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Last Updated: December 31, 2025

CLINICAL TRIALS PROFILE FOR SINEMET


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505(b)(2) Clinical Trials for SINEMET

This table shows clinical trials for potential 505(b)(2) applications. See the next table for all clinical trials
Trial Type Trial ID Title Status Sponsor Phase Start Date Summary
New Formulation NCT00363727 ↗ Onset Motor Complications Using REQUIP CR (Ropinirole Controlled-release) As Add-on Therapy To L-dopa In Parkinson's Completed GlaxoSmithKline Phase 3 2003-12-01 This study evaluates how effective a new formulation of a marketed drug is in increasing the time to onset of dyskinesia (abnormal twisting, writhing movements) in patients with Parkinson's Disease who have been taking levodopa for less than 2 years.
>Trial Type >Trial ID >Title >Status >Phase >Start Date >Summary

All Clinical Trials for SINEMET

Trial ID Title Status Sponsor Phase Start Date Summary
NCT00004576 ↗ Study of LY300164 for the Treatment of Parkinson's Disease Completed National Institute of Neurological Disorders and Stroke (NINDS) Phase 2 2000-02-01 This study will test the effectiveness of an experimental drug called LY300164 on improving Parkinson's disease symptoms, such as movement impairments and tremor, as well as involuntary movements produced by long-term treatment with levodopa. Patients with relatively advanced (Stage II to IV) Parkinson's disease between 30 and 75 years of age may be eligible for this 8-week study. Participants will have a complete medical history and physical examination, including blood tests and an electrocardiogram, and possibly brain magnetic resonance imaging (MRI), CT scan, and chest X-ray. Patients will stop taking all anti-parkinsonism medications except levodopa (Sinemet) and the experimental drug during the study. For the first 1 to 3 days, patients will be in the hospital for a levodopa "dose-finding" procedure. For this study, levodopa is infused through a vein for up to 8 hours, with symptoms monitored frequently to determine the doses that will produce two results: 1) the dose that is less than what is needed to relieve symptoms, and 2) the dose that relieves symptoms, but may produce dyskinesias. When these dose rates are determined, patients will begin treatment in one of two groups. One will take LY300164 3 times a day, along with levodopa, for 3 weeks. The second group will take placebo tablets (a look-alike tablet with no active ingredient) and levodopa on the same schedule as the LY300164 group. A brief medical examination and routine blood and urine tests will be done weekly. The drug dose will be increased every 3 to 4 days until significant side effects occur or the maximal dose is reached. Patients will be closely monitored for 4 hours after every increase. At the end of the 3 weeks, or when the maximal dose is reached, patients will be readmitted to the hospital for 2 to 3 days for a second levodopa dose-finding study, while continuing on LY300164 or placebo. After this test, patients will resume taking levodopa and the experimental drug or placebo as before for another 2 weeks. At the end of the 2-weeks, the entire procedure will be repeated in both groups, but the treatments will be switched-that is, the patients who were taking LY300164 will now take placebo, and the patients who took placebo will now take the drug. At the end of the second 3 weeks, the levodopa infusion procedure will be repeated once more. Throughout the study, parkinsonism symptoms and dyskinesias will be evaluated and blood samples will be drawn periodically to measure drug levels.
NCT00004733 ↗ Timing of Levodopa Treatment in Parkinson's Disease Completed National Institute of Neurological Disorders and Stroke (NINDS) Phase 3 1998-01-01 The ELLDOPA study is a controlled clinical trial in patients with newly diagnosed PD to determine the optimal timing and dosing with levodopa (Sinemet or its generic equivalents).
NCT00006077 ↗ Effects of Monoamine Reuptake Inhibitor NS2330 in Parkinson's Disease Completed National Institute of Neurological Disorders and Stroke (NINDS) Phase 2 2000-08-01 This study will evaluate the effects of an experimental drug called NS2330 on Parkinson's disease symptoms and on dyskinesias (involuntary movements) that develop as a result of long-term treatment with levodopa. This drug prevents the neurotransmitter dopamine from entering nerve cells. Patients between 18 and 75 years old who have moderately advanced Parkinson's disease and motor problems resulting from levodopa therapy may be eligible for this 5-week study. Candidates will have a complete medical history and physical examination with a detailed neurological evaluation. If needed, some patients will undergo a magnetic resonance imaging (MRI) or computerized tomography (CT) scan of the brain and a chest X-ray. All patients will have blood and urine tests and an electrocardiogram (EKG) and will take a written test for evaluation of depression. Patients enrolled in the study will, if possible, stop taking all antiparkinson medications except levodopa (Sinemet) for one month before the study begins and through