Advertisement
Research Article| Volume 404, P47-51, September 15, 2019

Safety and efficacy of edaravone compared to historical controls in patients with amyotrophic lateral sclerosis from North-Eastern Italy

  • Author Footnotes
    1 These authors contributed equally to the work.
    Andrea Fortuna
    Footnotes
    1 These authors contributed equally to the work.
    Affiliations
    Neuromuscular Center, Department of Neurosciences, University of Padova, Italy
    Search for articles by this author
  • Author Footnotes
    1 These authors contributed equally to the work.
    Matteo Gizzi
    Footnotes
    1 These authors contributed equally to the work.
    Affiliations
    Neuromuscular Center, Department of Neurosciences, University of Padova, Italy
    Search for articles by this author
  • Luca Bello
    Affiliations
    Neuromuscular Center, Department of Neurosciences, University of Padova, Italy
    Search for articles by this author
  • Ilaria Martinelli
    Affiliations
    Neuromuscular Center, Department of Neurosciences, University of Padova, Italy
    Search for articles by this author
  • Cinzia Bertolin
    Affiliations
    Neuromuscular Center, Department of Neurosciences, University of Padova, Italy
    Search for articles by this author
  • Elena Pegoraro
    Affiliations
    Neuromuscular Center, Department of Neurosciences, University of Padova, Italy
    Search for articles by this author
  • Maurizio Corbetta
    Affiliations
    Neuromuscular Center, Department of Neurosciences, University of Padova, Italy

    Department of Neurosciences, University of Padova, Italy
    Search for articles by this author
  • Gianni Sorarù
    Correspondence
    Corresponding author at: Neuromuscular Center, Department of Neurosciences, University of Padova, 35128 Padova, Italy.
    Affiliations
    Neuromuscular Center, Department of Neurosciences, University of Padova, Italy
    Search for articles by this author
  • Edaravone Study Group
    Author Footnotes
    2 G.S., E.P., and A.M. designed the research; A.F., M.G. and I.M. performed evaluations; L.B. conducted statistical analysis; G.S., C.B. and L.B. performed data analysis.; Medical Doctors belonging to EDARAVONE STUDY GROUP performed pre-starting evaluations and strict patients' follow up. All authors wrote and reviewed the article.
  • Author Footnotes
    1 These authors contributed equally to the work.
    2 G.S., E.P., and A.M. designed the research; A.F., M.G. and I.M. performed evaluations; L.B. conducted statistical analysis; G.S., C.B. and L.B. performed data analysis.; Medical Doctors belonging to EDARAVONE STUDY GROUP performed pre-starting evaluations and strict patients' follow up. All authors wrote and reviewed the article.

      Highlights

      • We conducted a retrospective study on edaravone in a Caucasian ALS population.
      • No benefit on ALS progression was observed at 3 and 6 months.
      • Creatinine values significantly decreased in treated patients at 3 and 6 months.
      • Quality of life significantly worsened in treated patients at 3 and 6 months.
      • Edaravone was overall well tolerated.

      Abstract

      Objective

      To test efficacy and tolerability of edaravone in patients with amyotrophic lateral sclerosis (ALS) originating from North-Eastern Italy.

      Methods

      We compared 3-month and 6-month changes of ALSFRS-R score, FVC value, and MRC score of 31 consecutive patients with ALS who were treated with edaravone to those of 50 historical ALS patients who were not treated with edaravone.

      Results

      No significant difference for any functional measures was found between the two groups at each time point as compared to baseline. In treated patients, we also observed creatinine values to significantly decrease at 3 and 6 months (p = 0.0078 and 0.030, respectively) and ALSAQ5 score to significantly increase (i.e. worse quality of life) at 3 and 6 months (p = 0.0005 and 0.0078, respectively). Yet, we observed an overall safety of the medication over the 6-month period of observation.

