Amyotrophic lateral sclerosis (ALS) is a debilitating neurodegenerative disease for which there is currently no cure. There has been much research carried out into this condition over the last couple of decades and our general understanding of ALS has greatly improved as a result.
The more research that is undertaken, the more likely it is that improved ALS treatment options will be developed and hopefully one day, a cure can be also be discovered. But for now, individuals diagnosed with amyotrophic lateral sclerosis have limited options at their disposal.
Despite there being no cure for ALS, there are some approved medications that have been shown to be useful in managing the disease. One of these is Rilutek (Riluzole).
Rilutek is also known by its more generic name Riluzole, which is the active ingredient that the drug contains. It became the first approved ALS drug when it was sanctioned by the Food and Drug Administration (FDA) in 1995. It works by helping to slow down the progression of the disease and can extend life expectancy of the patient.
It is important to note that Rilutek is not a cure for ALS and is not able to reverse the damage caused by the disease. The drug helps extend life expectancy by around 3 to 5 months and has been shown to work better when it is combined with other medications such as Nuedexta and Dexpramipexole.
Rilutek is thought to prevent the over-release of a substance called glutamate. This neurotransmitter is capable of damaging nerve cells if too much of it is produced. Rilutek disrupts the amount of glutamate that is released thus preventing many of the symptoms associated with ALS from occurring, at least in the short-term.
Neurotransmitters help move a message or signal between nerves. Normally, this is a quick process and the neurotransmitter is removed soon after so that other messages can be sent through. A build-up of glutamate is likely to have toxic consequences and damage the nerve cell irreparably.
The recommended dose of Rilutek has been proven to be important. Patients are normally put on 50mg a day on an empty stomach to start with. This is then increased to 100mg a day (50mg in the morning and 50mg in the evening) which has been shown to be the most effective dose.
Rilutek was initially a fairly expensive drug, but has become significantly cheaper in recent years. The drug has also now been sanctioned by the European Union.
There are several side-effects associated with Rilutek. The most significant one is the potential impact it can have on the liver. This is why the patient’s liver health should be monitored if they are taking the drug. The medication presents an increased risk of damage with long-term use.
Other side-effects include nausea, weakness, drowsiness, headache and loss of appetite. Those using the drug may also have issues with constipation or diarrhea.
Rilutek became an approved ALS drug following two important clinical trials in the 1990s. The first was a trial that involved 155 ALS patients in France and Belgium over the period of between one year and 18 months. The research found that those on Rilutek had an improved survival rate with an average of an extra 90 days life expectancy compared to those who were administered with a placebo.
The second trial was much larger and involved nearly a thousand patients in Europe and across the USA. This looked more closely at the dosage of Rilutek. Three groups received either 50mg, 100mg or 200mg, whilst another group was given a placebo. Although the results showed no difference between the placebo group and the 50mg group, there was a significant difference for those that were given 100mg and 200mg dosages.
100mg seemed to be the optimum dosage, with no further improvement noted when the amount was doubled. Both groups saw an increase in survival rate of 60 days compared to the placebo group.
This second trial was revisited recently and showed that Riluzole was not more effective in treating and prolonging survival rates when compared to a placebo in those who were in the later stages of the disease.
Research indeed suggests the best benefits of using the drug come with its adoption during the early stages of the disease.