Updated Review
Published: January 3, 2022
Since our review, the results of a 12-week open-label trial of inosine in people with ALS were published (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6292193/). This study showed excellent safety and tolerability, and it showed encouraging reductions in biomarkers of oxidative stress and damage. When ALSFRS-R progression was compared to predicted progression, no significant slowing was observed. However, this study was likely underpowered, and 12-weeks is a short duration in which to assess changes on this measure. Based on these results, we upgrade our Mechanisms grade to A. No other grade changes appear warranted. We continue to support further trials of inosine in people with ALS.
Key Information
Click on any letter grade below for more info:
Mechanism Grade: A
Preclinical Trials Grade: U
Cases Grade: D
Trials Grade: U
Risks Grade: C
Published: Aug 2016
Inosine is a low-cost supplement that increases the levels of urate, a naturally occurring antioxidant. With appropriate blood and urine monitoring, it appears reasonably safe. Epidemiologic data suggest that high urate levels may be associated with improved survival in ALS, which prompted preclinical studies and clinical trials of inosine. These are still ongoing and will help determine whether inosine could be a useful treatment for ALS.
Declaration of interest: ALSUntangled is sponsored by the ALS Association and the Motor Neurone Disease Association.
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