      Conclusions

      Our retrospective study suggests no benefit of edaravone on ALS in populations of Caucasian ancestry.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Journal of the Neurological Sciences
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Hardiman O.
        • Al-Chalabi A.
        • Chio A.
        • et al.
        Amyotrophic lateral sclerosis.
        Nat. Rev. Dis. Prim. 2017; 3https://doi.org/10.1038/nrdp.2017.71
        • Renton A.E.
        • Traynor B.J.
        State of play in amyotrophic lateral sclerosis genetics.
        Nat. Neurosci. 2015; 17: 17-23https://doi.org/10.1038/nn.3584.State
        • Phukan J.
        • Elamin M.
        • Bede P.
        • et al.
        The syndrome of cognitive impairment in amyotrophic lateral sclerosis: a population-based study.
        J. Neurol. Neurosurg. Psychiatry. 2012; 83: 102-108https://doi.org/10.1136/jnnp-2011-300188
        • Elamin M.
        • Bede P.
        • Byrne S.
        • et al.
        Cognitive changes predict functional decline in ALS: a population-based longitudinal study.
        Neurology. 2013; 80: 1-8https://doi.org/10.1212/WNL.0b013e31828f18ac
        • Talbott E.O.
        • Malek A.M.
        • Lacomis D.
        The Epidemiology of Amyotrophic Lateral Sclerosis.
        1st ed. vol 138. Elsevier B.V, 2016https://doi.org/10.1016/B978-0-12-802973-2.00013-6
        • Chia R.
        • Chiò A.
        • Traynor B.J.
        Novel genes associated with amyotrophic lateral sclerosis: diagnostic and clinical implications.
        Lancet Neurol. 2018; 17: 94-102https://doi.org/10.1016/S1474-4422(17)30401-5
        • Chiò A.
        • Traynor B.J.
        • Lombardo F.
        • et al.
        Prevalence of SOD1 mutations in the Italian ALS population.
        Neurology. 2008; 70: 533-537https://doi.org/10.1212/01.wnl.0000299187.90432.3f
        • Al-Chalabi A.
        • van den Berg L.H.
        • Veldink J.
        Gene discovery in amyotrophic lateral sclerosis: implications for clinical management.
        Nat. Rev. Neurol. 2017; 13: 96-104https://doi.org/10.1038/nrneurol.2016.182
        • D'Amico E.
        • Factor-Litvak P.
        • Santella R.M.
        • Mitsumoto H.
        Clinical perspective of oxidative stress in sporadic ALS.
        Free Radic. Biol. Med. 2013; 65https://doi.org/10.1016/j.freeradbiomed.2013.06.029
        • Garbuzova-Davis S.
        • Rodrigues M.C.O.
        • Hernandez-Ontiveros D.G.
        • et al.
        Amyotrophic lateral sclerosis: a neurovascular disease.
        Brain Res. 2011; 1398: 113-125https://doi.org/10.1016/j.brainres.2011.04.049
        • Fujisawa A.
        • Yamamoto Y.
        Edaravone, a potent free radical scavenger, reacts with peroxynitrite to produce predominantly 4-NO-edaravone.
        Redox Rep. 2016; 21: 98-103https://doi.org/10.1179/1351000215Y.0000000025
        • Beal M.F.
        • Ferrante R.J.
        • Browne S.E.
        • Matthews R.T.
        • Kowall N.W.
        • Brown R.H.J.
        Increased 3-nitrotyrosine in both sporadic and familial amyotrophic lateral sclerosis.
        Ann. Neurol. 1997; 42: 644-654https://doi.org/10.1002/ana.410420416
        • Yoshino H.
        • Kimura A.
        Investigation of the therapeutic effects of edaravone, a free radical scavenger, on amyotrophic lateral sclerosis (Phase II study).
        Amyotroph. Lateral Scler. 2006; 7: 247-251https://doi.org/10.1080/17482960600881870
        • Abe K.
        • Itoyama Y.
        • Sobue G.
        • et al.
        Confirmatory double-blind, parallel-group, placebo-controlled study of efficacy and safety of edaravone (MCI-186) in amyotrophic lateral sclerosis patients.
