Evidence map›Paper›PMID 36117390›Full record

ArticleMuscle & nerve2022

Early initiation of riluzole may improve absolute survival in amyotrophic lateral sclerosis.

Nimish J Thakore, Brittany R Lapin, Hiroshi Mitsumoto, Pooled Resource Open-Access Als Clinical Trials Consortium

Open access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Muscle & nerve, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
13citing papers in PubMed, 1 pooled it
3.0field-weighted citation impact, top 7% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

13 citing papers in PubMed, 1 synthesis or guideline pooled it, 25 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 3 institutions in 1 country.

Nimish J ThakoreNeuromuscular Center, Department of Neurology, Cleveland Clinic, Cleveland, Ohio, USA.ORCID 0000-0003-3418-3362
Brittany R LapinNeurological Institute Center for Outcomes Research and Evaluation (NICORE) and Lerner Research Institute Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio, USA.
Hiroshi MitsumotoDepartment of Neurology, Division of Neuromuscular Medicine, Columbia University Medical Center, New York, New York, USA.
Pooled Resource Open-Access Als Clinical Trials Consortium
Cleveland Clinic · USCleveland Clinic Lerner College of Medicine · USColumbia University Irving Medical Center · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

INTRODUCTION/

aimsRiluzole improves survival in amyotrophic lateral sclerosis (ALS), but optimal time and duration of treatment are unknown. The aim of this study was to examine if timing of riluzole initiation and duration of treatment modified its effect on survival.

methodsPatients from the PRO-ACT dataset with information on ALS Functional Rating Scale, time from onset to enrollment (TFOE), and riluzole use were selected for analysis. Survival from enrollment was the outcome. Multivariable Cox proportional hazard models were examined for interactions between riluzole and TFOE. Inverse probability of treatment weighting (IPTW) was used to assess average treatment effect.

resultsOf 4778 patients, 3446 (72.1%) had received riluzole. In unadjusted analyses, riluzole improved median survival significantly (22.6 vs. 20.2 months, log-rank p < 0.001). In multivariable analyses, no significant interaction between TFOE and riluzole was found. Riluzole effect was uniform during follow-up. By IPTW, estimated riluzole hazard ratio was 0.798 (95% confidence interval 0.686-0.927). Delaying riluzole initiation by 1 y (6 to 18 months from onset) may translate to reducing median survival from onset by 1.9 months (40.1 to 38.2 months). DISCUSSION: Riluzole appears to reduce risk of death uniformly, regardless of time from onset to treatment, and duration of treatment. Earlier treatment with riluzole may be associated with greater absolute survival gain from onset. Early diagnosis of ALS will facilitate early treatment and is expected to improve survival.

Indexed as

Amyotrophic Lateral SclerosisNeuroprotective AgentsEarly DiagnosisHumansProportional Hazards ModelsRiluzoleNeuroprotective AgentsRiluzolediagnostic delayprognosisRiluzolesurvivaltherapy

Identifiers

PMID36117390
PMCPMC9828202
OpenAlexW4296325047

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.