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Practice Updates Issued for Amyotrophic Lateral Sclerosis

Last Updated: October 13, 2009.

New research promises to improve the management of patients with amyotrophic lateral sclerosis, according to two Practice Parameter updates published in the Oct. 13 issue of Neurology.

TUESDAY, Oct. 13 (HealthDay News) -- New research promises to improve the management of patients with amyotrophic lateral sclerosis, according to two Practice Parameter updates published in the Oct. 13 issue of Neurology.

In one update, Robert G. Miller, M.D., of the California Pacific Medical Center in San Francisco, and colleagues reviewed two Class I studies, eight Class II studies, and 30 Class III studies. Among their Level B recommendations: consideration of multidisciplinary clinic referral for optimizing health care delivery and prolonging survival; botulinum toxin B treatment for refractory sialorrhea; dextromethorphan and quinidine treatment for pseudobulbar affect; and screening for cognitive and behavioral impairment.

In a second update, the same research group reviewed eight Class I studies, five Class II studies, and 43 Class III studies. They recommended riluzole treatment to slow disease progression (Level A), along with consideration of percutaneous endoscopic gastrostomy to stabilize weight and prolong survival, and noninvasive ventilation to treat respiratory insufficiency and prolong survival (both Level B).

"This evidence-based review indicates some progress in evaluating new therapies for patients with amyotrophic lateral sclerosis," state the authors of the second update. "More high-quality studies have been reported leading to more confident recommendations regarding the value of noninvasive ventilation and percutaneous endoscopic gastrostomy."

Several authors of both updates reported financial relationships with pharmaceutical companies.

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