A new study has investigated the safety and tolerability of administering inosine, a urate precursor, in patients with early untreated Parkinson’s disease with baseline levels of urate below normal median of 6 mg/dL. In the SURE-PD (Safety of Urate Elevation in PD) trial, 75 subjects (mean age 62 years) received inosine or placebo for up to 24 months (Parkinson Study Group SURE-PD Investigators et al. JAMA Neurol 2014;71:141-150).  Inosine dosing was titrated to produce mildly (6.1-7.0 mg/dL) or moderately (7.1-8.0 mg/dL) elevated serum urate levels; the maximum dose of inosine was 500-1000 mg TID.