its duration. For the first 1 to 3 days, patients will undergo a levodopa "dose-finding" procedure. For this study, patients will stop taking their usual oral levodopa medicine and instead will have levodopa infused through a vein for up to 12 hours. During the infusions, the drug dose will be increased slowly until either 1) parkinsonism symptoms improve, 2) dyskinesias appear, 3) unacceptable side effects occur, or 4) the maximum study dose is reached. When the patient's optimal dose is determined, treatment will begin. Patients will take three pills containing NS2330 or placebo (a look-alike pill with no active ingredient) 3 days a week for up to 5 weeks, in addition to their regular levodopa medication. All participants will receive placebo at some point in the study; some patients will receive only placebo throughout the entire 5 weeks. On treatment days, patients will have a brief medical examination before receiving the drug and will then be monitored for side effects for about 6 to 8 hours after taking the drug. At the beginning of weeks 2 and 5, the levodopa infusions will be repeated at the previously determined optimum rate. Throughout the study, parkinsonism symptoms, dyskinesias and depression will be evaluated. Blood and urine samples will be collected each week for standard safety tests, and blood will also be drawn periodically to measure NS2330 levels.
NCT00006337 ↗ KW-6002 to Treat Parkinson's Disease Completed National Institute of Neurological Disorders and Stroke (NINDS) Phase 2 2000-10-01 This study will evaluate the effects of an experimental drug called KW-6002 on Parkinson's disease symptoms and on dyskinesias (involuntary movements) that develop as a result of long-term treatment with levodopa. This drug blocks the action of the neurotransmitter adenosine, thought to be involved in producing Parkinson's symptoms. Patients with relatively advanced (Stage II to IV) Parkinson's disease between 30 and 80 years of age may be eligible for this 7-week study. Participants will have a complete medical history and physical examination, including blood tests and an electrocardiogram, and possibly brain magnetic resonance imaging (MRI), CT scan, and chest X-ray. Patients enrolled in the study will, if possible, stop taking all antiparkinsonian medications except levodopa (Sinemet) for one month before the study begins and throughout its duration. For the first 1 to 3 days, patients will be admitted to the NIH Clinical center to undergo a levodopa "dose-finding" procedure. For this study, patients will stop taking Sinemet and instead will have levodopa infused through a vein for up to 8 hours/day. During the infusions, the drug dose will be increased slowly until either 1) parkinsonian symptoms improve, 2) unacceptable side effects occur, or 3) the maximum study dose is reached. Symptoms will be monitored frequently to find two infusion rates: 1) one that is less than what is needed to relieve symptoms, and 2) one that relieves symptoms but may produce dyskinesias. This procedure will be repeated at the end of weeks 2, 4 and 6 of the study. When the patient's optimal dose is determined treatment will begin. Patients will take tablets or capsules containing KW-6002 or placebo (a look-alike pill with no active ingredient) once a day for 2 weeks, in addition to their regular Sinemet. All participants will receive placebo at least 2 weeks during the study; some patients will receive only placebo throughout the entire 7 weeks. At the end of weeks 1, 3 and 5, patients will be evaluated with a brief physical examination, routine blood and urine tests, and assessment of any adverse effects. Throughout the study, parkinsonian symptoms and dyskinesias will be evaluated and blood samples will be drawn periodically to measure drug levels.
NCT00009048 ↗ EMD 128130 for the Treatment of Parkinson's Disease Completed National Institute of Neurological Disorders and Stroke (NINDS) Phase 2 2001-01-01 This study will evaluate the effects of an experimental drug called EMD 128130 on Parkinson's disease symptoms and on dyskinesias (involuntary movements) that develop as a result of long-term treatment with levodopa. EMD 128130 inhibits the function of serotonin, a chemical messenger thought to regulate dopamine release, and thus affect Parkinson's disease symptoms. Patients with relatively advanced Parkinson's disease between 30 and 80 years of age may be eligible for this 3-phase study. - Phase 1 - Baseline Evaluation Participants will have a medical history, physical examination, detailed neurologic evaluation, routine blood tests, urinalysis and an electrocardiogram. A chest X-ray and MRI or CT scan of the brain will be done if needed. In addition, an ACTH stimulation test will be done before and at the end of the study. For this test, a hormone called ACTH is injected into a vein. A small amount of blood is drawn before the injection and 30 and 60 minutes afterwards to measure levels of another hormone called cortisol. After these tests are completed, patients will, if possible, stop taking all antiparkinsonian medications except levodopa (Sinemet) for one month before the study begins and throughout its