dc.contributor.author |
Koga Y. |
|
dc.contributor.author |
Povalko N. |
|
dc.contributor.author |
Inoue E. |
|
dc.contributor.author |
Nakamura H. |
|
dc.contributor.author |
Ishii A. |
|
dc.contributor.author |
Suzuki Y. |
|
dc.contributor.author |
Yoneda M. |
|
dc.contributor.author |
Kanda F. |
|
dc.contributor.author |
Kubota M. |
|
dc.contributor.author |
Okada H. |
|
dc.contributor.author |
Fujii K. |
|
dc.date.accessioned |
2019-01-22T20:37:10Z |
|
dc.date.available |
2019-01-22T20:37:10Z |
|
dc.date.issued |
2018 |
|
dc.identifier.issn |
0340-5354 |
|
dc.identifier.uri |
https://dspace.kpfu.ru/xmlui/handle/net/147996 |
|
dc.description.abstract |
© 2018, The Author(s). Objective: To examine the efficacy and safety of the therapeutic regimen using oral and intravenous l-arginine for pediatric and adult patients with mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episodes (MELAS). Methods: In the presence and absence of an ictus of stroke-like episodes within 6 h prior to efficacy assessment, we correspondingly conducted the systematic administration of oral and intravenous l-arginine to 15 and 10 patients with MELAS in two, 2-year, prospective, multicenter clinical trials at 10 medical institutions in Japan. Subsequently, patients were followed up for 7 years. The primary endpoint in the clinical trial of oral l-arginine was the MELAS scale, while that for intravenous l-arginine was the improvement rates of headache and nausea/vomiting at 2 h after completion of the initial intravenous administration. The relationships between the ictuses of stroke-like episodes and plasma arginine concentrations were examined. Results: Oral l-arginine extended the interictal phase (p = 0.0625) and decreased the incidence and severity of ictuses. Intravenous l-arginine improved the rates of four major symptoms—headache, nausea/vomiting, impaired consciousness, and visual disturbance. The maximal plasma arginine concentration was 167 μmol/L when an ictus developed. Neither death nor bedriddenness occurred during the 2-year clinical trials, and the latter did not develop during the 7-year follow-up despite the progressively neurodegenerative and eventually life-threatening nature of MELAS. No treatment-related adverse events occurred, and the formulations of l-arginine were well tolerated. Conclusions: The systematic administration of oral and intravenous l-arginine may be therapeutically beneficial and clinically useful for patients with MELAS. |
|
dc.relation.ispartofseries |
Journal of Neurology |
|
dc.subject |
Ictus |
|
dc.subject |
l-Arginine |
|
dc.subject |
MELAS |
|
dc.subject |
Mitochondrial disease |
|
dc.subject |
Stroke-like episodes |
|
dc.title |
Therapeutic regimen of l-arginine for MELAS: 9-year, prospective, multicenter, clinical research |
|
dc.type |
Article |
|
dc.relation.ispartofseries-issue |
12 |
|
dc.relation.ispartofseries-volume |
265 |
|
dc.collection |
Публикации сотрудников КФУ |
|
dc.relation.startpage |
2861 |
|
dc.source.id |
SCOPUS03405354-2018-265-12-SID85056577601 |
|