{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,6]],"date-time":"2026-09-06T04:12:48Z","timestamp":1788667968339,"version":"build-2803163510"},"reference-count":21,"publisher":"SAGE Publications","issue":"9","license":[{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Int Med Res"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>IPX203 is a newly approved oral carbidopa\u2013levodopa formulation designed to prolong the therapeutic effect and reduce complications associated with the standard immediate-release formulation. Immediate-release carbidopa\u2013levodopa remains the current standard of care but has a short duration of action. This study aimed to evaluate the efficacy and safety of IPX203 compared with immediate-release carbidopa\u2013levodopa in patients with advanced Parkinson's disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and was registered in the International Prospective Register of Systematic Reviews (registration number: CRD42024623230). A comprehensive search of PubMed\/MEDLINE, Cochrane Central Register of Controlled Trials, Web of Science, ScienceDirect, Scopus, and Embase identified randomized controlled trials comparing IPX203 with immediate-release carbidopa\u2013levodopa. The primary outcomes were changes from baseline in \u201cGood On-time\u201d (periods of effective symptom control with minimal dyskinesia) and \u201cOff-time\u201d (periods when medication effects wear off and symptoms return). Secondary outcomes included scores on Part III of the Movement Disorder Society\u2013Unified Parkinson's Disease Rating Scale and adverse events.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 466 records were screened, resulting in the inclusion of three randomized controlled trials involving 560 participants. Compared with immediate-release carbidopa\u2013levodopa, IPX203 increased total \u201cGood On-time\u201d and reduced \u201cOff-time.\u201d Scores on Part III of the Movement Disorder Society\u2013Unified Parkinson\u2019s Disease Rating Scale demonstrated greater improvement in motor function with IPX203. The incidence of adverse events was comparable between the two groups, although treatment-emergent adverse events and treatment discontinuations were more frequent in the IPX203 group.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Compared with immediate-release carbidopa\u2013levodopa, IPX203 increased \u201cGood On-time,\u201d reduced \u201cOff-time,\u201d improved motor function as measured by Part III of the Movement Disorder Society\u2013Unified Parkinson\u2019s Disease Rating Scale, and demonstrated a comparable safety profile.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/03000605261477638","type":"journal-article","created":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T22:55:13Z","timestamp":1788389713000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Efficacy and safety of extended-release carbidopa\u2013levodopa (IPX203) versus immediate-release carbidopa\u2013levodopa for Parkinson's disease: A systematic review"],"prefix":"10.1177","volume":"54","author":[{"given":"Ahmed","family":"Attar","sequence":"first","affiliation":[{"name":"King Saud Bin Abdulaziz University for Health Sciences"},{"name":"King Abdullah International Medical Research Center, Jeddah, Saudi Arabia"},{"name":"Department of Neurology, Ministry of the National Guard-Health Affairs, Saudi Arabia"},{"name":"Department of Medicine, Faculty of Health Sciences, McMaster University, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-2076-8184","authenticated-orcid":false,"given":"Hasen H","family":"Aljadani","sequence":"additional","affiliation":[{"name":"King Saud Bin Abdulaziz University for Health Sciences"},{"name":"King Abdullah International Medical Research Center, Jeddah, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-6574-492X","authenticated-orcid":false,"given":"Khalid F","family":"Barwais","sequence":"additional","affiliation":[{"name":"King Saud Bin Abdulaziz University for Health Sciences"},{"name":"King Abdullah International Medical Research Center, Jeddah, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-4020-0986","authenticated-orcid":false,"given":"Abdalmajed A","family":"Alqsair","sequence":"additional","affiliation":[{"name":"King Saud Bin Abdulaziz University for Health Sciences"},{"name":"King Abdullah International Medical Research Center, Jeddah, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-5837-4533","authenticated-orcid":false,"given":"Faisal A","family":"Alharbi","sequence":"additional","affiliation":[{"name":"King Saud Bin Abdulaziz University for Health Sciences"},{"name":"King Abdullah International Medical Research Center, Jeddah, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harith M","family":"Alharith","sequence":"additional","affiliation":[{"name":"King Saud Bin Abdulaziz University for Health Sciences"},{"name":"King Abdullah International Medical Research Center, Jeddah, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-3361-4051","authenticated-orcid":false,"given":"Abdullah A","family":"Fallatah","sequence":"additional","affiliation":[{"name":"King Saud Bin Abdulaziz University for Health Sciences"},{"name":"King Abdullah International Medical Research Center, Jeddah, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-4513-2819","authenticated-orcid":false,"given":"Mumen H","family":"Halabi","sequence":"additional","affiliation":[{"name":"King Saud Bin Abdulaziz University for Health Sciences"},{"name":"King Abdullah International Medical Research Center, Jeddah, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2477-1339","authenticated-orcid":false,"given":"Alqassem Y","family":"Hakami","sequence":"additional","affiliation":[{"name":"King Saud Bin Abdulaziz University for Health Sciences"},{"name":"King Abdullah International Medical Research Center, Jeddah, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nirmeen","family":"Zagzoog","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Beth Israel Deaconess Medical Center, USA"},{"name":"Harvard University School of Medicine, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,9,2]]},"reference":[{"key":"e_1_3_3_2_2","unstructured":"Rajput A Noyes E. Parkinsonism https:\/\/www.msdmanuals.com\/home\/brain-spinal-cord-and-nerve-disorders\/movement-disorders\/parkinsonism (2024 accessed 18 August 2025)."},{"key":"e_1_3_3_3_2","doi-asserted-by":"crossref","unstructured":"Petersen J Kamp C Faltermeier P et al. Deep brain stimulation for Parkinson\u2019s disease: systematic review with meta-analysis and trial sequential analysis https:\/\/bmjmedicine.bmj.com\/content\/3\/1\/e000705 (2024 accessed 12 February 2025).","DOI":"10.1136\/bmjmed-2023-000705"},{"key":"e_1_3_3_4_2","unstructured":"Chou LK. UpToDate [Internet]. Uptodate.com. 2024 https:\/\/www.uptodate.com\/contents\/clinical-manifestations-of-parkinson-disease?search=parkinsons%20clinical%20&source=search_result&selectedTitle=1%7E150&usage_type=default&display_rank=1 (2024 accessed 12 February 2025)."},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1002\/mds.870080507"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1002\/mds.25260"},{"key":"e_1_3_3_7_2","volume-title":"Parkinson disease","author":"World Health Organization","unstructured":"World Health Organization. Parkinson disease, https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/parkinson-disease (2023, accessed 12 February 2025)."},{"key":"e_1_3_3_8_2","unstructured":"Gandhi KR Saadabadi A. Levodopa (L-dopa). In: StatPearls. Treasure Island (FL): StatPearls Publishing 2026."},{"key":"e_1_3_3_9_2","unstructured":"Leyden E Tadi A. Carbidopa. In: StatPearls. 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