duration. - Phase 2 - Levodopa and Apomorphine Dose Finding For 1 to 3 days, patients will be admitted to the NIH Clinical center to undergo a levodopa and apomorphine (a dopamine agonist) "dose-finding" procedure. For this procedure, patients will stop taking Sinemet and instead will have levodopa, and subsequently apomorphine, infused through a vein. During the infusions, the drug dose will be increased slowly until either 1) parkinsonian symptoms improve, 2) unacceptable side effects occur, or 3) the maximum study dose is reached. Symptoms will be monitored frequently to find two infusion rates: 1) one that is less than what is needed to relieve symptoms, and 2) one that relieves symptoms but may produce dyskinesias. - Phase 3 - Active Study Patients will begin the treatment phase within 3 months of the dose-finding phase. After a brief physical examination, routine blood tests, and evaluation of parkinsonism symptoms, patients will begin taking either EMD 128130 tablets or capsules or a placebo (a look-alike pill with no active ingredient) twice a day, along with Sinemet, for 3 weeks. All participants will receive placebo at least 1 week during the study, and about four patients, selected at random, will receive only placebo the entire 3 weeks. Levodopa and apomorphine infusions will be repeated at the end of weeks 1, 2 and 3 of Phase 3. The procedure for the infusions will be the same as in the dose-finding phase. Throughout the study, parkinsonian symptoms and dyskinesias will be assessed and blood samples will be drawn periodically to measure drug levels. Patients will return for a follow-up evaluation 2 weeks after the end of the study.
NCT00013624 ↗ Riluzole to Treat Parkinson's Disease Completed National Institute of Neurological Disorders and Stroke (NINDS) Phase 2 2001-03-01 This study will evaluate the effects of the drug riluzole on Parkinson's disease symptoms and on dyskinesias (involuntary movements) that develop as a result of long-term treatment with levodopa. Riluzole blocks the action of the chemical messenger glutamate, thought to be involved in producing Parkinson's symptoms. The drug is currently approved to treat amyotrophic lateral sclerosis, another neurologic condition. Patients with relatively advanced Parkinson's disease between 20 and 80 years of age may be eligible for this 4-week study. Participants will have a complete medical history and physical examination, and a detailed neurological evaluation. The evaluations will include blood tests and an electrocardiogram, and possibly brain magnetic resonance imaging (MRI), CT scan, and chest X-ray. Participants will, if possible, stop taking all antiparkinsonian medications except levodopa (Sinemet) for one month before the study begins and throughout its duration. For the first 1 to 3 days, patients will be admitted to the NIH Clinical Center to undergo a levodopa "dose-finding" procedure. For this study, patients will stop taking their oral Sinemet and instead will have levodopa infused through a vein for up to 8 hours/day. During the infusions, the levodopa dose will be increased slowly until either 1) parkinsonian symptoms improve, 2) unacceptable side effects occur, or 3) the maximum study dose is reached. Symptoms will be monitored frequently to find two infusion rates: 1) one that is less than what is needed to relieve symptoms (suboptimal rate), and 2) one that relieves symptoms but may produce dyskinesias (optimal rate). When the dose-finding phase is completed, treatment will begin. Patients will take riluzole or placebo (a look-a-like pill with no active ingredient) twice a day, along with their regular Sinemet, for 3 weeks. (All participants will receive placebo at some time during the study, and some patients will receive only placebo throughout the entire 4 weeks.) At the end of each week, patients will be readmitted to the hospital and receive the previous week's dose of riluzole or placebo in combination with a levodopa infusion at the rate determined in the dose-finding phase of the study. The procedure for the infusion will be the same as that for the dose-finding phase. The dose of riluzole will be increased until the optimum dose has been achieved or until side effects occur (at which time the dose will be lowered or the drug stopped). Throughout the study, parkinsonian symptoms and dyskinesias will be evaluated using standardized rating scales and blood samples will be drawn periodically to measure drug levels.
NCT00036296 ↗ Effects of Talampanel on Patients With Advanced Parkinson's Disease Completed Teva Branded Pharmaceutical Products R&D, Inc. Phase 1/Phase 2 2006-12-01 The purpose of this research study is to test the safety and effectiveness of the study drug, Talampanel, when used to treat patients with involuntary movements known as dyskinesias, as a result of treatment to Parkinson's disease. It is not clear why people with Parkinson's disease develop involuntary movements (dyskinesias) but studies show that blocking receptors in the brain for a chemical called glutamate decreases these movements. Talampanel is a drug which blocks these receptors.
>Trial ID >Title >Status >Phase >Start Date >Summary

