biostudies-literatureParkinson Study Group SURE-PD3 InvestigatorsNINDS NIH HHS926-939https://www.ebi.ac.uk/biostudies/studies/S-EPMC8441591biostudies-literatureUnknown326(10)<h4>Importance</h4>Urate elevation, despite associations with crystallopathic, cardiovascular, and metabolic disorders, has been pursued as a potential disease-modifying strategy for Parkinson disease (PD) based on convergent biological, epidemiological, and clinical data.<h4>Objective</h4>To determine whether sustained urate-elevating treatment with the urate precursor inosine slows early PD progression.<h4>Design, participants, and setting</h4>Randomized, double-blind, placebo-controlled, phase 3 trial of oral inosine treatment in early PD. A total of 587 individuals consented, and 298 with PD not yet requiring dopaminergic medication, striatal dopamine transporter deficiency, and serum urate below the population median concentration (<5.8 mg/dL) were randomized between August 2016 and DJAMAEffect of Urate-Elevating Inosine on Early Parkinson Disease Progression: The SURE-PD3 Randomized Clinical Trial.PMC8441591U01 NS090259U01 NS089666Brodsky MWaters CDaley AZhang LGoetz CLeWitt PAHoughton DJJames RLaFaver KHunter CSuski VLanghammer AAhmed APahwa RBwala GJain SRezak MEspay AJde Marcaida JAMestre TRussell DShah BBPeterson CLeehey MOakes DPoon CSerrano CCasaceli CKostrzebski MAscherio ABodis-Wollner ICurhan GCHouston EMacklin EAGoudreau JBolger PRudolph ABhatti DPothier LThomas KSchneider RBSoileau MMihaila DLaroche AShill HARabin MBixby MShoulson IRatel ASTogasaki DMVidenovic AWaikar SSMcMahon GMKeith KBluett BZauber SEKumar RCriswell SRLitvan IGauger LCiccarello JMari ZLang AMozaffarian DChristine CKaminski PDewey RBDeik AFBlindauer KGerald AHauser RAGunzler SAFitzgerald RCrotty GFEvatt MFang JYBoyd JTSimon DKMehta SHStover NSchwarzschild MAMarek KKurlan RPark AFriedman JHReich SAinslie MAldred JScott BHung ADurphy JLungu CBeck CASchiess MCChou KSimuni TMosovsky SLeDoux MSJimenez-Shahed JRosenthal LCloud LCallahan KFShprecher DHenchcliffe CKlements DSaint-Hilaire MParkinson Study Group SURE-PD3 InvestigatorsKamp CHinson VMcGraw MMorgan JCfalseEffect of Urate-Elevating Inosine on Early Parkinson Disease Progression: The SURE-PD3 Randomized Clinical Trial.<h4>Importance</h4>Urate elevation, despite associations with crystallopathic, cardiovascular, and metabolic disorders, has been pursued as a potential disease-modifying strategy for Parkinson disease (PD) based on convergent biological, epidemiological, and clinical data.<h4>Objective</h4>To determine whether sustained urate-elevating treatment with the urate precursor inosine slows early PD progression.<h4>Design, participants, and setting</h4>Randomized, double-blind, placebo-controlled, phase 3 trial of oral inosine treatment in early PD. A total of 587 individuals consented, and 298 with PD not yet requiring dopaminergic medication, striatal dopamine transporter deficiency, and serum urate below the population median concentration (<5.8 mg/dL) were randomized between August 2016 and D2021-01-01T00:00:00Z2021 Sep2026-05-31T05:00:43.333Z2026-04-08T08:11:38.853ZS-EPMC84415913451980210.1001/jama.2021.10207