Current and emerging treatments for amyotrophic lateral sclerosis

Review

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Authors: Stefano Zoccolella, Andrea Santamato, Paolo Lamberti

Published Date November 2009 Volume 2009:5 Pages 577 - 595

DOI: http://dx.doi.org/10.2147/NDT.S7788

Stefano Zoccolella¹, Andrea Santamato², Paolo Lamberti³

¹Azienda Ospedaliero-Universitaria

Ospedali Riuniti, Department of Medical and Neurological Sciences, Clinic of Nervous System Diseases, University of Foggia, Italy; ²Department of Physical Medicine and Rehabilitation, University of Foggia, OORR, Italy; ³Department of Neurology and Psychiatry, University of Bari, Italy

Background: Amyotrophic lateral sclerosis (ALS) is a relatively rare neurodegenerative disorder of both upper and lower motoneurons. Currently, the management of ALS is essentially symptoms-based, and riluzole, an antiglutamatergic agent, is the only drug for the treatment of ALS approved by the food and drug administration.

Objective: We reviewed current literature concerning emerging treatments for amyotrophic lateral sclerosis.

Methods: A Medline literature search was performed to identify all studies on ALS treatment published from January 1st, 1986 through August 31st, 2009. We selected papers concerning only disease-modifying therapy.

Results: Forty-eight compounds were identified and reviewed in this study.

Conclusions: Riluzole is the only compound that demonstrated a beneficial effect on ALS patients, but with only modest increase in survival. Although several drugs showed effective results in the animal models for ALS, none of them significantly prolonged survival or improved quality of life of ALS patients. Several factors have been implicated in explaining the predominantly negative results of numerous randomized clinical trials in ALS, including methodological problems in the use of animal-drug screening, the lack of assessment of pharmacokinetic profile of the drugs, and methodological pitfalls of clinical trials in ALS patients.

Keywords: amyotrophic lateral sclerosis, therapy, drug, survival