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IPX203 is a next-generation modified-release levodopa\/carbidopa formulation that delivers rapid onset and sustained plasma levodopa concentrations through IR granules and extended-release pellets. Clinical studies have shown that IPX203 increases Good ON time (ON time without dyskinesia plus ON time with non-troublesome dyskinesia, equivalent to ON time without troublesome dyskinesia), reduces OFF time and improves motor symptom control compared with IR levodopa\/carbidopa. In anticipation of the introduction of IPX203 in Europe, nine PD specialists convened to develop consensus recommendations for its use in clinical practice. Through a structured process incorporating predefined statements, voting and moderated discussion, the group reached high levels of agreement (88.9% to 100%) across seven topics. These included defining motor symptoms control, identifying patients most likely to benefit from IPX203, positioning of IPX203 within the treatment pathway, practical considerations for switching to IPX203 from current regimens and recommendations for monitoring and follow-up. The experts emphasised that IPX203 should be considered for patients with motor fluctuations insufficiently controlled on optimised oral levodopa therapy, before introduction of device-aided therapies. They highlighted the need for flexible dose adjustments, comprehensive patient and neurologist education and practical tools to support conversion to IPX203. This consensus insight provides practical guidance for integrating IPX203 into routine care of PD patients with motor fluctuations, aiming to increase mobility and reduce treatment burden for patients with PD.<\/jats:p>","DOI":"10.1007\/s00415-026-14186-1","type":"journal-article","created":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T23:54:16Z","timestamp":1791676456000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Consensus-based perspectives on integrating IPX203 into Parkinson\u2019s disease management"],"prefix":"10.1007","volume":"273","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7587-6187","authenticated-orcid":false,"given":"G\u00fcnter","family":"H\u00f6glinger","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8540-3789","authenticated-orcid":false,"given":"Carsten","family":"Buhmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georg","family":"Ebersbach","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7250-592X","authenticated-orcid":false,"given":"Margherita","family":"Fabbri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7749-8060","authenticated-orcid":false,"given":"Georg","family":"K\u00e4gi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Javier","family":"Pagonabarraga","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3126-5111","authenticated-orcid":false,"given":"Diego","family":"Santos Garc\u00eda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Tessitore","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele","family":"Tinazzi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,10,11]]},"reference":[{"key":"14186_CR1","doi-asserted-by":"publisher","DOI":"10.1186\/2047-9158-4-4","volume":"4","author":"F Stocchi","year":"2015","unstructured":"Stocchi F, Vacca L, Radicati FG (2015) How to optimize the treatment of early stage Parkinson\u2019s disease. 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CB has received a grant from the Hilde-Ulrichs-Stiftung; served as a consultant for Bial, Hormosan Pharma, Merz Pharmaceuticals and Zambon; received honoraria for scientific presentations from AbbVie, Bial, Stada Pharma, TAD Pharma, UCB Pharma and Zambon; and received royalties from the Thieme and Kohlhammer publishing houses. GE has received honoraria for consultancy from AbbVie GmbH, Britannia Ltd., Bial GmbH, Boehringer GmbH, Canopy Medical GmbH, Desitin GmbH, Merz GmbH, Mitsubishi Tanabe GmbH, Stada GmbH, and Zambon; for lectures from AbbVie GmbH, Bial GmbH, Cogitando GmbH, Desitin GmbH, Merz GmbH, Ipsen Pharma GmbH, Neuraxpharm GmbH, Stada Pharma GmbH, and Zambon GmbH; and royalties from Kohlhammer Verlag, Springer\/Nature-Verlag, and Thieme Verlag. MF has received honoraria for speaking from AbbVie, ORKYN, Medtronic, and BIAL; consultancy fees from Bial, Zambon and Medtronic; and grants from France Parkinson, HORIZON 2022, French Ministry of Health and MSA Coalition. GK has received a grant from the Swiss Parkinson Association; and honoraria for consultancy, travel and lectures from Merz, Bial, and Insightec. JP has received honoraria as a speaker and advisory board member from AbbVie, Bial, Zambon, Esteve, Merz, and Medtronic. DSG has received honoraria for educational presentations and advice services from AbbVie, KRKA, Zambon, Bial, Italfarmaco, Teva, Arch\u00edmedes, Brittania, Merz, Esteve, Stada and Orion Pharma; financial compensation for INIBIC\/Fundaci\u00f3n Professor Novoa Santos in relation to activities as the principal investigator in phase 2 to phase 4 clinical trials for Parkinson\u2019s disease and other movement disorders; compensation for Fundaci\u00f3n Degen in relation to different projects and grants from the \u201cFundaci\u00f3n Professor Novoa Santos\u201d as a result of the \u201cConvocatoria de ayudas para la realizaci\u00f3n de proyectos de investigaci\u00f3n para grupos emergentes y asociados del INIBIC (2023\/2024)\u201d. AT has been a member of scientific advisory boards for UCB Pharma, Bial, Sanofi, Abbvie, Lilly, Zambon. MT has received honoraria as a speaker and advisory board\u00a0for Bial, Zambon, Abbvie, Chiesi and as a speaker from the Movement Disorders Societies.","order":1,"name":"Ethics","label":"Conflicts of interest","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"656"}}