What Are the Treatment Options for ALS?
Current treatment options for ALS are limited, but new treatments are on the horizon.
Amyotrophic lateral sclerosis (ALS) is a chronic, progressive disease characterized by nerve degeneration and loss of muscle function. Also known as Lou Gehrig’s disease, ALS is life changing and may leave you wondering what all the treatment options are.
ALS treatment involves working with a team of healthcare professionals who can help address all of your needs. This usually involves a neurologist and respiratory therapist at the very least.
There aren’t many treatment options available for ALS, but novel treatments are currently being explored. It’s possible that within the next decade, new and better treatments will be available for ALS. It’s hoped that these new medications will address the cause of the illness rather than the symptoms.
Treatment for ALS is largely focused on relieving your symptoms. This is because the exact cause of ALS isn’t fully understood. But there are medications that can help slow the progression of ALS.
Riluzole is a medication that’s often recommended to be started immediately. It’s the only medication shown to prolong survival time in those with ALS. It works by preventing the buildup of glutamate, a neurotransmitter thought to cause some of the main symptoms like weakness and loss of muscle function.
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Several other medications may also be recommended to manage troublesome symptoms like painful muscle spasms. These may include the following:
Since breathing eventually becomes a central issue in ALS, options for respiratory support are discussed with a healthcare professional early in your treatment plan. This is because weakness of your breathing muscles can ultimately lead to respiratory failure.
There are a few different options to support breathing with ALS:
- positive pressure ventilation
- tracheostomy (a tube is surgically placed into your trachea)
- ventilator
The need for assisted breathing tools depends on how much the disease has progressed. You might initially benefit from positive pressure ventilation and later require a tracheostomy. A ventilator may be required in late-stage ALS.
Difficulties with chewing and swallowing are also commonly observed in ALS and can lead to weight loss or malnourishment. Eating calorie-dense foods and nutritional beverages is recommended. Working with a dietician may be beneficial.
In some cases, a tube may be inserted into your stomach to provide direct nutritional support. This can be considered if chewing and swallowing become too challenging.
Are there any new treatments for ALS?
Edaravone is a relatively new medication that’s sometimes recommended to taken with riluzole. It’s an antioxidant that helps to protect your nerves from degeneration. It’s not been shown to improve survival time, but it may improve your function according to a 2018 review.
Relyvrio is another medication that was recently approved by the Food and Drug Administration (FDA) for ALS. It was shown to slow ALS progression in a small clinical trial performed in 2020. Research on Relyvrio is extremely limited though.
Several other potential therapies are currently being studied for their use in ALS, although none so far have shown to be beneficial. Therapies are nonetheless being aggressively pursued.
According to 2022 research, some therapies currently undergoing research include:
