PMID- 33064299
OWN - NLM
STAT- MEDLINE
DCOM- 20210915
LR  - 20210915
IS  - 1532-6535 (Electronic)
IS  - 0009-9236 (Linking)
VI  - 109
IP  - 5
DP  - 2021 May
TI  - Inosine 5'-Monophosphate to Raise Serum Uric Acid Level in Multiple System 
      Atrophy (IMPROVE-MSA study).
PG  - 1274-1281
LID - 10.1002/cpt.2082 [doi]
AB  - 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 x 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.
CI  - (c) 2020 The Authors. Clinical Pharmacology & Therapeutics (c) 2020 American Society 
      for Clinical Pharmacology and Therapeutics.
FAU - Jung Lee, Jae
AU  - Jung Lee J
AD  - Department of Neurology, Ilsan Paik Hospital, Inje University College of 
      Medicine, Goyang, South Korea.
FAU - Han Yoon, Jung
AU  - Han Yoon J
AD  - Department of Neurology, Ajou University School of Medicine, Suwon, South Korea.
FAU - Jin Kim, Sang
AU  - Jin Kim S
AD  - Department of Neurology, Busan Paik Hospital, Inje University College of 
      Medicine, Busan, South Korea.
FAU - Soo Yoo, Han
AU  - Soo Yoo H
AD  - Department of Neurology, Yonsei University College of Medicine, Seoul, South 
      Korea.
FAU - Jong Chung, Seok
AU  - Jong Chung S
AD  - Department of Neurology, Yonsei University College of Medicine, Seoul, South 
      Korea.
FAU - Hyun Lee, Yang
AU  - Hyun Lee Y
AD  - Department of Neurology, Yonsei University College of Medicine, Seoul, South 
      Korea.
FAU - Yun Kang, Suk
AU  - Yun Kang S
AD  - Department of Neurology, Hallym University Dongtan Sacred Heart Hospital, 
      Hwaseong, South Korea.
FAU - Shin, Hae-Won
AU  - Shin HW
AD  - Department of Neurology, Chung-Ang University College of Medicine, Seoul, South 
      Korea.
FAU - Keun Song, Sook
AU  - Keun Song S
AD  - Department of Neurology, Jeju National University School of Medicine, Jeju, South 
      Korea.
FAU - Yong Hong, Jin
AU  - Yong Hong J
AD  - Department of Neurology, Yonsei University Wonju College of Medicine, Wonju, 
      South Korea.
FAU - Sunwoo, MunKyung
AU  - Sunwoo M
AD  - Department of Neurology, Bundang Jesaeng General Hospital, Seongnam, South Korea.
FAU - Eun Lee, Ji
AU  - Eun Lee J
AD  - Department of Neurology, National Health Insurance Service Ilsan Hospital, 
      Goyang, South Korea.
FAU - Sam Baik, Jong
AU  - Sam Baik J
AD  - Department of Neurology, Sanggye Paik Hospital, Inje University College of 
      Medicine, Seoul, South Korea.
FAU - Sohn, Young H
AU  - Sohn YH
AD  - Department of Neurology, Yonsei University College of Medicine, Seoul, South 
      Korea.
FAU - Hyu Lee, Phil
AU  - Hyu Lee P
AD  - Department of Neurology, Yonsei University College of Medicine, Seoul, South 
      Korea.
AD  - Severance Biomedical Science Institute, Yonsei University College of Medicine, 
      Seoul, South Korea.
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
DEP - 20201130
PL  - United States
TA  - Clin Pharmacol Ther
JT  - Clinical pharmacology and therapeutics
JID - 0372741
RN  - 131-99-7 (Inosine Monophosphate)
RN  - 268B43MJ25 (Uric Acid)
SB  - IM
MH  - Aged
MH  - Female
MH  - Humans
MH  - Inosine Monophosphate/*adverse effects/*therapeutic use
MH  - Male
MH  - Middle Aged
MH  - Multiple System Atrophy/blood/*drug therapy
MH  - Treatment Outcome
MH  - Uric Acid/*blood
EDAT- 2020/10/17 06:00
MHDA- 2021/09/16 06:00
CRDT- 2020/10/16 12:11
PHST- 2020/05/23 00:00 [received]
PHST- 2020/09/28 00:00 [accepted]
PHST- 2020/10/17 06:00 [pubmed]
PHST- 2021/09/16 06:00 [medline]
PHST- 2020/10/16 12:11 [entrez]
AID - 10.1002/cpt.2082 [doi]
PST - ppublish
SO  - Clin Pharmacol Ther. 2021 May;109(5):1274-1281. doi: 10.1002/cpt.2082. Epub 2020 
      Nov 30.