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NCT Number: NCT07839793

A 12-Week Study of Flexilev With the OraFID Device and App in Parkinson's Patients

Flexilev is a Parkinson's disease medicine made of small, dissolvable tablets containing low doses of levodopa and carbidopa, allowing doses to be adjusted in small, precise steps. OraFID is a new mechanical device that dispenses the exact number of tablets needed, with better than 99% accuracy, in amounts from 1 to 20 tablets. An optional companion app, Levilog, reminds patients when to take their dose and records how much medicine (tablets and milligrams) was taken.

This 12-week study will mainly assess how acceptable this treatment routine is and how well patients stick with it when using Flexilev with the OraFID device and app. It will also evaluate the treatment's efficacy, safety, and tolerability.

Recruiting

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Key information

Age range

30 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Phase 4

Primary location

Karolinska University Hospital, Stockholm, Stockholm County, Sweden

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About this study

This is an open-label, observational, up to 12-week study evaluating patients' experience with Flexilev minitablets delivered through the OraFID dosing device and the Levilog reminder app.

Participants first complete an up-to-two-week run-in period, during which their current treatment is recorded and eligibility is assessed. Eligible patients then switch to Flexilev delivered by OraFID, are trained on the device and app, and receive an individualized dosing schedule based on their doctor's evaluation and prior treatment. Other daytime levodopa medications are stopped during the study, though slow-release levodopa is allowed at night; levodopa infusions are not permitted.

Within a week of starting treatment, patients receive a follow-up phone call to confirm or adjust the dosing schedule and check for any safety or device/app issues. This is followed by a 12-week treatment period, with phone check-ins at weeks 4 and 8 and an in-person visit at week 12. Dose adjustments are permitted throughout the study if needed.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Male or female subjects, 30 years of age or older at the time of screening, with a diagnosis of idiopathic PD that is levodopa-responsive
  • Have a minimum of 4 levodopa dosing occasions per day
  • Stable medication within the last 4 weeks
  • Be judged by the investigator to be eligible for Flexilev treatment.
  • Subject (or caregiver, if applicable) demonstrates the understanding and correct use of the OraFID delivery system, as assessed by the investigator or designee.
  • Subject (or caretaker on behalf of the subject) is willing to use Patients Own Reporting module in the Parkinson registry and is willing to answer all questionnaires.
  • Have a smartphone (either patient or caregiver)
  • Ability to consent and comply with study specific procedures
  • Able to read and write in Swedish

Exclusion criteria

  • Inability of subject or caregiver to use the device
  • Female patients who are pregnant or breast-feeding or who wish to become pregnant during the period of the clinical study and for three months later.
  • Female patients of childbearing age (less than 24 months after the last menstrual cycle) who do not use adequate contraception.

Treatment and study plan

OraFID dosing device, Levodopa/Carbidopa minitablets delivered via OraFID dosing device

Device

Intervention Description

Levodopa 5 mg/carbidopa 1.25 mg dispersible minitablets, individually dosed in 5 mg levodopa increments (1-20 tablets per dose) via the OraFID mechanical dispensing device, with an optional Levilog app for dosing reminders and adherence tracking.

Primary outcomes

  1. Patient acceptability and satisfaction with the OraFID dosing device, self-reported via questionnaire

    Time frame: 12 weeks

    Assessed using a patient-reported questionnaire evaluating acceptability, ease of use, and satisfaction with the OraFID dosing device.

Secondary outcomes

  1. User opinion, usage, and ability to use the Levilog app

    Time frame: 12 weeks

    Self-reported via questionnaire on app usage and usability

  2. Time required per dispensation/treatment with the OraFID device

    Time frame: 12 weeks

    Self-reported via questionnaire regarding the device

  3. Compliance with the dosing schedule

    Time frame: 12 weeks

    Data obtained from the Levilog app and drug accountability records

  4. Compliance with the app, i.e., willingness to register doses

    Time frame: 12 weeks

    Compliance and treatment data from Levilog app use, combined with self-reported data

  5. Safety and acceptability of Flexilev delivered by OraFID and the app

    Time frame: 12 weeks

    Assessed via adverse event and serious adverse event reporting, and study withdrawals

  6. Overall acceptability of Flexilev/OraFID/App

    Time frame: 12 weeks

    Self-reported via questionnaire regarding the device

  7. User opinion of Flexilev treatment

    Time frame: 12 weeks

    Self-reported via questionnaire regarding treatment

  8. Change in non-motor symptoms

    Time frame: Baseline to week 12

    Non-Motor Symptoms Questionnaire (NMSQ), self-reported

  9. Change in depression symptoms

    Time frame: Baseline to week 12

    Hospital Anxiety and Depression Scale (HADS-D), self-reported

  10. Change in quality of life

    Time frame: Baseline to week 12

    Parkinson's Disease Questionnaire (PDQ-8) and EQ-5D-5L (including VAS), self-reported

  11. Change in symptom variation (On-Off phenomena)

    Time frame: Baseline to week 12

    Self-reported OnOff Scale questionnaire

  12. Change in average daily normalized "off" time

    Time frame: Baseline to week 12

    Self-reported OnOff Scale questionnaire

  13. Change in average daily normalized "on" time without troublesome dyskinesia

    Time frame: Baseline to week 12

    Self-reported OnOff Scale questionnaire

  14. Change in sleep quality

    Time frame: Baseline to week 12

    Parkinson's Disease Sleep Scale (PDSS-2), self-reported

  15. Motor function in daily life

    Time frame: 12 weeks

    Unified Parkinson's Disease Rating Scale (UPDRS), physician-reported

  16. Change in motor function (UPDRS Parts II and III)

    Time frame: Baseline to week 12

    Movement Disorder Society - Unified Parkinson's Disease Rating Scale (UPDRS), physician-reported

  17. Change in disease severity

    Time frame: Baseline to week 12

    Clinical Impression of Severity Index for Parkinson's Disease (CISI-PD), physician-reported

  18. Change in symptoms, treatment effects, and overall quality

    Time frame: Baseline to week 12

    Patient-Reported Outcomes in Parkinson's Disease (PRO-PD), self-reported

Interested in participating?

Recruiting

Interested in participating?

Request Info

Sponsors and collaborators

Lead sponsor

Navamedic AB

Industry

Registry information

Acronym: FLORA

Important dates

Study start
2026
Primary completion
2027
Study completion
2027
First posted
Sep 24, 2026
Registry last updated
Sep 24, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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