Date of Award

2021

Degree Type

Selective Evidence-Based Medicine Review

Degree Name

Master of Science in Health Sciences - Physician Assistant

Department

Physician Assistant Studies

Abstract

Objective: The objective of this EBM review is to determine whether or not Edaravone is effective at slowing disease progression in patients with ALS.

Study Design: Review of three randomized control trials.

Data Source: All articles were published in English between 2014 and 2019. Articles were obtained from peer-reviewed journals and databases using Cochrane Collaboration, PubMed, Medline, and Embase.

Outcomes: The outcome measured was physical function assessed by the Amyotrophic Lateral Sclerosis Assessment and Questionnaire 40 Revised (ALSAQ-40R). Patients are asked to provide a perceived ability rating on a scale of 0 to 100, with 0 indicating perfect health and 100 a total loss of function.

Results: The Double bind RCTs of both Abe et al. (Amyotroph Lateral Scler Frontotemporal Degener. 2014;15:610-617. Doi: 10.3109/21678421.2014959024.) as well as The Writing Group on behalf of the Edaravone (MCI-186) ALS 17 Study Group. (Amyotroph Lateral Scler Frontotemporal Degener. 2017;18:20-31. Doi: 10.1080/21678421.2017.1362000) failed to demonstrate Edaravone efficacy against placebo (p=0.892 and p=0.1651, respectively). Final trial conducted by The Writing Group on behalf of the Edaravone (MCI-186) ALS 19 Study Group. (Lancet Neurol. 2017;15:505-512. Doi: 10.106/S1474-4422(17)30115-1) found that Edaravone was more effective at slowing disease progression than placebo in a well-defined patient population (p=0.0309).

Conclusion: A summation of results from three articles reviewed here would indicate that Edaravone does not slow disease progression in patients with ALS. There does appear to be some utility in early disease patients, but this finding requires further evaluation.

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