ALSFRS-R decline rate prior to baseline is not useful for stratifying subsequent progression of functional decline.
Amyotroph Lateral Scler Frontotemporal Degener
; 25(3-4): 388-399, 2024 May.
Article
in En
| MEDLINE
| ID: mdl-38323575
ABSTRACT
OBJECTIVE:
One of the difficulties in developing a novel drug for patients with amyotrophic lateral sclerosis (ALS) is the significant variation in the clinical course. To control this variation, a 12-week run-in period is used in some clinical trials. Based on the Amyotrophic Lateral Sclerosis Functional Rating Scale Revised (ALSFRS-R) change during the run-in period, only moderate progressors are selected in some clinical trials. Some reports showed that the ALSFRS-R progression rate was associated with survival. However, it is unclear whether the ALSFRS-R change in the run-in period is a useful prognostic factor of the ALSFRS-R change from baseline. In addition, we explore the inclusion criteria that could control the variability in ALS-function progression without setting a run-in period.METHODS:
We utilized the Japanese and US ALS registry databases (JaCALS and PRO-ACT). Patients were classified into three populations (rapid, moderate, and slow progressors) based on the ALSFRS-R change prior to baseline. We also classified patients into three prognostic populations based on the ALSFRS-R change from baseline. We confirmed whether each of the three populations were matched with their respective three prognostic populations.RESULTS:
Our data showed that the three groups classified by the ALSFRS-R change during the 12 weeks prior to baseline or by the rate of progression from onset to baseline did not accord with the three prognostic groups.CONCLUSIONS:
Our results showed that the ALSFRS-R change in the run-in period or from onset to baseline is not useful for stratifying subsequent progression of functional decline in clinical trials.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Amyotrophic Lateral Sclerosis
Type of study:
Prognostic_studies
Limits:
Humans
Language:
En
Journal:
Amyotroph Lateral Scler Frontotemporal Degener
Year:
2024
Document type:
Article
Affiliation country:
Japan
Country of publication:
United kingdom