HealthDay News — For patients with early Parkinson’s disease (PD), inosine seems safe and effective for raising urate levels, according to a study in JAMA Neurology.
Michael A. Schwarzschild, MD, PhD, from Massachusetts General Hospital in Boston, and colleagues from the Parkinson Study Group Safety of Urate Elevation in PD enrolled 75 adults with early PD who did not yet require symptomatic treatment and who had a serum urate concentration <6 mg/dL into a multicenter trial.
Patients were randomly assigned to one of three treatment arms: placebo or inosine titrated to produce mild (6.1 to 7.0 mg/dL) or moderate (7.1 to 8.0 mg/dL) serum urate elevation using 500-mg capsules.
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The researchers found that serious adverse events occurred at the same or lower rates in the inosine groups versus placebo. No cases of gout were seen, but three patients receiving inosine developed symptomatic urolithiasis. No participants withdrew because of an adverse event, with 955% of participants tolerating treatment at six months.
In the inosine groups, serum urate rose by 2.3 and 3.0 mg/dL (P<0.001 for each) compared to placebo. Cerebrospinal fluid urate levels were also significantly greater in both inosine groups (P=0.006 and P<0.001, respectively). Non-futility of inosine treatment for slowing disability was seen in secondary analyses.
“The findings support advancing to more definitive development of inosine as a potential disease-modifying therapy for PD,” the researchers wrote.