges from 0 to 136. A higher score indicated more severe symptoms of PD. Baseline was defined as data obtained from PD Diary collected over 3 days prior to Week 7/Randomization.
Measured: Baseline (Week 7) and Week 20/ET
Change From Baseline in The Sum of MDS-UPDRS Part II and Part III at Week 20/ET
MDS-UPDRS is a multimodal scale assessing impairment and disability consisting of 4 parts. (Part I; 13 items) non-motor experiences of daily living, (Part II; 13 items) motor experiences of daily living completed by the participants, (Part III; 34 items) motor examination of PD and was administered by the rater, and (Part IV; 6 items) motor complication integrates participant-derived information with the rater's clinical observations and judgements and is completed by the rater. For each question a numeric score was assigned between 0-4, where 0 = Normal, 1 = Slight, 2 = Mild, 3 = Moderate, 4 = Severe. MDS-UPDRS Total Score equals the sum of Parts I, II, and III and IV (Range 0-234). The scale range for Part II+III score is 0-188. A higher score indicated more severe symptoms of PD. Baseline was defined as data obtained from PD Diary collected over 3 days prior to Week 7/Randomization.
Measured: Baseline (Week 7) and Week 20/ET
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted14 Sep 2018
- Study start6 Nov 2018
- Primary completion15 Jun 2021
- Study completion15 Jun 2021
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Publications (1)Papers the sponsor has linked to this study.
- Other trials for Parkinson's Disease (Disorder)Studies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 3
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Model description
- Multicenter, randomized, double-blind, double-dummy, active-controlled, parallel-group study.
- Masking
- Quadruple blind
- Who is masked
- Participant, Care provider, Investigator, Outcomes assessor
- Enrolment
- 630 participants (actual)
Sponsor and investigators
- Lead sponsor
- Impax Laboratories, LLC
- Sponsor type
- Industry (pharma, biotech, devices)
- Responsible party
- Sponsor
- Investigators
- Impax Study Director, Study director, Impax Laboratories, LLC
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT03670953
- Sponsor's protocol ID
- IPX203-B16-02
- Other IDs
- 2018-002233-37, 2018
- Status last verified
- Sep 2022
- First submitted
- 12 Sep 2018
- Last updated
- 9 Feb 2023
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- No
- FDA-regulated drug
- Yes
- FDA-regulated device
- No
- Individual data sharing
- No
Publications
Hauser RA, Espay AJ, Ellenbogen AL, Fernandez HH, Isaacson SH, LeWitt PA, Ondo WG, Pahwa R, Schwarz J, Stocchi F, Zeitlin L, Banisadr G, Fisher S, Visser H, D'Souza R. IPX203 vs Immediate-Release Carbidopa-Levodopa for the Treatment of Motor Fluctuations in Parkinson Disease: The RISE-PD Randomized Clinical Trial. JAMA Neurol. 2023 Oct 1;80(10):1062-1069. doi: 10.1001/jamaneurol.2023.2679.
PubMed 37578800
Study at a glance
From the registry record, last updated by the sponsor on 9 Feb 2023. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Randomized Controlled Study to Compare the Safety and Efficacy of IPX203 With Immediate-Release Carbidopa-Levodopa in Parkinson's Disease Patients With Motor Fluctuations
- ClinicalTrials.gov ID
- NCT03670953
- Acronym / sponsor ID
- IPX203-B16-02
- Conditions
- Parkinson's Disease (Disorder)
- Keywords
- Idiopathic Parkinson's Disease, Lewy Body Parkinson's Disease, Paralysis Agitans, Primary Parkinsonism
- Phase
- Phase 3
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 630 participants (actual)
- Lead sponsor
- Impax Laboratories, LLCIndustry (pharma, biotech, devices)
- Study start
- 6 Nov 2018 (actual)
- Primary completion
- 15 Jun 2021 (actual)
- Study completion
- 15 Jun 2021 (actual)
- First posted
- 14 Sep 2018 (actual)
- Results
- Posted 9 Feb 2023
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
To evaluate the safety and efficacy of IPX203 (carbidopa and levodopa) extended-release capsules (IPX203 ER CD-LD) in comparison to immediate release (IR) CD-LD in the treatment of CD-LD-experienced participants with Parkinson's disease (PD) who have motor fluctuations.
