Study examines inosine to increase urate levels in patients with Parkinson disease

December 23, 2013

The drug inosine appears to be a safe and effective way to raise blood and cerebrospinal fluid urate levels in patients with early Parkinson disease (PD), suggesting it may be a potential strategy to slow the disability progression of the degenerative neurological disorder, according to a report published by JAMA Neurology, a JAMA Network publication.

Urate is an end product of human metabolism. Animal experiments suggest that urate may protect against PD, and higher blood urate levels are associated with reduced risk and slower progression of PD, according to the study background. Inosine is a drug that raises urate levels and therefore may be useful for PD.

Researchers in the Parkinson Disease Study Group SURE-PD (Safety of Urate Elevation in PD) trial randomized 75 patients with early PD (average age 62 years and not yet requiring treatment for their symptoms) to placebo or doses of inosine to produce mild or moderate elevation in blood urate levels to examine the safety, tolerability and ability of inosine to elevate urate levels. Patients were administered inosine in 500-mg capsules taken orally.

Blood (serum) urate levels rose by 2.3 and 3.0 mg/dL in the two inosine groups vs. placebo, and cerebrospinal fluid (CSF) urate levels were greater in both inosine groups. Serious adverse events (17) occurred at the same or lower rates in the inosine groups compared to placebo. The treatment also was tolerated by 95 percent of patients at six months and no participants withdrew because of an adverse event.

"The results of the SURE-PD trial demonstrate that oral inosine treatment in early PD is clinically safe and tolerable and produces an increase in serum and CSF urate. ... The present findings support the development of a more definitive trial to investigate the ability of inosine treatment to slow clinical progression among persons with early PD who have lower urate," the authors conclude.
(JAMA Neurol. Published online December 23, 2013. doi:10.1001/.jamaneurol.2013.5528. Available pre-embargo to the media at

Editor's Note: This project was funded by a grant from the MJFF. Additional support was provided by a National Institutes of Health grant, the Harvard NeuroDiscovery Center, the RJG Foundation and the Parkinson's Disease Foundation Advancing Parkinson's Therapies initiative. Conflict of interest disclosures were made. Please see the articles for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

The JAMA Network Journals

Related Placebo Articles from Brightsurf:

Effect of fluvoxamine vs placebo on clinical deterioration in outpatients with symptomatic COVID-19
This randomized trial compares the effects of fluvoxamine, a selective serotonin reuptake inhibitor with immunomodulatory effects, versus placebo on a composite of dyspnea or pneumonia and oxygen desaturation among adult outpatients with polymerase chain reaction-confirmed mild COVID-19 illness.

Hydroxychloroquine no more effective than placebo in preventing COVID-19
Clinical trial with COVID-19 testing of participants shows health care workers in contact with coronavirus patients who took hydroxychloroquine each day did not reduce their rate of infection.

Compared to placebo, vitamin D has no benefit for severe asthma attacks
Contrary to earlier observational results, vitamin D supplements do not prevent severe asthma attacks in at-risk children, according to the first placebo-controlled clinical trial to test this relationship.

UMN trial shows hydroxychloroquine has no benefit over placebo in preventing COVID-19
Today, University of Minnesota Medical School researchers published the results from the first randomized clinical trial testing hydroxychloroquine for the post-exposure prevention of COVID-19.

The placebo effect and psychedelic drugs: tripping on nothing?
A new study from McGill suggests that, in the right context, some people may experience psychedelic-like effects from placebos alone.

Methotrexate reduces joint damage progression over placebo in erosive hand OA
According to new research findings presented at the 2019 ACR/ARP Annual Meeting, methotrexate did not demonstrate superior efficacy over placebo for pain relief and function evolution at three and 12 months in patients with erosive hand osteoarthritis, but did significantly reduce the progression of joint damage over placebo and seems to facilitate bone remodeling in these patients.

Botulinum toxin reduces chronic migraine attacks, compared to placebo
A growing body of evidence supports the effectiveness of botulinum toxin injections in reducing the frequency of chronic migraine headaches, concludes an updated review and analysis in the January issue of Plastic and Reconstructive Surgery, the official medical journal of the American Society of Plastic Surgeons (ASPS).

Opioids vs. placebo, nonopioid alternatives for chronic noncancer pain
An estimated 50 million adults in the United States were living with chronic noncancer pain in 2016 and many of them were prescribed opioid medications, even though a clinical benefit is uncertain.

Probiotic no better than placebo for acute gastroenteritis in children
While probiotics are often used to treat acute gastroenteritis (also known as infectious diarrhea) in children, the latest evidence shows no significant differences in outcomes, compared to a placebo.

Most common shoulder operation is no more beneficial than placebo surgery
In a landmark study published this week in the BMJ, Finnish researchers show that one of the most common surgical procedures in the Western world is probably unnecessary.

Read More: Placebo News and Placebo Current Events is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to