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Last Updated: April 4, 2025

CLINICAL TRIALS PROFILE FOR CARBIDOPA AND LEVODOPA


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505(b)(2) Clinical Trials for CARBIDOPA AND LEVODOPA

This table shows clinical trials for potential 505(b)(2) applications. See the next table for all clinical trials
Trial TypeTrial IDTitleStatusSponsorPhaseStart DateSummary
New Combination NCT01766258 ↗ Efficacy and Safety Proof of Concept Study in Patients With Parkinson's Disease and End-of-dose Motor Fluctuations Completed Orion Corporation, Orion Pharma Phase 2 2011-05-01 The primary objective of the study is to assess the efficacy, carbidopa dose response and safety of ODM-101, a new combination of levodopa, carbidopa and entacapone in the treatment of Parkinson's disease (PD) patients with end-of-dose motor fluctuations.
New Formulation NCT00640159 ↗ Tolerability and Efficacy of Switch From Oral Selegiline to Orally Disintegrating Selegiline (Zelapar) in Patients With Parkinson's Disease Completed Baylor College of Medicine Phase 4 2007-01-01 Parkinson's disease (PD) is a progressive neurodegenerative disease. Symptomatic therapy is primarily aimed at restoring dopamine function in the brain. Oral selegiline in conjunction with L-dopa has been a mainstay of therapy for PD patients experiencing motor fluctuations for many years. The mechanisms accounting for selegiline's beneficial adjunctive action in the treatment of PD are not fully understood. Inhibition of monoamine oxidase (MAO) type B (MAO-B) activity is generally considered to be of primary importance. Oral selegiline has low bio-availability and is typically dosed BID, for a total of 5-10 mg daily. Recently, the FDA approved a new orally disintegration tablet (ODT) formulation of selegiline, called ZelaparTM. This new formulation utilizes Zydis technology to dissolve in the mouth, with absorption through the oral mucosa, thereby largely bypassing the gut and avoiding first pass hepatic metabolism. This allows more active drug to be delivered at a lower dose. Consequently, Zelapar is dosed once-daily, up to 2.5 mg per day. There are no empirical data indicating whether the use of the new approved formulation of selegiline ODT (Zelapar) is superior or preferred by patients compared to traditional oral selegiline. It is believed that clinical efficacy will be preserved or enhanced, by delivering more active drug, with improved patient preference for the ODT formulation due to the once-daily dosing . The effectiveness of orally disintegrating selegiline as an adjunct to carbidopa/levodopa in the treatment of PD was established in a multicenter randomized placebo-controlled trial (n=140; 94 received orally disintegrating selegiline, 46 received placebo) of three months' duration. Patients randomized to orally disintegrating selegiline received a daily dose of 1.25 mg for the first 6 weeks and a daily dose of 2.5 mg for the last 6 weeks. Patients were all treated with levodopa and could additionally have been on dopamine agonists, anticholinergics, amantadine, or any combination of these during the trial. At 12 weeks, orally disintegrating selegiline-treated patients had an average of 2.2 hours per day less "OFF" time compared to baseline. Placebo treated patients had 0.6 hours per day less "OFF" time compared to baseline. These differences were significant (p < 0.001). Adverse events were very similar between drug and placebo.
>Trial Type>Trial ID>Title>Status>Phase>Start Date>Summary
Showing 1 to 2 of 2 entries

