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Inosine 5'-Monophosphate to Raise Serum Uric Acid Level in Multiple System Atrophy (IMPROVE-MSA study)

Authors
 Jae Jung Lee  ;  Jung Han Yoon  ;  Sang Jin Kim  ;  Han Soo Yoo  ;  Seok Jong Chung  ;  Yang Hyun Lee  ;  Suk Yun Kang  ;  Hae-Won Shin  ;  Sook Keun Song  ;  Jin Yong Hong  ;  MunKyung Sunwoo  ;  Ji Eun Lee  ;  Jong Sam Baik  ;  Young H Sohn  ;  Phil Hyu Lee 
Citation
 CLINICAL PHARMACOLOGY & THERAPEUTICS, Vol.109(5) : 1274-1281, 2021-05 
Journal Title
CLINICAL PHARMACOLOGY & THERAPEUTICS
ISSN
 0009-9236 
Issue Date
2021-05
Abstract
The aim of this trial was to investigate the safety, tolerability, and capability of serum uric acid (UA) elevation of inosine 5'-monophosphate (IMP) in multiple system atrophy (MSA). The IMPROVE-MSA trial was a randomized, double-blind, placebo-controlled trial in patients with MSA with no history of hyperuricemia-related disorders. The participants were assigned to placebo (n = 25) or IMP (n = 30) in a 1 to 1 ratio, and then followed up for 24 weeks. The primary end points included safety, tolerability, and alteration of the serum UA level during the follow-up period. The secondary end points were changes in scores of the unified MSA rating scale (UMSARS) and the Mini-Mental Status Examination (MMSE) and Montreal Cognitive Assessment (MoCA). The total number of adverse events (AEs) and serious AEs was comparable between the active and placebo groups. Serum UA level (mg/dL) was significantly increased from baseline (active vs. placebo, 4.57 vs. 4.58; P = 0.98) to study end point (6.96 vs. 4.43; P < 0.001) in the active group compared with the placebo group (time × group interaction; P < 0.001). The change in UMSARS scores did not differ between the active and placebo groups. However, the active group showed better alterations in MoCA scores with nominal significance (P < 0.001) and tendency for better alterations in MMSE scores (P = 0.09) than the placebo group. Our data demonstrated that IMP treatment was generally safe and well-tolerated in patients with MSA. A further trial with a long-term follow-up is required to examine whether UA elevation will slow clinical progression in early MSA.
Full Text
https://ascpt.onlinelibrary.wiley.com/doi/10.1002/cpt.2082
DOI
10.1002/cpt.2082
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Neurology (신경과학교실) > 1. Journal Papers
Yonsei Authors
Sohn, Young Ho(손영호) ORCID logo https://orcid.org/0000-0001-6533-2610
Yoo, Han Soo(유한수) ORCID logo https://orcid.org/0000-0001-7846-6271
Lee, Yang Hyun(이양현)
Lee, Phil Hyu(이필휴) ORCID logo https://orcid.org/0000-0001-9931-8462
Chung, Seok Jong(정석종) ORCID logo https://orcid.org/0000-0001-6086-3199
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/183970
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