Detailed description
This was a multicenter, randomized, double-blind, double-dummy, active-controlled, parallel-group study. The study consisted of a 3-week, open-label IR CD-LD dose adjustment period; a 4-week, open-label period for conversion to IPX203; followed by a 13-week double-blind treatment period with participants randomized in a 1:1 ratio, stratified by center, to receive either IPX203 (with matching IR CD-LD placebo) or IR CD-LD (with matching IPX203 placebo).
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Quadruple blind (participant, care provider, investigator, outcomes assessor)
- Number of arms
- 4
- Model description
- Multicenter, randomized, double-blind, double-dummy, active-controlled, parallel-group study.
| Arm | Type | Receives |
|---|---|---|
| IR CD-LD - Dose Adjustment | Active comparator | Drug: IR CD-LDParticipants started on the same dose as the pre-study dosing regimen of IR CD-LD and then received dose adjusted IR CD-LD tablets daily orally, for a period of 3 weeks. If the participant was taking controlled release carbidopa-levodopa (CR CD-LD), the CR CD-LD was discontinued and substituted with a 1:1 milligram-equivalent dose of IR CD-LD. |
| IPX203 - Dose Conversion | Experimental | Drug: IPX203 ER CD-LDParticipants received extended release (ER) CD-LD (IPX203) capsules orally, every 6 - 12 hours for a period of 4 weeks at a dose based on their most frequent stable dose of IR CD-LD in dose adjustment period. Participant with most frequent stable dose of 25-100 milligrams (mg) IR CD-LD received 70 - 280 mg IPX203 thrice daily (TID); >25-100 - 37.5-150 mg IR CD-LD received 105-420 mg IPX203 TID; >37.5-150 - 50-200 mg IR CD-LD received 140-560 mg IPX203 TID; >50 - 200 mg IR CD-LD received 175-700 mg IPX203 TID. Participants who received a daily total dose of less than 125-500 mg IR CD-LD in dose adjustment received IPX203 every 12 hours. After initial dose conversion from IR CD-LD to IPX203 as per above mentioned dose conversion schedule, the dose of IPX203 could be further adjusted during the 4 week dose conversion period. |
| IPX203 - Double-Blind Maintenance | Experimental | Drug: IPX203 ER CD-LD, Other: Placebo Matching IPX203Participants received IPX203 capsules orally, every 6 - 12 hours for 13 weeks at a stable dose established at the end of dose conversion period along with placebo matched to IR CD-LD. |
| IR CD-LD - Double -Blind Maintenance | Active comparator | Drug: IR CD-LD, Other: Placebo Matching IR CD-LDParticipants received IR CD-LD tablets daily orally, for 13 weeks at a stable dose established at the end of dose adjustment period along with placebo matched to IPX203. |
Who may qualify
- Ages
- 40 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (11 listed)
- Male or female participants diagnosed at age ≥ 40 years with PD, consistent with the United Kingdom Parkinson's Disease Society Brain Bank Diagnostic Criteria and who are being treated with stable regimens of CD-LD but experiencing motor fluctuations.
- Able to provide written informed consent prior to the conduct of any study-specific procedures.
- Female participants of childbearing potential must have a negative urine pregnancy test at Screening Visit.
- Negative urine screen for drugs of abuse and negative alcohol breath test at Screening.