All Clinical Trials for CARBIDOPA AND LEVODOPA

Trial IDTitleStatusSponsorPhaseStart DateSummary
NCT00125567 ↗ Stalevo in Early Wearing-Off Patients Completed Orion Corporation, Orion Pharma Phase 4 2005-08-01 The purpose of this study is to demonstrate in patients with Parkinson's disease that, when compared to levodopa/carbidopa, Stalevo will delay the time from initiation of study drug to the time an increase in antiparkinsonian medication is required due to inadequately controlled parkinsonian symptoms.
NCT00129181 ↗ Study of the Effects of Dopaminergic Medications on Dopamine Transporter Density in Subjects With Parkinson's Disease Completed GE Healthcare N/A 2005-01-01 This study investigates whether there is a change in 123iodine-2ß- carbomethoxy-3ß-(4-iodophenyl) tropane ([123I]ß-CIT) uptake after short-term treatment with levodopa compared to either dopamine agonist or placebo.
NCT00129181 ↗ Study of the Effects of Dopaminergic Medications on Dopamine Transporter Density in Subjects With Parkinson's Disease Completed Pfizer N/A 2005-01-01 This study investigates whether there is a change in 123iodine-2ß- carbomethoxy-3ß-(4-iodophenyl) tropane ([123I]ß-CIT) uptake after short-term treatment with levodopa compared to either dopamine agonist or placebo.
NCT00129181 ↗ Study of the Effects of Dopaminergic Medications on Dopamine Transporter Density in Subjects With Parkinson's Disease Completed Institute for Neurodegenerative Disorders N/A 2005-01-01 This study investigates whether there is a change in 123iodine-2ß- carbomethoxy-3ß-(4-iodophenyl) tropane ([123I]ß-CIT) uptake after short-term treatment with levodopa compared to either dopamine agonist or placebo.
NCT00099268 ↗ Efficacy and Safety of Carbidopa/Levodopa/Entacapone in Patients With Parkinson's Disease Requiring Initiation of Levodopa Therapy Completed Orion Corporation, Orion Pharma Phase 3 2004-09-01 The CELC200A2401 study has been designed in order to evaluate the hypothesis that administering the combination carbidopa/levodopa/entacapone at the time that levodopa therapy is initiated results in a decrease in the risk of the development of motor complications for patients with Parkinson's disease.
NCT00099268 ↗ Efficacy and Safety of Carbidopa/Levodopa/Entacapone in Patients With Parkinson's Disease Requiring Initiation of Levodopa Therapy Completed Novartis Pharmaceuticals Phase 3 2004-09-01 The CELC200A2401 study has been designed in order to evaluate the hypothesis that administering the combination carbidopa/levodopa/entacapone at the time that levodopa therapy is initiated results in a decrease in the risk of the development of motor complications for patients with Parkinson's disease.
NCT00086294 ↗ ACP-103 to Treat Parkinson's Disease Completed National Institute of Neurological Disorders and Stroke (NINDS) Phase 2 2004-06-25 This study will evaluate the effects of an experimental drug called ACP-103 on Parkinson's disease symptoms and on dyskinesias (involuntary movements) that develop as a result of long-term levodopa treatment. ACP-103 changes the spread of certain brain signals that are affected in patients with Parkinson's disease. Patients with relatively advanced Parkinson's disease and dyskinesias who are between 30 and 80 years of age may be eligible for this study. Candidates are screened with a complete medical history and physical examination, neurological evaluation, blood and urine tests, and electrocardiogram (ECG). A brain magnetic resonance imaging (MRI) scan, CT scan, and chest x-ray may be done if medically indicated. Patients enrolled in the study will, if possible, stop taking all antiparkinsonian medications for one month (2 months for Selegiline) before the study begins and throughout its duration. Exceptions are Sinemet (levodopa/carbidopa), Mirapex (pramipexole) and Requip (ropinirole). Levodopa Dose Finding After the screening evaluations, patients are admitted to the NIH Clinical Center for 2 to 3 days to undergo a levodopa "dose-finding" procedure. For this test, patients stop taking Sinemet and instead have levodopa infused through a vein. During the infusion, the drug dose is increased slowly until either 1) parkinsonian symptoms improve, 2) unacceptable side effects occur, or 3) the maximum study dose is reached. Side effects are monitored closely during the infusions, and parkinsonian symptoms are evaluated frequently during and after the infusions. The infusions usually begin early in the morning and continue until evening. Once the infusion is finished, patients resume taking their regular oral Sinemet dose. The infusions are repeated once a week during 1-day inpatient evaluations. Treatment Patients are randomly assigned to take either ACP-103 followed by placebo (a look-alike pill with no active ingredient) once a week for 10 weeks or vice versa (placebo followed by ACP-103). Patients are admitted to the Clinical Center for each dose. During this admission they have a brief medical examination, blood and urine tests, ECG, and review of symptoms or changes in their condition. They also have an infusion of levodopa (see above) at the previously determined optimal rate. Parkinsonism symptoms and dyskinesias are evaluated every 30 minutes for about 6 hours. At the end of the infusions and ratings, patients are discharged home with their regular Parkinson's medications until the following visit. Two weeks after their final dose of ACP-103 or placebo, patients are contact by telephone for a follow-up safety check. At that time, the investigator may ask the patient to return to the clinic for closer evaluation.
>Trial ID>Title>Status>Phase>Start Date>Summary
Showing 1 to 7 of 7 entries

Clinical Trial Conditions for CARBIDOPA AND LEVODOPA

Condition Name

7034990010203040506070Parkinson's DiseaseParkinson DiseaseAdvanced Parkinson's DiseaseParkinson's Disease (PD)[disabled in preview]
Condition Name for CARBIDOPA AND LEVODOPA
Intervention Trials
Parkinson's Disease 70
Parkinson Disease 34
Advanced Parkinson's Disease 9
Parkinson's Disease (PD) 9
[disabled in preview] 0
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Condition MeSH

