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After 12 months,45 of 78 patients(58 percent)in the placebo group were still alive,as compared with 57 of 77 patients(74 percent)in the riluzole group(P=0.014).For patients with bulbar-onset disease,one-year survival rates were 35 percent(6 of 17)with placebo and 73 percent(11 of 15)with riluzole(P=0.014),whereas for those with limb-onset disease one-year survival was 64 percent and 74 percent,respectively(P=0.17).The survival advantage with riluzole was smaller(37 percent[29 of 78]with placebo vs.49 percent[38 of 77]with riluzole)at the end of the placebo-controlled period,but it remained significant in the overall population(P=0.046)as well as in the patients with bulbar-onset disease(18 percent[3 of 17]vs.53 percent[8 of 15],P=0.013).The deterioration of muscle strength was significantly slower in the riluzole group than in the placebo group(P=0. 028).Adverse reactions to riluzole included asthenia,spasticity,and mild elevations in aminotransferase levels.Twenty-seven patients in the riluzole group withdrew from the study,as compared with 17 of the placebo group.The antiglutamate agent riluzole appears to slow the progression of amyotrophic lateral sclerosis,and it may improve survival in patients with disease of bulbar onset. |
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