title: Effects of metal-containing drugs taken simultaneously with clioquinol upon clinical features of SMON.
abstract: In order to explore the effects of metals upon the subsequent onset of several clinical events in SMON, a retrospective cohort study was attempted. Study subjects were 216 "exposed" patients and 149 "unexposed" patients. "Exposure" was defined as the simultaneous ingestion of metal-containing drugs with clioquinol before the onset of neurological disorders. These two cohorts were identified from 531 patients among 832 patients, collected by the nationwide survey in 1975 and 1976. Effects provoked by ingestion of five metals (alminum, calcium, magnesium, copper and bismuth) were evaluated by relative risks with and without adjustment of the total amount of clioquinol ingested. Adjusted relative risks were estimated by maximum likelihood method. Significance of relative risk was determined by its 95% confidence interval. Following major findings emerged from the present analysis. (1) Simultaneous ingestion of Al-, Ca-, Mg-, Cu- or Bi-containing drugs with clioquinol significantly reduced the risk of developing motor disturbances. (2) Risk of developing visual disturbances were favorably modified by Al-containing drugs. (3) Clinical severity was significantly reduced by ingestion of Al-, Ca-, Mg- or Bi-containing drugs. (4) About 2-fold increase in risk of unfavorable clinical course was demonstrated by Al-containing drugs. (5) Onset of both green-fur on the tongue and relapse appeared unrelated to the metal-containing drugs ingested. (6) Combined ingestion of two kinds of metal-containing drugs with clioquinol appeared to yield more favorable effects than single ingestion of metal-containing drugs. (7) Al- or Bi-containing drugs demonstrated the strongest association with clinical features of SMON, followed by the drugs containing Mg or Ca. Cu-containing drugs had little association.
mesh_terms: D007464:Clioquinol / Q000008:administration & dosage / Q000378:metabolism / Q000633:toxicity*; D004347:Drug Interactions; D005260:Female; D006801:Humans; D006912:Hydroxyquinolines / Q000633:toxicity*; D008297:Male; D008670:Metals / Q000008:administration & dosage*; D008875:Middle Aged; D009043:Motor Activity / Q000187:drug effects; D009187:Myelitis / Q000139:chemically induced*; D009902:Optic Neuritis / Q000139:chemically induced*; D012306:Risk; D013577:Syndrome; D014059:Tongue / Q000187:drug effects; D014786:Vision Disorders / Q000139:chemically induced
chemical_list: D006912:Hydroxyquinolines; D008670:Metals; D007464:Clioquinol