Urate levels predict survival in amyotrophic lateral sclerosis: Analysis of the expanded Pooled Resource Open-Access ALS clinical trials database

Muscle Nerve. 2018 Mar;57(3):430-434. doi: 10.1002/mus.25950. Epub 2017 Sep 21.

Abstract

Introduction: Urate has been identified as a predictor of amyotrophic lateral sclerosis (ALS) survival in some but not all studies. Here we leverage the recent expansion of the Pooled Resource Open-Access ALS Clinical Trials (PRO-ACT) database to study the association between urate levels and ALS survival.

Methods: Pooled data of 1,736 ALS participants from the PRO-ACT database were analyzed. Cox proportional hazards regression models were used to evaluate associations between urate levels at trial entry and survival.

Results: After adjustment for potential confounders (i.e., creatinine and body mass index), there was an 11% reduction in risk of reaching a survival endpoint during the study with each 1-mg/dL increase in uric acid levels (adjusted hazard ratio 0.89, 95% confidence interval 0.82-0.97, P < 0.01).

Discussion: Our pooled analysis provides further support for urate as a prognostic factor for survival in ALS and confirms the utility of the PRO-ACT database as a powerful resource for ALS epidemiological research. Muscle Nerve 57: 430-434, 2018.

Keywords: PRO-ACT; outcomes; predictor; prognostic factor; survival; uric acid.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Aged
  • Amyotrophic Lateral Sclerosis / blood
  • Amyotrophic Lateral Sclerosis / mortality*
  • Biomarkers / blood
  • Databases, Factual
  • Disease Progression
  • Female
  • Humans
  • Male
  • Middle Aged
  • Prognosis
  • Survival Rate
  • Uric Acid / blood*

Substances

  • Biomarkers
  • Uric Acid