        Amyotroph. Lateral Scler. Frontotemporal Degener. 2014; 15: 610-617https://doi.org/10.3109/21678421.2014.959024
        • Abe K.
        • Aoki M.
        • Tsuji S.
        • et al.
        Safety and efficacy of edaravone in well defined patients with amyotrophic lateral sclerosis: a randomised, double-blind, placebo-controlled trial.
        Lancet Neurol. 2017; 16: 505-512https://doi.org/10.1016/S1474-4422(17)30115-1
        • Corporation MTP
        Mitsubishi Tanabe Pharma Corporation Receives Approval for Additional Indication for Amyotrophic Lateral Sclerosis (ALS) in Japan.
        2015: 6205
        • Services D of H and H
        Approval Letter NDA 209176.
        2017
        • AIFA
        Determina 28 giugno 2017.
        in: Gazz Uff della Repubb Ital. 2017
        • Nakamaru Y.
        • Kinoshita S.
        • Kawaguchi A.
        • Takei K.
        • Palumbo J.
        • Suzuki M.
        Pharmacokinetic profile of edaravone: a comparison between Japanese and Caucasian populations.
        Amyotroph Lateral Scler Frontotemporal Degener. 2017; 18: 80-87https://doi.org/10.1080/21678421.2017.1353100
        • Corporation MTP
        Edaravone injection.
        in: The Japanese Pharmacopoeia. 2015
        • Chiò A.
        • Calvo A.
        • Bovio G.
        • et al.
        Amyotrophic lateral sclerosis outcome measures and the role of albumin and creatinine: a population-based study.
        JAMA Neurol. 2014; 71: 1134-1142https://doi.org/10.1001/jamaneurol.2014.1129
        • Gladman M.
        • Dehaan M.
        • Pinto H.
        • Geerts W.
        • Zinman L.
        Venous thromboembolism in amyotrophic lateral sclerosis: a prospective study.
        Neurology. 2014; 82: 1674-1677https://doi.org/10.1212/WNL.0000000000000405
        • Russell C.D.
        • Koch O.
        • Laurenson I.F.
        • Shea D.T.O.
        • Sutherland R.
        • Mackintosh C.L.
        Diagnosis and features of hospital-acquired pneumonia: a retrospective cohort study.
        J. Hosp. Infect. 2016; 92: 273-279https://doi.org/10.1016/j.jhin.2015.11.013
        • Steel H.C.
        • Cockeran R.
        • Anderson R.
        • Feldman C.
        Overview of community-acquired pneumonia and the role of inflammatory mechanisms in the immunopathogenesis of severe pneumococcal disease.
        Mediat. Inflamm. 2013; 2013
        • Wolf J.
        • Safer A.
        • Wohrle J.C.
        • et al.
        Causes of death in amyotrophic lateral sclerosis: results from the Rhineland-Palatinate ALS registry.
        Nervenarzt. 2017; 88: 911-918https://doi.org/10.1007/s00115-017-0293-3
        • Corcia P.
        • Pradat P.-F.
        • Salachas F.
        • et al.
        Causes of death in a post-mortem series of ALS patients.
        Amyotroph. Lateral Scler. 2008; 9: 59-62https://doi.org/10.1080/17482960701656940
        • Fang T.
        • Al Khleifat A.
        • Meurgey J.H.
        • et al.
        Stage at which riluzole treatment prolongs survival in patients with amyotrophic lateral sclerosis: a retrospective analysis of data from a dose-ranging study.
        Lancet Neurol. 2018; 17: 416-422https://doi.org/10.1016/S1474-4422(18)30054-1
        • Miller R.G.
        • Mitchell J.D.
        • Lyon M.
        • Moore D.H.
        Riluzole for amyotrophic lateral sclerosis (ALS)/motor neuron disease (MND).
        Cochrane Database Syst. Rev. 2002; CD001447https://doi.org/10.1002/14651858.CD001447
        • Zou Z.-Y.
        • Zhou Z.-R.
        • Che C.-H.
        • Liu C.-Y.
        • He R.-L.
        • Huang H.-P.
        Genetic epidemiology of amyotrophic lateral sclerosis: a systematic review and meta-analysis.
        J. Neurol. Neurosurg. Psychiatry. 2017; 88: 540-549https://doi.org/10.1136/jnnp-2016-315018