Disease-modifying and symptomatic treatment of amyotrophic lateral sclerosis.

Disease-modifying and symptomatic treatment of amyotrophic lateral sclerosis.
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肌萎缩性侧硬化症的疾病改良和有症状治疗。

DOI:
10.1177/1756285617734734
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发表时间:
2018
影响因子:
5.9
通讯作者:
Huebers A
Huebers A
中科院分区:
医学2区
文献类型:
--
作者:
Dorst J;Ludolph AC;Huebers A

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在这篇综述中,我们总结了肌萎缩侧索硬化症(ALS)治疗的最重要的最新进展。在缓解疾病的治疗方案方面,右旋普拉克索、吡格列酮、锂等多种药物已经在大型多中心试验中进行了测试,尽管结果令人失望。因此,利鲁唑仍然是唯一直接缓解疾病的药物。此外,我们还讨论了反义寡核苷酸(ASO)作为一种新的潜在因果治疗选择。对症治疗的进展更为重要。营养和通气现在是 ALS 治疗的重要重点。多项研究已证实无创通气可改善患者的生活质量并延长生存期。另一方面,关于最佳营养管理尚未达成共识,但解决这一问题的大型多中心试验目前正在进行中。关于痉挛、肌肉痉挛或流涎等继发症状的证据通常仍然很少,但也将讨论一些新的见解。越来越多的证据表明,专科诊所的多学科护理可以提高生存率。
In this review, we summarize the most important recent developments in the treatment of amyotrophic lateral sclerosis (ALS). In terms of disease-modifying treatment options, several drugs such as dexpramipexole, pioglitazone, lithium, and many others have been tested in large multicenter trials, albeit with disappointing results. Therefore, riluzole remains the only directly disease-modifying drug. In addition, we discuss antisense oligonucleotides (ASOs) as a new and potentially causal treatment option. Progress in symptomatic treatments has been more important. Nutrition and ventilation are now an important focus of ALS therapy. Several studies have firmly established that noninvasive ventilation improves patients’ quality of life and prolongs survival. On the other hand, there is still no consensus regarding best nutritional management, but big multicenter trials addressing this issue are currently ongoing. Evidence regarding secondary symptoms like spasticity, muscle cramps or sialorrhea remains generally scarce, but some new insights will also be discussed. Growing evidence suggests that multidisciplinary care in specialized clinics improves survival.
DOI: 10.1212/01.wnl.0000156519.41681.27
发表时间: 2005-04-12
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影响因子: 9.9
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