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Therapeutic regimen of l-arginine for MELAS: 9-year, prospective, multicenter, clinical research
http://hdl.handle.net/2241/00154105
http://hdl.handle.net/2241/0015410553d69f40-e917-44b6-bc21-9cb086f2324c
名前 / ファイル | ライセンス | アクション |
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JN_265-12 (566.0 kB)
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Item type | Journal Article(1) | |||||
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公開日 | 2019-01-15 | |||||
タイトル | ||||||
タイトル | Therapeutic regimen of l-arginine for MELAS: 9-year, prospective, multicenter, clinical research | |||||
言語 | ||||||
言語 | eng | |||||
資源タイプ | ||||||
資源 | http://purl.org/coar/resource_type/c_6501 | |||||
タイプ | journal article | |||||
著者 |
石井, 亜紀子
× 石井, 亜紀子× Koga, Yasutoshi× Povalko, Nataliya× Inoue, Eisuke× Nakamura, Hidefumi× Suzuki, Yasuhiro× Yoneda, Makoto× Kanda, Fumio× Kubota, Masaya× Okada, Hisashi× Fujii, Katsunori |
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抄録 | ||||||
内容記述タイプ | Abstract | |||||
内容記述 | 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. |
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書誌情報 |
Journal of neurology 巻 265, 号 12, p. 2861-2874, 発行日 2018-12 |
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ISSN | ||||||
収録物識別子タイプ | ISSN | |||||
収録物識別子 | 0340-5354 | |||||
書誌レコードID | ||||||
収録物識別子タイプ | NCID | |||||
収録物識別子 | AA00703276 | |||||
PubMed番号 | ||||||
識別子タイプ | PMID | |||||
関連識別子 | 30269300 | |||||
DOI | ||||||
識別子タイプ | DOI | |||||
関連識別子 | 10.1007/s00415-018-9057-7 | |||||
権利 | ||||||
権利情報 | © The Author(s) 2018 | |||||
権利 | ||||||
権利情報 | This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creat iveco mmons .org/licen ses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. | |||||
著者版フラグ | ||||||
値 | publisher | |||||
出版者 | ||||||
出版者 | Springer |