- Hoehn and Yahr Stages 1, 2, 3, or 4 in the "On" state (part of Movement Disorders Society version of the Unified Parkinson's Disease Rating Scale [MDS-UPDRS] Part III)
Key exclusion criteria (21 listed)
- Received any investigational medications within 30 days or 5 times the half-life, whichever is longer, prior to Visit 1.
- Female participants who are currently breastfeeding or lactating.
- Had prior neurosurgical treatment for PD or if such procedure is planned or anticipated during the study period.
- Allergic to any excipient in the study drugs.
- History of medical conditions or of a prior surgical procedure that would interfere with LD absorption, such as gastrectomy, proximal small-bowel resection, or bariatric surgery.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| IR CD-LDAlso: Generic for Sinemet tabletsActive comparator - IR CD-LD | Drug | IR CD-LD - Dose Adjustment, IR CD-LD - Double -Blind Maintenance |
| IPX203 ER CD-LDInvestigational formulation - ER CD-LD | Drug | IPX203 - Dose Conversion, IPX203 - Double-Blind Maintenance |
| Placebo Matching IPX203Double dummy placebo capsules | Other | IPX203 - Double-Blind Maintenance |
| Placebo Matching IR CD-LDDouble dummy placebo tablets | Other | IR CD-LD - Double -Blind Maintenance |
Primary outcome
Mean Change From Baseline in "Good on" Time Per Day at Week 20/Early Termination (ET)
Time frame: Baseline (Week 7) and Week 20/ET
"Good on" time was derived from the 3-day PD Diaries. For each day, "Good on" time was calculated by adding the number of half-hour intervals in which either an "On" without dyskinesia or "On" with nontroublesome dyskinesia was checked. Baseline was defined as data obtained from PD Diary collected over 3 days prior to Week 7/Randomization. Least square mean (LSM), standard error (SE), confidence interval (CI), Mixed model repeated measures (MMRM), Change from baseline (CFB).
4 secondary outcomes
Change From Baseline in "Off" Time Per Day at Week 20/ET
Time frame: Baseline (Week 7) and Week 20/ET
Percentage of Participants With Either "Much Improved" or "Very Much Improved" in Patient Global Impression of Change (PGI-C) Scores at Week 20/ET
Time frame: Week 20/ET
Change From Baseline in The Movement Disorders Society Version of the Unified Parkinson's Disease Rating Scale (MDS-UPDRS) Part III at Week 20/ET
Time frame: Baseline (Week 7) and Week 20/ET
Change From Baseline in The Sum of MDS-UPDRS Part II and Part III at Week 20/ET
Time frame: Baseline (Week 7) and Week 20/ET
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 9 Feb 2023.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
- Derived from this study: PubMed 37578800Hauser RA, Espay AJ, Ellenbogen AL, Fernandez HH, Isaacson SH, LeWitt PA, Ondo WG, Pahwa R, Schwarz J, Stocchi F, Zeitlin L, Banisadr G, Fisher S, Visser H, D'Souza R. IPX203 vs Immediate-Release Carbidopa-Levodopa for the Treatment of Motor Fluctuations in Parkinson Disease: The RISE-PD Randomized Clinical Trial. JAMA Neurol. 2023 Oct 1;80(10):1062-1069. doi: 10.1001/jamaneurol.2023.2679.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Impax Study Director study director
Impax Laboratories, LLC
108 sites in 8 countries: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 3 study testing IR CD-LD and IPX203 ER CD-LD in people with Parkinson's Disease (Disorder), run by Impax Laboratories, LLC at 108 sites in 8 countries.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 11 inclusion and 21 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 9 Feb 2023. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 108 sites in United States, Spain, Germany, Italy, Poland and 3 more countries. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this phase mean?
Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
Yes. Results are posted in the registry (first posted 9 Feb 2023). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Mean Change From Baseline in "Good on" Time Per Day at Week 20/Early Termination (ET) (time frame: Baseline (Week 7) and Week 20/ET). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT03670953, which also lists 1 linked publication.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 9 Feb 2023.