Evidence⁃based evaluation of therapeutic measures for amyotrophic lateral sclerosis

Abstract

Objective To evaluate the therapeutic efficacy and side effects of various treatments for amyotrophic lateral sclerosis (ALS) in order to formulate the best therapeutic regimen. Methods ALS, Riluzole, Gabapentin, Lamotrigine, neurotrophic factor, antioxidant and free radical scavenger gene therapy, neural stem cell treatment, treatment were appointed as retrieval words. MEDLINE, Cochrane Library, Wanfang Database for Scientific Journals in China and Chinese National Knowledge Infrastructure (CNKI) for Scientific Journals Database were used for retrieval. Related clinical guidelines, systematic reviews, randomised controlled trials, controlled clinical trials and case⁃observation studies were collected following the corresponding inclusion criteria and exclusion criteria and evaluated by Jadad Scale to judge the authenticity and reliability of the conclusion. Manual searching was also used. Results After screening, 39 related articals were selected as follow: 4 systematic reviews, 18 randomised controlled trials, 11 controlled clinical trials, and 6 case ⁃ observation studies. Twenty ⁃ seven articals were of high quality (according to Jadad Scale, 11 with score 4, 13 with score 5, and 3 with score 7), while 12 were of low quality with score 3. According to the evaluation of therapeutic efficacy and side effects of various therapies, it is suggested that: 1) The Riluzole is the only drug approved by American FDA, lacking of more effective treatments. 2) When the patients' condition is not relieved, medicine ⁃ combined therapies and symptomatic treatments should be used. Conclusion Evidence⁃based medicine can provide best clinical evidence on ALS treatment. DOI：10.3969/j.issn.1672⁃6731.2012.03.009