1340020406080100120140Parkinson DiseaseDyskinesiasDepressionDepressive Disorder[disabled in preview]
Condition MeSH for CARBIDOPA AND LEVODOPA
Intervention Trials
Parkinson Disease 134
Dyskinesias 7
Depression 7
Depressive Disorder 6
[disabled in preview] 0
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Clinical Trial Locations for CARBIDOPA AND LEVODOPA

Trials by Country

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Trials by Country for CARBIDOPA AND LEVODOPA
Location Trials
United States 550
Italy 41
Canada 40
Germany 39
Spain 33
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Trials by US State

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Trials by US State for CARBIDOPA AND LEVODOPA
Location Trials
California 38
Florida 34
New York 29
Illinois 29
Texas 28
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Clinical Trial Progress for CARBIDOPA AND LEVODOPA

Clinical Trial Phase

15.5%19.3%63.5%0020406080100120Phase 4Phase 3Phase 2/Phase 3[disabled in preview]
Clinical Trial Phase for CARBIDOPA AND LEVODOPA
Clinical Trial Phase Trials
Phase 4 28
Phase 3 35
Phase 2/Phase 3 3
[disabled in preview] 115
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Clinical Trial Status

72.2%8.3%6.7%12.8%020406080100120140CompletedRecruitingNot yet recruiting[disabled in preview]
Clinical Trial Status for CARBIDOPA AND LEVODOPA
Clinical Trial Phase Trials
Completed 130
Recruiting 15
Not yet recruiting 12
[disabled in preview] 23
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Clinical Trial Sponsors for CARBIDOPA AND LEVODOPA

Sponsor Name

trials0510152025303540Bial - Portela C S.A.IMPAX Laboratories, Inc.Impax Laboratories, LLC[disabled in preview]
Sponsor Name for CARBIDOPA AND LEVODOPA
Sponsor Trials
Bial - Portela C S.A. 13
IMPAX Laboratories, Inc. 12
Impax Laboratories, LLC 12
[disabled in preview] 38
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Sponsor Type

53.0%39.0%6.3%0020406080100120140160IndustryOtherNIH[disabled in preview]
Sponsor Type for CARBIDOPA AND LEVODOPA
Sponsor Trials
Industry 159
Other 117
NIH 19
[disabled in preview] 5
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Carbidopa and Levodopa: Clinical Trials, Market Analysis, and Projections

Introduction

Carbidopa and levodopa, a combination medication, are cornerstone treatments for managing Parkinson's disease (PD), a progressive neurological disorder characterized by the loss of dopamine-producing neurons in the brain. This article delves into recent clinical trials, market analysis, and future projections for this crucial medication.

Clinical Trials Update

IPX203: Extended-Release Formulation

A significant development in the treatment of Parkinson's disease is the introduction of IPX203, an extended-release formulation of carbidopa-levodopa. The RISE-PD study, a 20-week, randomized, double-blind, double-dummy, active-controlled phase 3 clinical trial, compared IPX203 with immediate-release carbidopa-levodopa. The trial involved 630 patients and demonstrated that IPX203 provided more hours of "good on-time" per day, even with less frequent dosing. Patients on IPX203 experienced a statistically significant improvement in daily good on-time compared to those on immediate-release carbidopa-levodopa, with IPX203 dosed a mean 3 times per day versus 5 times per day for the immediate-release formulation[1].

ND0612: Liquid Levodopa/Carbidopa

Another promising development is ND0612, a liquid levodopa/carbidopa formulation designed for continuous subcutaneous infusion. In a Phase III trial, patients receiving ND0612 had nearly one and three-quarters hours more "on" time per day without significant symptoms like tremor, slowness, or stiffness compared to those taking oral levodopa/carbidopa pills. This continuous infusion aims to provide consistent medication levels, bypassing the stomach and its potential for irregular emptying, which can interfere with medication absorption[4].

Market Analysis

Current Market Size and Growth

The global levodopa market, which includes carbidopa-levodopa combinations, was valued at $1.7 billion in 2022 and is projected to reach $2.9 billion by 2032, growing at a Compound Annual Growth Rate (CAGR) of 6.1% from 2023 to 2032. This growth is driven by the increasing prevalence of Parkinson's disease, largely attributed to an aging population and changing lifestyle patterns[2].

