10 years of riluzole use in a tertiary ALS clinic
Objectives: Riluzole is a glutamate inhibitor approved for the treatment of amyotrophic lateral sclerosis (ALS). There are scant data regarding factors associated with riluzole initiation and adherence. The goal of this study was to describe the use of riluzole at the Penn State Hershey Medical Center (PSHMC) ALS clinic. Methods: A retrospective medical record review of ALS patients seen at PSHMC from January 2007 to December 2016. A timeline of riluzole use was established for each patient. Factors contributing to dose changes or discontinuations were recorded. Riluzole adherence was assessed using the proportion of days covered (PDC) calculated by the patient-reported length of riluzole use divided by total time from prescription to death/censor. Multivariable analysis was performed to evaluate the association of demography and clinical course with adherence. Results: 723 records were screened, with 508 (307 men, 201 women) meeting criteria for inclusion. The median length of riluzole use was 435 days (range 0-3773). The median PDC for the group was 64%. Those with higher initial overall function and slower rate of decline were more likely to have a larger PDC. No trends in patient demographics, riluzole use, and tracheostomy-free survival were found over time. Discussion: A high rate of riluzole initiation and adherence was found in this sample. The most common reasons for dose modification were related to adverse effects, though social, economic, and patient related factors were also common. The characteristics of riluzole prescription and use have remained relatively unchanged in a single tertiary ALS center over the last ten years.
This is the peer reviewed version of the following article: "10 years of riluzole use in a tertiary ALS clinic", which has been published in final form at https://onlinelibrary.wiley.com/doi/abs/10.1002/mus.27541. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions. This article may not be enhanced, enriched or otherwise transformed into a derivative work, without express permission from Wiley or by statutory rights under applicable legislation. Copyright notices must not be removed, obscured or modified. The article must be linked to Wiley’s version of record on Wiley Online Library and any embedding, framing or otherwise making available the article or pages thereof by third parties from platforms, services and websites other than Wiley Online Library must be prohibited.
|10 years of riluzole use in a tertiary ALS clinic
|CC BY-NC-ND 4.0 (Attribution-NonCommercial-NoDerivatives)
|March 30, 2022
|Publisher Identifier (DOI)
|January 23, 2023
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