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ALSUntangled #65: glucocorticoid corticosteroids. Amyotroph Lateral Scler Frontotemporal Degener 2023 May;24(3-4):351-357

Date

08/24/2022

Pubmed ID

35997522

DOI

10.1080/21678421.2022.2099746

Scopus ID

2-s2.0-85136863606 (requires institutional sign-in at Scopus site)

Abstract

ALSUntangled reviews alternative and off-label treatments for people with amyotrophic lateral sclerosis (PALS). Here we review glucocorticoids. Neuroinflammation plays a prominent role in amyotrophic lateral sclerosis (ALS) pathogenesis, so some hypothesize that glucocorticoids might be an effective ALS therapy through their immunosuppressive effects. In this paper, we review the available evidence for glucocorticoids in ALS, including one pre-clinical study with a genetic mouse model of ALS, nine case reports (ranging from 1 to 26 patients each), and four clinical trials. We also review the possible side effects (including steroid myopathy) and the costs of therapy. We graded the level of evidence as follows: Mechanism, D; Pre-Clinical, F; Cases, B; Trials, F; Risks, C. Our review of the current evidence concludes that glucocorticoids do not offer clinical benefit in ALS and confer serious risks. Thus, ALSUntangled does not recommend glucocorticoids as a treatment for ALS.

Author List

Goslinga JA, Terrelonge M Jr, Bedlack R, Barkhaus P, Barnes B, Bertorini T, Bromberg M, Carter G, Chen A, Crayle J, Dimachkie M, Jiang L, Levitsky G, Lund I, Martin S, Mcdermott C, Pattee G, Pierce K, Ratner D, Slachtova L, Sun Y, Wicks P

Author

Paul E. Barkhaus MD Professor in the Neurology department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Amyotrophic Lateral Sclerosis
Animals
Disease Models, Animal
Glucocorticoids
Humans
Mice