Related Experiment Videos
Riluzole for amyotrophic lateral sclerosis (ALS)/motor neuron disease (MND).
R G Miller1, J D Mitchell, D H Moore
1Department of Neurology, California Pacific Medical Center, 2324 Sacramento Street, San Francisco 94115, USA. rmiller@cooper.cpmc.org
The Cochrane Database of Systematic Reviews
|November 1, 2001
Summary
Riluzole (100 mg daily) modestly improves survival for amyotrophic lateral sclerosis (ALS) patients. While not affecting neurological function, it delays disease progression and increases survival rates, though with increased liver enzyme levels.
Area of Science:
- Neurology
- Pharmacology
- Clinical Trials
Background:
- Amyotrophic lateral sclerosis (ALS) treatment options are limited.
- Riluzole's efficacy and safety profile remain subjects of ongoing debate.
- Concerns exist regarding riluzole's cost, modest effectiveness, and potential adverse effects.
Purpose of the Study:
- To evaluate the efficacy of riluzole in extending survival for ALS patients.
- To determine if riluzole delays the need for life-sustaining interventions like tracheostomy and mechanical ventilation.
Main Methods:
- Systematic review and meta-analysis of randomized controlled trials.
- Searched the Cochrane Neuromuscular Disease Group Register and contacted experts.
- Included trials involving adults diagnosed with ALS, comparing riluzole to placebo.
Main Results:
- Riluzole (100 mg/day) significantly reduced 12-month mortality (OR 0.57).
- A survival advantage was observed at 6, 9, 12, and 15 months, but not at 3 or 18 months.
- No significant improvement in bulbar function or muscle strength was noted; however, quality of life was maintained longer in the riluzole group. Increased alanine transferase levels were more frequent with riluzole.
Conclusions:
- Riluzole at 100 mg daily offers a modest survival benefit for individuals with ALS.
- The drug appears to delay disease progression, contributing to longer survival.
- Elevated liver enzymes are a notable adverse effect requiring monitoring.