Abstract
Background and purpose: Tauroursodeoxycholic acid (TUDCA) is a hydrophilic bile acid that is produced in the liver and used for treatment of chronic cholestatic liver diseases. Experimental studies suggest that TUDCA may have cytoprotective and anti-apoptotic action, with potential neuroprotective activity. A proof of principle approach was adopted to provide preliminary data regarding the efficacy and tolerability of TUDCA in a series of patients with amyotrophic lateral sclerosis (ALS). Methods: As a proof of principle, using a double-blind placebo controlled design, 34 ALS patients under treatment with riluzole who were randomized to placebo or TUDCA (1 g twice daily for 54 weeks) were evaluated after a lead-in period of 3 months. The patients were examined every 6 weeks. The primary outcome was the proportion of responders [those subjects with improvement of at least 15% in the Amyotrophic Lateral Sclerosis Functional Rating Scale Revised (ALSFRS-R) slope during the treatment period compared to the lead-in phase]. Secondary outcomes included between-treatment comparison of ALSFRS-R at study end, comparison of the linear regression slopes for ALSFFRS-R mean scores and the occurrence of adverse events. Results: Tauroursodeoxycholic acid was well tolerated; there were no between-group differences for adverse events. The proportion of responders was higher under TUDCA (87%) than under placebo (P = 0.021; 43%). At study end baseline-adjusted ALSFRS-R was significantly higher (P = 0.007) in TUDCA than in placebo groups. Comparison of the slopes of regression analysis showed slower progression in the TUDCA than in the placebo group (P < 0.01). Conclusions: This pilot study provides preliminary clinical data indicating that TUDCA is safe and may be effective in ALS.
Lingua originale | English |
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pagine (da-a) | 45-52 |
Numero di pagine | 8 |
Rivista | European Journal of Neurology |
Volume | 23 |
DOI | |
Stato di pubblicazione | Pubblicato - 2016 |
Keywords
- Adult
- Aged
- Amyotrophic Lateral Sclerosis
- Amyotrophic lateral sclerosis
- Cholic acids
- Double-Blind Method
- Drug Therapy, Combination
- Female
- Humans
- Male
- Middle Aged
- Neurology
- Neurology (clinical)
- Neuroprotective Agents
- Outcome Assessment (Health Care)
- Pilot Projects
- Riluzole
- Taurochenodeoxycholic Acid
- Tauroursodeoxycholic acid