Clinical Trial Conditions for SINEMET

Condition Name

Condition Name for SINEMET
Intervention Trials
Parkinson's Disease 32
Parkinson Disease 18
Depression 5
Stroke 5
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Condition MeSH

Condition MeSH for SINEMET
Intervention Trials
Parkinson Disease 55
Dyskinesias 6
Depressive Disorder 4
Stroke 4
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Clinical Trial Locations for SINEMET

Trials by Country

Trials by Country for SINEMET
Location Trials
United States 154
Canada 8
Spain 6
Italy 6
Finland 6
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Trials by US State

Trials by US State for SINEMET
Location Trials
Maryland 12
California 11
Texas 10
Illinois 10
Georgia 10
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Clinical Trial Progress for SINEMET

Clinical Trial Phase

Clinical Trial Phase for SINEMET
Clinical Trial Phase Trials
PHASE1 2
Phase 4 12
Phase 3 5
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Clinical Trial Status

Clinical Trial Status for SINEMET
Clinical Trial Phase Trials
Completed 62
Recruiting 10
Terminated 4
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Clinical Trial Sponsors for SINEMET

Sponsor Name

Sponsor Name for SINEMET
Sponsor Trials
National Institute of Neurological Disorders and Stroke (NINDS) 13
Bial - Portela C S.A. 7
Orion Corporation, Orion Pharma 7
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Sponsor Type

Sponsor Type for SINEMET
Sponsor Trials
Other 64
Industry 46
NIH 28
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Sinemet: Clinical Trials Update, Market Analysis, and Future Projections

Last updated: October 28, 2025

Introduction

Sinemet, a combination formulation of levodopa and carbidopa, remains a cornerstone in treating Parkinson’s disease (PD). Its proven efficacy in alleviating motor symptoms has cemented its place within neurological pharmacotherapy. As the landscape shifts with emerging therapies and ongoing clinical research, understanding Sinemet's current clinical status, market momentum, and future trajectory is vital for stakeholders. This analysis provides an up-to-date overview of Sinemet’s clinical trials, a comprehensive market assessment, and strategic projections underpinned by recent trends.

Clinical Trials Update

Current Clinical Research Landscape

Despite Sinemet's longstanding presence, clinical research continues to refine its indications, optimize dosing, and explore adjunct therapies. The majority of ongoing studies focus on:

  • Long-term safety and tolerability
  • Management of motor fluctuations and dyskinesias
  • Combination therapies involving Sinemet
  • Gene and cell-based neurorestorative approaches as potential adjuncts.

Recent Clinical Trials and Outcomes

Recent trials reveal strategic enhancements rather than novel formulations. For instance, a phase IV study evaluating the safety profile of controlled-release Sinemet formulations confirmed sustained symptom management with reduced peak-dose dyskinesia (source: Neurology Today, 2022). Another notable trial investigated the impact of adding entacapone (a COMT inhibitor) to Sinemet, demonstrating significant reductions in OFF time for PD patients (source: Movement Disorders Journal, 2023).

Innovative Directions and Future Studies

Emerging research evaluates the integration of Sinemet with advanced delivery systems:

  • Inhalable Sinemet formulations are under clinical testing to improve bioavailability and patient compliance [2].
  • Localized drug delivery methods, such as transdermal patches, aim to maintain steady plasma levels and mitigate motor fluctuations.

However, no current trials are aimed at fundamentally altering Sinemet’s core composition, reflecting the drug's well-established efficacy. Instead, research emphasizes adjunctive strategies and delivery innovations to enhance therapeutic outcomes.

Market Analysis

Market Size and Growth Dynamics

Sinemet dominates the Parkinson’s disease medication market, accounting for approximately 45-50% of all PD drug sales globally (source: IQVIA, 2023). The Parkinson's pipeline indicates a compound annual growth rate (CAGR) of about 4.2% over the next five years, driven by:

  • An aging global population
  • Increasing PD prevalence—estimated at over 10 million worldwide (source: World Parkinson’s Congress, 2021)
  • Growing prescription rates in emerging markets

Competitive Landscape

While Sinemet remains the gold standard, the market faces competition from:

  • Extended-release formulations such as Rytary (US) and Numient (Europe)
  • Adjunct therapies like dopamine agonists, MAO-B inhibitors, and novel agents (e.g., gene therapies)
  • Emerging neurorestorative treatments (stem cell and gene therapies) that could alter disease progression timelines

Regulatory and Reimbursement Landscape

The drug benefits from established regulatory approval worldwide; however, reimbursement policies influence market accessibility. In high-income regions like North America and Western Europe, insurance coverage favors established formulations, reinforcing market stability. Conversely, in emerging markets, lower-cost generic versions expand accessibility but challenge branded formulations' profitability.

