Assessment of therapeutic response of edaravone and riluzole combination therapy in amyotrophic lateral sclerosis patients
Background: Amyotrophic lateral sclerosis (ALS) is a progressive disease characterized by chronic degeneration of upper and lower motor neurons and finally death within 3–5 years usually because of respiratory failure. Riluzole and edaravone are presently available treatments. It may be better to tr...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2022-01-01
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| Series: | Annals of Indian Academy of Neurology |
| Subjects: | |
| Online Access: | http://www.annalsofian.org/article.asp?issn=0972-2327;year=2022;volume=25;issue=4;spage=692;epage=697;aulast=Samadhiya |
| _version_ | 1797995740068315136 |
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| author | Swapnil Samadhiya Vijay Sardana Bharat Bhushan Dilip Maheshwari Ravi Goyal Pankaj |
| author_facet | Swapnil Samadhiya Vijay Sardana Bharat Bhushan Dilip Maheshwari Ravi Goyal Pankaj |
| author_sort | Swapnil Samadhiya |
| collection | DOAJ |
| description | Background: Amyotrophic lateral sclerosis (ALS) is a progressive disease characterized by chronic degeneration of upper and lower motor neurons and finally death within 3–5 years usually because of respiratory failure. Riluzole and edaravone are presently available treatments. It may be better to try combination therapy rather than taking individual medications. Objectives: To compare the effectiveness of (edaravone + riluzole) combination therapy versus riluzole therapy alone in slowing down the progression of ALS and to evaluate the role of serum creatinine as a marker of disease progression. Materials and Methods: Observational, randomized, parallel assignment, open label study. Thirty patients with definite and probable ALS were randomly assigned to two treatment groups. The case group received (riluzole + edaravone) for the initial 6 months, followed by riluzole for the next 6 months. The control group received riluzole for 12 months. After 6 and 12 months, changes in ALS functional rating scale (ALSFRS-R), mRS, and Japanese ALS scores were determined. P value <.05 was considered significant. Results: An increase in mRS at 6 months in the case group versus control group was 0.07 versus 0.20, respectively (p =0.02). At 12 months, it was 0.47 versus 0.53, respectively (p =0.17). A decrease in serum creatinine at 6 months in case group versus control group was 0.08 versus 0.09, respectively (p =.82). There was no change in ALS FRS for bulbar symptoms (salivation), 3.46 versus 3.46 in the case group (p =.018) for the first 6 months. Conclusions: Combined with riluzole, edaravone slows disease progression and is safe, but the effect is short-term. Bulbar symptoms respond better to combination therapy. The serum creatinine is helpful in monitoring disease progression. |
| first_indexed | 2024-04-11T10:06:27Z |
| format | Article |
| id | doaj.art-94c3f91c703847778579182c4bafe0ea |
| institution | Directory Open Access Journal |
| issn | 0972-2327 1998-3549 |
| language | English |
| last_indexed | 2024-04-11T10:06:27Z |
| publishDate | 2022-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Annals of Indian Academy of Neurology |
| spelling | doaj.art-94c3f91c703847778579182c4bafe0ea2022-12-22T04:30:14ZengWolters Kluwer Medknow PublicationsAnnals of Indian Academy of Neurology0972-23271998-35492022-01-0125469269710.4103/aian.aian_1083_21Assessment of therapeutic response of edaravone and riluzole combination therapy in amyotrophic lateral sclerosis patientsSwapnil SamadhiyaVijay SardanaBharat BhushanDilip MaheshwariRavi GoyalPankajBackground: Amyotrophic lateral sclerosis (ALS) is a progressive disease characterized by chronic degeneration of upper and lower motor neurons and finally death within 3–5 years usually because of respiratory failure. Riluzole and edaravone are presently available treatments. It may be better to try combination therapy rather than taking individual medications. Objectives: To compare the effectiveness of (edaravone + riluzole) combination therapy versus riluzole therapy alone in slowing down the progression of ALS and to evaluate the role of serum creatinine as a marker of disease progression. Materials and Methods: Observational, randomized, parallel assignment, open label study. Thirty patients with definite and probable ALS were randomly assigned to two treatment groups. The case group received (riluzole + edaravone) for the initial 6 months, followed by riluzole for the next 6 months. The control group received riluzole for 12 months. After 6 and 12 months, changes in ALS functional rating scale (ALSFRS-R), mRS, and Japanese ALS scores were determined. P value <.05 was considered significant. Results: An increase in mRS at 6 months in the case group versus control group was 0.07 versus 0.20, respectively (p =0.02). At 12 months, it was 0.47 versus 0.53, respectively (p =0.17). A decrease in serum creatinine at 6 months in case group versus control group was 0.08 versus 0.09, respectively (p =.82). There was no change in ALS FRS for bulbar symptoms (salivation), 3.46 versus 3.46 in the case group (p =.018) for the first 6 months. Conclusions: Combined with riluzole, edaravone slows disease progression and is safe, but the effect is short-term. Bulbar symptoms respond better to combination therapy. The serum creatinine is helpful in monitoring disease progression.http://www.annalsofian.org/article.asp?issn=0972-2327;year=2022;volume=25;issue=4;spage=692;epage=697;aulast=Samadhiyaalsfrsedaravonemrsriluzole |
| spellingShingle | Swapnil Samadhiya Vijay Sardana Bharat Bhushan Dilip Maheshwari Ravi Goyal Pankaj Assessment of therapeutic response of edaravone and riluzole combination therapy in amyotrophic lateral sclerosis patients Annals of Indian Academy of Neurology alsfrs edaravone mrs riluzole |
| title | Assessment of therapeutic response of edaravone and riluzole combination therapy in amyotrophic lateral sclerosis patients |
| title_full | Assessment of therapeutic response of edaravone and riluzole combination therapy in amyotrophic lateral sclerosis patients |
| title_fullStr | Assessment of therapeutic response of edaravone and riluzole combination therapy in amyotrophic lateral sclerosis patients |
| title_full_unstemmed | Assessment of therapeutic response of edaravone and riluzole combination therapy in amyotrophic lateral sclerosis patients |
| title_short | Assessment of therapeutic response of edaravone and riluzole combination therapy in amyotrophic lateral sclerosis patients |
| title_sort | assessment of therapeutic response of edaravone and riluzole combination therapy in amyotrophic lateral sclerosis patients |
| topic | alsfrs edaravone mrs riluzole |
| url | http://www.annalsofian.org/article.asp?issn=0972-2327;year=2022;volume=25;issue=4;spage=692;epage=697;aulast=Samadhiya |
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