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Therapeutic regimen of l-arginine for MELAS: 9-year, prospective, multicenter, clinical research

Overview of attention for article published in Journal of Neurology, September 2018
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Title
Therapeutic regimen of l-arginine for MELAS: 9-year, prospective, multicenter, clinical research
Published in
Journal of Neurology, September 2018
DOI 10.1007/s00415-018-9057-7
Pubmed ID
Authors

Yasutoshi Koga, Nataliya Povalko, Eisuke Inoue, Hidefumi Nakamura, Akiko Ishii, Yasuhiro Suzuki, Makoto Yoneda, Fumio Kanda, Masaya Kubota, Hisashi Okada, Katsunori Fujii

Abstract

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). 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. 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. The systematic administration of oral and intravenous L-arginine may be therapeutically beneficial and clinically useful for patients with MELAS.

Twitter Demographics

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Mendeley readers

The data shown below were compiled from readership statistics for 12 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 12 100%

Demographic breakdown

Readers by professional status Count As %
Student > Bachelor 3 25%
Unspecified 2 17%
Other 2 17%
Student > Postgraduate 2 17%
Student > Master 1 8%
Other 2 17%
Readers by discipline Count As %
Medicine and Dentistry 4 33%
Unspecified 3 25%
Neuroscience 2 17%
Nursing and Health Professions 1 8%
Agricultural and Biological Sciences 1 8%
Other 1 8%

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 01 October 2018.
All research outputs
#11,325,731
of 12,731,604 outputs
Outputs from Journal of Neurology
#2,113
of 2,398 outputs
Outputs of similar age
#225,445
of 261,217 outputs
Outputs of similar age from Journal of Neurology
#57
of 61 outputs
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