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Review
. 2017 Oct 9:11:1756285617734734.
doi: 10.1177/1756285617734734. eCollection 2018.

Disease-modifying and symptomatic treatment of amyotrophic lateral sclerosis

Johannes Dorst  1 , Albert C Ludolph  2 , Annemarie Huebers  2
Affiliations
Review

Disease-modifying and symptomatic treatment of amyotrophic lateral sclerosis

Johannes Dorst et al. Ther Adv Neurol Disord. .

Abstract

In this review, we summarize the most important recent developments in the treatment of amyotrophic lateral sclerosis (ALS). In terms of disease-modifying treatment options, several drugs such as dexpramipexole, pioglitazone, lithium, and many others have been tested in large multicenter trials, albeit with disappointing results. Therefore, riluzole remains the only directly disease-modifying drug. In addition, we discuss antisense oligonucleotides (ASOs) as a new and potentially causal treatment option. Progress in symptomatic treatments has been more important. Nutrition and ventilation are now an important focus of ALS therapy. Several studies have firmly established that noninvasive ventilation improves patients' quality of life and prolongs survival. On the other hand, there is still no consensus regarding best nutritional management, but big multicenter trials addressing this issue are currently ongoing. Evidence regarding secondary symptoms like spasticity, muscle cramps or sialorrhea remains generally scarce, but some new insights will also be discussed. Growing evidence suggests that multidisciplinary care in specialized clinics improves survival.

Keywords: amyotrophic lateral sclerosis; antisense nucleotides; nutrition; riluzole; symptomatic therapy; ventilation.

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Conflict of interest statement

Conflict of interest statement: The authors declare that there is no conflict of interest.

Figures

Figure 1.
Figure 1.
Mode of action of ASOs in patients with SOD1 mutations. ASO, antisense oligonucleotide.
See this image and copyright information in PMC

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