Maximizing the Survival of Amyotrophic Lateral Sclerosis Patients: Current Perspectives

Table 1

Interventions that may lead to survival benefits in ALS patients.

Intervention	Mechanism	Possible survival and progression benefits
Riluzole	Glutamate antagonist	3 months (possibility > 6 months if used early on)
Edaravone	free-radical scavenger that interferes with the oxidative stress	Slows disease progression by 33% in selected subgroup of ALS patients
Masitinib	Tyrosine kinase inhibitor. Modulates neuroinflammation and microgliosis	Slows disease progression by 27%
Gene therapy	Antisense oligonucleotide; Silences SOD1 expression	No available data
Stem cell transplantation	Release of growth factors and enhance regeneration of degenerated neurons	No efficacy was demonstrated in phase II studies
Vitamin E	Antioxidant	Reduces the risk of developing ALS; Conflicting data on efficacy on disease progression
Vitamin D	Antioxidant; Increase neurotrophic factors; Increase calcium binding protein	Slows the disease progression by 1–4 points on the ALSFRS-R
Multidisciplinary clinic	Early institution of interventions with survival benefits; Monitoring and preventing complications; Reduces hospitalization duration	7.5 months
Enteral feeding	Weight stabilization	10 months but recent data argue against this
Non-invasive ventilation	Improves oxygenation by supporting respiratory muscle function; Slows rate of FVC^# decline	5–7 months
Invasive ventilation	Improves oxygenation by replacing respiratory muscle function	1–2 years

ALSFRS-R: amyotrophic lateral sclerosis functional rating scale-revised.
^#FVC: forced vital capacity.