The Evidence for Symptomatic Treatments in ALS
The Evidence for Symptomatic Treatments in ALS
ALS remains an incurable, fatal condition and better disease-modifying treatments are urgently required. However, much can be done for people living with ALS while we wait. Symptomatic treatments can improve quality of life, which is paramount when quantity of life is limited. There is good evidence underpinning riluzole and NIV and reasonable evidence for multidisciplinary care. In clinic, many other measures appear helpful to individuals, but evidence is generally weak and RCTs are required. Areas of priority include vitamin D supplementation, role of gastrostomy, optimal management of secretions, pain, spasticity and depression, and DVT prophylaxis. Exciting new techniques such as diaphragmatic pacing are undergoing further evaluation.
Conclusion
ALS remains an incurable, fatal condition and better disease-modifying treatments are urgently required. However, much can be done for people living with ALS while we wait. Symptomatic treatments can improve quality of life, which is paramount when quantity of life is limited. There is good evidence underpinning riluzole and NIV and reasonable evidence for multidisciplinary care. In clinic, many other measures appear helpful to individuals, but evidence is generally weak and RCTs are required. Areas of priority include vitamin D supplementation, role of gastrostomy, optimal management of secretions, pain, spasticity and depression, and DVT prophylaxis. Exciting new techniques such as diaphragmatic pacing are undergoing further evaluation.
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