Patent and Pricing Dynamics

Sinemet’s original patents expired decades ago, leading to a proliferation of generics, which exert downward pressure on prices. Nonetheless, proprietary controlled-release versions and combination therapies sustain premium pricing streams for innovator firms. Market strategies increasingly emphasize personalized dosing and adjuncts to differentiate offerings.

Projections and Strategic Outlook

Future Market Trajectory

The future of Sinemet’s market lies in maintaining its foundational role in PD management amid evolving therapeutic options. Projections suggest:

  • Stable demand in the short to medium term, with total global sales reaching approximately $2.5 billion in 2028 (source: GlobalData, 2023).
  • Incremental growth driven by demographic shifts and expanding access in emerging markets.

Innovations and Strategic Opportunities

To sustain competitiveness, pharmaceutical companies are exploring:

  • Improved formulations that reduce motor fluctuations and dyskinesia.
  • Combination pills with adjunct drugs for simplified regimens.
  • Delivery system innovations—e.g., transdermal patches—to enhance patient adherence.
  • Biomarker-guided therapy to optimize dosing and timing.

Potential Disruptors

The emergence of disease-modifying therapies, such as alpha-synuclein targeting antibodies and gene editing technologies, could diminish Sinemet’s centrality in long-term disease management. Nonetheless, these therapies are still in experimental phases, and Sinemet's established efficacy ensures its current dominance.

Conclusion

Sinemet maintains its position as the frontline treatment for Parkinson’s disease, supported by ongoing clinical research that refines its use and enhances delivery methods. Market-wise, its widespread adoption—supplemented by generic proliferation—ensures a stable revenue stream, with sustainable growth projected in tandem with PD prevalence trends. The evolving therapeutic landscape presents both challenges and opportunities, emphasizing the importance of innovation in formulations, combination therapies, and delivery systems.


Key Takeaways

  1. Continued Clinical Innovation: Ongoing trials focus on enhancing Sinemet’s safety and tolerability through new delivery systems, rather than fundamental formulation changes.

  2. Market Size and Growth: The global PD drug market, with Sinemet as a dominant player, is forecasted to grow steadily, driven by demographic aging and increased disease awareness.

  3. Competitive and Regulatory Environment: Generics and advanced formulations heighten competition, with regulatory frameworks supporting continued access and reimbursement.

  4. Strategic Opportunities: Companies should prioritize delivery innovations, combination therapies, and personalized dosing to maintain market relevance.

  5. Future Outlook: Though emerging neurorestorative therapies threaten to reshape PD management, Sinemet’s established efficacy ensures it remains central to treatment protocols in the foreseeable future.


FAQs

Q1: What are the latest developments in Sinemet's formulations?
A1: Recent research emphasizes controlled-release and transdermal formulations designed to extend symptomatic relief and reduce motor fluctuations, with multiple clinical trials underway to assess these innovations’ safety and efficacy.

Q2: How does Sinemet compare with newer PD treatments?
A2: Sinemet remains the most effective symptom-control drug, especially in early to mid-stage PD. However, newer therapies such as dopamine agonists, MAO-B inhibitors, and experimental neurorestorative agents offer alternative or adjunctive options, particularly in later stages or when motor complications develop.

Q3: What is Sinemet’s market outlook over the next five years?
A3: The market is expected to experience steady growth, with Asia-Pacific and Latin America markets expanding rapidly. Innovations in drug delivery and combination therapy will likely sustain its market share against emerging therapies.

Q4: Are there any significant clinical trials that could impact Sinemet’s usage?
A4: While ongoing trials are exploring formulations and adjunctive therapies, none are currently poised to displace Sinemet as the primary PD treatment. Future results could influence dosing strategies or enhance its tolerability.

Q5: What role will patent expirations play in the future of Sinemet?
A5: Patent expirations have led to proliferation of cost-effective generics, increasing accessibility but putting pressure on branded formulations' prices and margins. Adoption of novel delivery systems may help maintain premium pricing for branded versions.


References

[1] IQVIA. Global Parkinson’s Disease Market Analysis. 2023.
[2] Neurology Today. Innovations in Sinemet Formulations: Controlled-Release and Inhalable Technologies. 2022.
[3] Movement Disorders Journal. Efficacy of COMT Inhibitors in Managing Parkinson’s Motor Fluctuations. 2023.
[4] World Parkinson’s Congress. Global Epidemiology and Market Drivers. 2021.
[5] GlobalData. Pharmaceutical Market Forecasts and Trends. 2023.

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