Dominance of Carbidopa-Levodopa

The carbidopa-levodopa drug class segment dominates the Parkinson's disease treatment market, with a revenue share of more than 25.02% in 2021. This dominance is due to the high prescription rate of these drugs, with an estimated 527,530 prescriptions for 183,690 Parkinson’s patients in the U.S. in 2020. Carbidopa and levodopa are available in various oral formulations, including immediate-release tablets, controlled-release tablets, enteral suspension, and extended-release capsules[5].

Market Dynamics

Rising Prevalence of Parkinson's Disease

The increasing prevalence of Parkinson's disease is a key driver of the levodopa market. As the global population ages, the demand for effective treatments for Parkinson's disease is rising. Levodopa, being a precursor to dopamine, plays a crucial role in replenishing dopamine levels in the brain, thereby mitigating motor symptoms associated with Parkinson's disease[2].

Research and Development

The clinical pipeline for anti-Parkinson's drugs is robust, with over 200 clinical trials underway and several new drugs in the later stages of development. Leading pharmaceutical companies such as Novartis, GSK, Pfizer, and UCB are investing heavily in the development of new therapeutic drugs for Parkinson's disease. This intense research and development activity is expected to lead to the approval of new anti-Parkinson's drugs in the coming years[3].

Future Projections

Market Growth

The levodopa market is expected to continue growing, driven by the increasing demand for effective treatments for Parkinson's disease. The projected growth to $2.9 billion by 2032 underscores the ongoing need for therapeutic interventions to alleviate symptoms and improve the quality of life for individuals with Parkinson's disease[2].

New Formulations and Delivery Methods

The development of new formulations such as IPX203 and ND0612 is expected to offer patients more effective and convenient treatment options. These new formulations aim to address the limitations of traditional oral medications, such as motor fluctuations and inconsistent medication absorption, by providing more consistent and reliable symptom control[1][4].

Key Players

Several key pharmaceutical companies are actively involved in the development and marketing of carbidopa-levodopa combinations. These include Sun Pharmaceutical Industries Ltd., Novartis AG, Bristol-Myers Squibb Co., Teva Pharmaceutical Industries Ltd., Pfizer Inc., Impax Laboratories Inc., UCB SA, Merck and Co. Inc., Eli Lilly and Company, and Mylan Nv[2].

Conclusion

Carbidopa and levodopa remain essential medications in the management of Parkinson's disease. Recent clinical trials, such as those for IPX203 and ND0612, highlight the ongoing efforts to improve the efficacy and convenience of these treatments. The market for levodopa is poised for significant growth, driven by the increasing prevalence of Parkinson's disease and the development of new formulations and delivery methods.

Key Takeaways

  • Clinical Trials: IPX203 and ND0612 have shown promising results in improving symptom control and reducing motor fluctuations in Parkinson's disease patients.
  • Market Growth: The global levodopa market is projected to grow from $1.7 billion in 2022 to $2.9 billion by 2032.
  • Dominance of Carbidopa-Levodopa: This drug class segment continues to dominate the Parkinson's disease treatment market.
  • New Formulations: Developments in extended-release and continuous infusion formulations aim to address the limitations of traditional oral medications.
  • Research and Development: Ongoing research and development are expected to lead to the approval of new anti-Parkinson's drugs in the coming years.

FAQs

Q: What is the primary use of carbidopa and levodopa in medical treatment? A: Carbidopa and levodopa are primarily used to manage symptoms of Parkinson's disease by replenishing dopamine levels in the brain.

Q: What are the key findings of the RISE-PD study on IPX203? A: The RISE-PD study found that IPX203 provided more hours of "good on-time" per day compared to immediate-release carbidopa-levodopa, even with less frequent dosing.

Q: How does ND0612 differ from traditional levodopa/carbidopa formulations? A: ND0612 is a liquid levodopa/carbidopa formulation designed for continuous subcutaneous infusion, bypassing the stomach to provide consistent medication levels.

Q: What is driving the growth of the levodopa market? A: The growth of the levodopa market is driven by the increasing prevalence of Parkinson's disease, largely attributed to an aging population and changing lifestyle patterns.

Q: Which pharmaceutical companies are key players in the levodopa market? A: Key players include Sun Pharmaceutical Industries Ltd., Novartis AG, Bristol-Myers Squibb Co., Teva Pharmaceutical Industries Ltd., and others.

Sources

  1. IPX203 vs Immediate-Release Carbidopa-Levodopa for ... - PubMed
  2. Levodopa Market Size, Growth Analysis | Forecast - 2032
  3. Parkinson's Drug Market and Clinical Trial Insights Report, 2020-2025
  4. New Parkinson's Drug Formulation Shows Positive Phase III Trial ...
  5. Parkinson's Disease Treatment Market Size, Share | Report 2022 ...

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