Parkinson's Disease Clinical Trial
Official title:
A Randomized, Double-blind, Placebo-controlled Trial of Urate-elevating Inosine Treatment to Slow Clinical Decline in Early Parkinson's Disease
A multicenter, randomized, double-blind, placebo-controlled, phase 3 trial to determine
whether oral inosine dosed to moderately elevate serum urate (from ≤5.7 mg/dL to 7.1-8.0
mg/dL) over 2 years slows clinical decline in early PD.
Clinical decline will be assessed as change in the primary outcome variable of the Movement
Disorders Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS), a composite scale
comprising patient- and clinician-reported outcomes.
Capsules containing 500 mg of inosine (active drug) or ~500 mg of lactose (placebo) will be
taken orally up to two capsules three times per day (i.e., up to 3 g/day) for 24 months. In
the inosine-treated group the number of capsules taken per day will be titrated to serum
urate levels - measured at trough at study visits no more than three months apart - in order
to achieve concentrations of 7.1-8.0 mg/dL. Initial dosing will be tailored to individualized
factors including gender and pretreatment serum urate, and then advanced gradually toward the
projected target dose. Adjustments in dosing of placebo capsules in the control arm will be
algorithm-based to match dosing of inosine capsules in the active drug arm.
Following study drug discontinuation all subjects will be followed during a 3-month wash-out
period by telephone calls and a final study visit. All study visits after screening will
include measurement of the primary outcome variable (MDS-UPDRS) and most will include
secondary outcome variables: adverse events, dose adjustments, disability warranting
initiation of dopaminergic therapy, Quality of Life in Neurological Disorders (Neuro-QOL),
39-item Parkinson's Disease Questionnaire (PDQ-39), Schwab & England Activities of Daily
Living (S&E ADL) scale, Montreal Cognitive Assessment (MoCA), and orthostatic vital signs.
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