Add-on treatment with Cerebrolysin improves clinical symptoms in patients with ALS: results from a prospective, single-center, placebo-controlled, randomized, double-blind, phase II study.

Journal: Journal of medicine and life
PMID:

Abstract

Amyotrophic lateral sclerosis (ALS) is a devastating and progressive neurodegenerative disease with limited treatment options available. Cerebrolysin is a drug candidate for the treatment of ALS because of its neuroprotective and neuroregenerative effects. We initiated a pilot clinical study of a combination of Cerebrolysin and riluzole to assess the therapeutic benefit of Cerebrolysin as an add-on treatment on clinical signs and symptoms in outpatients with ALS. Twenty patients with a clinically definitive diagnosis of ALS were enrolled and randomly assigned in a 1:1 ratio to receive Cerebrolysin or placebo. All patients received 50 mg of riluzole PO twice daily as a standard treatment. Patients in the Cerebrolysin group received intravenous injections of 10 mL of Cerebrolysin once daily, five days a week for the first month and three days a week for the next two months. Analysis of the ALS Functional Rating Scale - revised at Month 1 (primary outcome measure), showed a significant treatment effect in favor of Cerebrolysin with a 2.3-point improvement from baseline to Month 1 compared to a 0.9-point decrease in patients on placebo (P=0.005). The effect was maintained over the three-month study period, and the beneficial effect of Cerebrolysin over placebo was also evident in the secondary outcome measures. The safety analysis showed that the combination of riluzole and Cerebrolyisn was well tolerated. Our results demonstrate for the first time a significant clinical effect of Cerebrolysin in improving functional outcomes in patients with ALS and suggest that Cerebrolysin has potential as a novel therapeutic option for ALS.

Authors

  • Alfredo José Firstenfeld
    Servicio de Neurociencias, Universidad de Buenos Aires, Instituto Cardiológico Banfield, Buenos Aires, Argentina.
  • Jorge Listorti
    Servicio de Neurociencias, Universidad de Buenos Aires, Instituto Cardiológico Banfield, Buenos Aires, Argentina.
  • Nasser Jalaff
    Servicio de Neurociencias, Universidad de Buenos Aires, Instituto Cardiológico Banfield, Buenos Aires, Argentina.
  • Claudia Patricia Loaiza Orozco
    Servicio de Neurociencias, Universidad de Buenos Aires, Instituto Cardiológico Banfield, Buenos Aires, Argentina.
  • Francisco Navarrete Gosdenovich
    Servicio de Neurociencias, Universidad de Buenos Aires, Instituto Cardiológico Banfield, Buenos Aires, Argentina.
  • Timo Schurr
    Department of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, Division of Psychiatry I, Medical University Innsbruck, Innsbruck, Austria.