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Urate Natural Antioxidant: No Longer Effective for Slowing the Progression of Parkinson's Disease

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News Release, International Society of Antioxidants – February 22, 2022

The hypothesis that raising the brain levels of the natural antioxidant urate could slow the progression of Parkinson's disease (PD) has been disproven by researchers at Massachusetts General Hospital (MGH). In more details, "While our study did not rule out a protective effect of urate in Parkinson's, it clearly showed that increasing urate did not slow disease progression based on clinical assessments and serial bran scan biomarkers of neurodegeneration."

No treatment to date has been shown to prevent or forestall progression of Parkinson's disease, which affects the body's motor system. For its Phase III trial, known as SURE-PD3, the MGH-led team enrolled 298 individuals recently diagnosed with early Parkinson's disease based on scans that indicated substantial loss of the dopamine-producing brain cells characteristic of PD. The results showed that of participants who received over the course of two years the metabolite inosine—which raises levels of urate in the brain and blood and has shown neuroprotective properties in preclinical models—there was no significant difference in the rate of disease progression compared to those in the placebo group. The study did reveal, however, an increased rate of kidney stones among those randomized to inosine treatment.

Despite the lack of evidence to support urate elevation, Schwarzschild found the study successful in other ways. "The findings were very helpful in providing a reality check that now allows the field to move on to other therapeutic approaches," he explains. "We also learned a lot in terms of clinical trials science for Parkinson's, and ways to conduct future studies that will increase their chance of success." One of those ways is to tailor treatment to subsets of patients who are most likely to benefit—a hallmark of the move to precision medicine in Parkinson's research. In SURE-PD3, for example, only patients who had lower levels of urate were enrolled to increase the chance of benefit and reduce the chance of side effects. Another innovative feature of the trial is that many participants gave blood samples for genotyping—a valuable source of genetic information that could figure in the hunt for clinical solutions in smaller subpopulations of PD patients.

Redox medicine will be extensively discussesd in Paris Redox 2022 by expert speakers like Prof. Kenneth Olson and Dr. Cristian O'Flaherty.

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