A double-blind clinical trial of the effects of inosine pranobex in immunodepressed patients with prolonged generalized lymphadenopathy.

In a double-blind clinical trial, 61 immunodepressed males with persistent generalized lymphadenopathy (PGL) received one of two doses (1 or 3 g/day) of the immunomodulating drug inosine pranobex (INPX) or placebo for a period of 28 days. In the high-dose group, clinical improvement was reported by 11 of 21 patients (52%), within 5 months of the cessation of treatment. In contrast, 3 of 19 patients (16%) in the placebo group reported clinical improvement by that time. Patients receiving 3 g/day INPX showed a significant increase in NK cell activity by Day 14 and this elevation was still evident at the last follow-up examination 1 year after treatment. Increases in total T lymphocytes (T-11) and the percentage of T helper cells (T-4) were also observed. These responses were delayed and reached their peaks 2 months after the termination of drug treatment. The kinetics of these effects suggest that INPX stimulates the production of precursor cells and initiates a cascade of lymphocyte differentiation capable of producing long-term restoration of cell-mediated immunity. These data indicate that INPX may be beneficial to patients with PGL.