Amneal Pharmaceuticals, Inc. (NYSE: AMRX) today announced the U.S. Food and Drug Administration (FDA) has accepted for review the New Drug Application (NDA) for IPX203 for the treatment of Parkinsonâ€™s disease (PD). IPX203 is a novel, oral formulation of carbidopa/levodopa (CD/LD) extended-release capsules.
â€śThe FDA filing acceptance of IPX203 marks another important milestone for Amneal as we strive to improve the lives and care of people living with Parkinsonâ€™s disease,â€ť said Gustavo Pesquin, Chief Commercial Officer, Amneal Specialty. â€śWe look forward to engaging in conversations with the FDA as we advance the application. We believe the data in our RISE-PD study supports the important benefit IPX203 can offer to this community by providing longer duration of symptom control with the benefit of fewer doses.â€ť
CD/LD has been the leading treatment for PD since the 1970s. Data from the pivotal Phase 3 RISE-PD clinical trial found that IPX203â€™s extended-release formulation offers significantly more â€śGood Onâ€ť time, as well as significantly less â€śOffâ€ť time, compared to immediate-release CD/LD, even when dosed less frequently.
â€śAmneal aims to provide people living with Parkinsonâ€™s disease effective treatments that allow them to live their lives with less concern about their mobility and symptoms, and more freedom to choose how to spend their time,â€ť said Pesquin. â€śWe are pleased that IPX203 has the potential to address this need by extending periods when symptoms are better controlled, with less frequent dosing.â€ť
The FDA assigned a Prescription Drug User Fee Act (PDUFA) date of June 30, 2023 to complete its evaluation of the NDA.
About the RISE-PD Trial
The multicenter, randomized, double-blind, double-dummy, active-controlled, parallel-group RISE-PD trial evaluated the efficacy and safety of IPX203 CD/LD extended-release capsules compared with immediate-release CD/LD in the treatment of people living with PD who have motor fluctuations.
The trial consisted of a 3-week, open-label immediate-release CD/LD dose adjustment period and a 4-week, open-label period for conversion to IPX203. This was followed by a 13-week double-blind treatment period in which patients were randomized 1:1 to receive either IPX203 (with matching immediate-release CD/LD placebo) or immediate-release CD/LD (with matching IPX203 placebo). The baseline for all endpoints was Week 7 (Visit 4), which occurred pre-randomization. The most common adverse reaction (incidence â‰Ą 3% and greater than immediate-release CD-LD) was nausea (4.3%).
The primary endpoint of the trial assessed the change from baseline in â€śGood Onâ€ť time in hours per day at the end of the double-blind treatment period (Week 20 or early termination). â€śGood Onâ€ť time is defined as the sum of â€śOnâ€ť time without dyskinesia and â€śOnâ€ť time with non-troublesome dyskinesia. Secondary endpoints assessed the change from baseline in â€śOffâ€ť time in hours per day, proportion of patients who were either â€śmuch improvedâ€ť or â€śvery much improvedâ€ť in Patients’ Global Impression of Change (PGI-C) scores, change from baseline in the Movement Disorder Society – Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) Part III score, and the change from baseline in sum of MDS-UPDRS Parts II and III scores.
The trial was conducted at 105 clinical sites in the U.S. and in European countries, including Czechia, France, Germany, Italy, Poland, Spain and the United Kingdom. The study randomized 506 patients who had received a PD diagnosis at age 40 or older. The study design was reviewed by the FDA and conducted pursuant to a Special Protocol Assessment. A nine-month safety extension study was completed earlier this year (2022).
IPX203 is a novel, oral formulation of CD/LD extended-release capsules designed for the treatment of Parkinsonâ€™s disease. IPX203 contains immediate-release granules and extended-release beads. The IR granules consist of CD and LD, with a disintegrant polymer to allow for rapid dissolution. The ER beads consist of LD, coated with a sustained release polymer to allow for slow release of the drug, a mucoadhesive polymer to keep the granules adhered to the area of absorption longer, and an enteric coating to prevent the granules from disintegrating prematurely in the stomach. This formulation is distinct from RYTARYÂ®Â (carbidopa/levodopa) extended-release capsules, Amnealâ€™s extended-release CD/LD treatment for PD approved by the U.S. FDA in 2015.
About Parkinsonâ€™s Disease
Parkinsonâ€™s disease (PD) has become the fastest growing neurological disorder worldwide, with approximately 1 million people diagnosed in the U.S.1,2Â It is a progressive disorder of the central nervous system (CNS) that affects dopamine-producing neurons in the brain that affect movement.
PD is characterized by slowness of movement, stiffness, resting tremor and impaired balance.3Â While PD is not considered a fatal disease, it is associated with significant morbidity and disability.4Â The average age at diagnosis for people with PD is 60; as people live longer, the number of people living with PD is predicted to grow significantly over the coming decades.1,5
Amneal Pharmaceuticals, Inc. (NYSE: AMRX), headquartered in Bridgewater, NJ, is a fully integrated essential medicines company. We make healthy possible through the development, manufacturing, and distribution of generic and specialty pharmaceuticals, primarily within the United States. The Company has a diverse portfolio of over 250 products in its Generics segment and is expanding across a broad range of complex products and therapeutic areas, including injectables and biosimilars. In its Specialty segment, Amneal has a growing portfolio of branded pharmaceutical products focused primarily on central nervous system and endocrine disorders, with a pipeline focused on unmet needs. Through its AvKARE segment, the Company is a distributor of pharmaceuticals and other products for the U.S. federal government, retail, and institutional markets. For more, please visitÂ www.amneal.com.
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- Dorsey ER et al. JAMA Neurol. 2018;75(1):9-10.
- Marras et al. NPJ Parkinsons Dis. 2018;4:21.
- NINDS. Parkinsonâ€™s disease: challenges, progress, and promise. Reviewed August 2019. Accessed April 16, 2021.
- Data Monitor: Gibrat et al., 2009; Goldenberg, 2008; Muangpaisan et al., 2009; Pringsheim et al., 2014.
- John Hopkins Medicine. Young-Onset Parkinsonâ€™s disease. Accessed August 17, 2021.