Edaravone (Radicava): New Options for Slowing Progression
In 2017, edaravone became the second drug approved by the FDA for treating ALS. Edaravone is an antioxidant that helps reduce free radical cell damage. Results from clinical trials in Japan found edaravone slowed decline in daily living activities by 33% compared to placebo after 24 weeks of treatment. Common side effects include constipation, peripheral edema, and bruising. Edaravone requires an intravenous infusion daily for 14 days, followed by a 14-day drug holiday, then another 14-day treatment cycle. This treatment is typically continued long-term. Edaravone provides more options but is also very expensive and requires frequent clinic visits.
Experimental Medications Amyotrophic Lateral Sclerosis Treatment
Numerous other medications are being studied for treating Amyotrophic Lateral Sclerosis Treatment but have not yet received FDA approval. Some examples currently in clinical trials include dexpramipexole, lithium carbonate, resveratrol, neurpoetin, olesoxime, and giovanni. These experimental drugs target different pathways such as oxidative stress, inflammation, glutamate toxicity, or growth factors that may play a role in ALS. While results from early phase trials are promising, larger phase 3 trials are still needed to determine if they can truly slow progression or extend survival compared to existing standard of care medications. The drug development process takes many years and most experimental treatments ultimately fail to show meaningful benefit. Hope remains that future studies may identify more effective therapies.
Alternative and Complementary Approaches
While no alternative or complementary therapies have unequivocal scientific evidence to change the course of ALS, some patients choose to incorporate these approaches as part of support for symptom management or quality of life. Examples include dietary supplements (coenzyme Q10, acetyl-L-carnitine), physical or occupational therapy, acupuncture, and integrative medicine strategies focused on stress reduction. Stem cell therapy is another area attracting interest, but remains highly experimental with more research needed to determine safety and efficacy for ALS. As with any “alternative” treatment, patients are advised to discuss risks and benefits with their medical team given potential for unsafe drug interactions or delayed standard treatment.
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