Trial reportJournal of alternative and complementary medicine (New York, N.Y.)2009
The treatment of multiple sclerosis with inosine.
Trial report in Journal of alternative and complementary medicine (New York, N.Y.), 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 48 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
48 citing papers in PubMed, 2 syntheses or guidelines pooled it, 100 citations in OpenAlex.
- Mendelian randomization study shows no causal effects of serum urate levels on the risk of MS.Neurology(R) neuroimmunology & neuroinflammation · 2021Pooled it
- Dietary interventions for multiple sclerosis-related outcomes.The Cochrane database of systematic reviews · 2020Pooled it
- Effects of elevated serum urate on cardiometabolic and kidney function markers in a randomised clinical trial of inosine supplementation.Scientific reports · 2022Trial
- Sex differences by design and outcome in the Safety of Urate Elevation in PD (SURE-PD) trial.Neurology · 2019Trial
- Inosine to increase serum and cerebrospinal fluid urate in Parkinson disease: a randomized clinical trial.JAMA neurology · 2014Trial
- Modulation of serum uric acid levels by inosine in patients with multiple sclerosis does not affect blood pressure.Journal of human hypertension · 2010Trial
- Serum Uric Acid Trajectories in Multiple Sclerosis: A 5-Year Longitudinal Comparison of High- and Moderate-Efficacy Therapies.Medical sciences (Basel, Switzerland) · 2026Article
- Changes in nucleotide and nucleoside metabolism in zebrafish brain exposed to paraquat and 6-hydroxydopamine.Fish physiology and biochemistry · 2025Article
- Identifying novel metabolites in children with attention-deficit hyperactivity disorder through metabolome profiling.Translational psychiatry · 2025Article
- Xanthine Oxidoreductase: A Double-Edged Sword in Neurological Diseases.Antioxidants (Basel, Switzerland) · 2025Review
- Multifaceted role of inosine in complex diseases and human health.Nutrition reviews · 2025Review
- The impact of purine nucleosides on neuroplasticity in the adult brain.Purinergic signalling · 2025Review
- Targeting uric acid: a promising intervention against oxidative stress and neuroinflammation in neurodegenerative diseases.Cell communication and signaling : CCS · 2025Review
- Metabolic reprogramming of CAR T cells: a new frontier in cancer immunotherapy.Frontiers in immunology · 2025Review
- Inosine reverses multidrug resistance in Gram-negative bacteria carrying mobilized RND-type efflux pump gene clustermSystems · 2024Article
- Antioxidant Therapies in the Treatment of Multiple Sclerosis.Biomolecules · 2024Review
- Uric acid and neurological disease: a narrative review.Frontiers in neurology · 2023Review
- Inosine in Neurodegenerative Diseases: From the Bench to the Bedside.Molecules (Basel, Switzerland) · 2022Review
- Investigating the Effect of Inosine on Brain Purinergic Receptors and Neurotrophic and Neuroinflammatory Parameters in an Experimental Model of Alzheimer's Disease.Molecular neurobiology · 2022Article
- Inosine in Biology and Disease.Genes · 2021Review
Corrections and comments
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Authors and funding
7 authors at 2 institutions in 1 country.
Funding
Abstract
objectiveThe objective of this study is to evaluate the safety and tolerability of inosine in patients with relapsing-remitting multiple sclerosis (RRMS). The secondary objectives are to assess the effects of inosine administration on serum urate (UA) levels, the progression of neurologic disability, the cumulative number of new, active lesions on magnetic resonance imaging (MRI), and changes in serum levels for markers of inflammation.
designOral administration of inosine was used to raise serum levels of the natural peroxynitrite scavenger UA in 16 patients with RRMS during a 1-year randomized, double-blind trial. OUTCOME MEASURES: The endpoints studied were relapse rate, disability assessed by the Kurtzke Expanded Disability Status Scale (EDSS), MRI, and analysis of serum levels of nitrotyrosine, and oxidative and pro-inflammatory makers.
resultsIncreased serum UA levels correlated with a significant decrease in the number of gadolinium-enhanced lesions and improved EDSS. A number of MRI intensity-based parameters were altered by inosine treatment, in certain cases correlating with changes in serum UA levels. In a patient with low serum UA and high lesion activity, raising UA levels by inosine treatment decreased serum nitrotyrosine while increasing the ratio of Th2 to Th1 cytokines in circulating cells. The only side-effect correlated with inosine treatment was kidney stone formation in 4/16 subjects.
conclusionsThese data suggest that the use of inosine to raise serum UA levels may have benefits for at least some MS patients. The effect of this treatment is likely to be a consequence of inactivation of peroxynitrite-dependent free radicals. Close monitoring of serum UA levels as well as other measures are required to avoid the potential development of kidney stones.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.