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04:41
Lumbar Intrathecal Injection of SOD1-ASOs for Precise CNS Targeting and Predictive Efficacy in Human SOD1-G93A ALS Mice
Published on: February 24, 2026
Riluzole for amyotrophic lateral sclerosis (ALS)/motor neuron disease (MND).
R G Miller1, J D Mitchell, M Lyon
1California Pacific Medical Center, Department of Neurosciences, 2324 Sacramento Street, Suite 150, San Francisco, California 94115, USA. millerrx@sutterhealth.org
The Cochrane Database of Systematic Reviews
|January 27, 2007
Summary
Riluzole (riluzole) at 100 mg daily may extend survival for amyotrophic lateral sclerosis (ALS) patients by approximately two to three months. This treatment is generally safe, offering a modest survival benefit for ALS management.
Area of Science:
- Neurology
- Pharmacology
Background:
- Riluzole is approved for amyotrophic lateral sclerosis (ALS) treatment globally.
- Its clinical utility is debated due to cost and modest efficacy.
Purpose of the Study:
- To evaluate riluzole's efficacy in prolonging survival in ALS patients.
- To assess its impact on delaying tracheostomy and mechanical ventilation.
Main Methods:
- Systematic review of randomized controlled trials (RCTs) identified through comprehensive database searches (Cochrane, MEDLINE, EMBASE).
- Included adults diagnosed with ALS, comparing riluzole treatment against placebo.
- Primary outcome: pooled hazard ratio for tracheostomy-free survival; Secondary outcomes: mortality, neurological function, muscle strength, and adverse events.
Main Results:
- Four RCTs with 974 riluzole and 503 placebo patients were analyzed.
- Riluzole 100 mg/day showed a statistically significant survival benefit in a homogeneous subgroup (P=0.042, HR=0.80).
- Overall analysis, including heterogeneous trials, approached significance (P=0.056, HR=0.84), indicating a 9% increase in one-year survival probability. Mild benefits in bulbar/limb function noted, but not muscle strength. Increased alanine transferase levels observed.
Conclusions:
- Riluzole 100 mg daily appears safe and likely extends median survival by 2-3 months for ALS patients.
- The drug offers a modest but potentially valuable survival benefit in ALS management.
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