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Butz, Miriam; Wollinsky, K. H.; Wiedemuth-Catrinescu, Ursula; Sperfeld, Anne D.; Winter, Susanne; Mehrkens, Hans; Ludolph, Albert C.; Schreiber, Herbert

doi:10.1097/00002060-200308000-00005

Cited by 11 publications

(6 citation statements)

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“…2 The positive effect on blood-gas parameters, quality of life, and hypercapnia-associated symptoms was reproduced convincingly in several subsequent studies. Polysomnographic studies showed an improvement of oxygen saturation, pCO 2 , and apnea-hypopnea-index, 8,9 leading to reduced daytime fatigue and depression, 10 as well as improved sleep and quality of life. 9,11 Patients may notice improvements already after the first night of NIV usage, 8 and continued therapy promises long-lasting positive effects over several months, 10,12 although they weaken over time.…”

Section: Effects On Survival and Quality Of Lifementioning

confidence: 96%

Non-invasive ventilation in amyotrophic lateral sclerosis

Dorst

Ludolph

2019

Ther Adv Neurol Disord

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Non-invasive ventilation (NIV) has become an important cornerstone of symptomatic treatment in amyotrophic lateral sclerosis (ALS), improving survival and quality of life. In this review, we summarize the most important recent developments and insights, including evidence of efficacy, indication criteria and time of initiation, ventilation parameters and adaptation strategies, treatment of complicating factors, transition from NIV to invasive ventilation, termination of NIV and end-of-life management. Recent publications have questioned former conventions and guideline recommendations, especially with regard to timing and prognostic factors; therefore, a fresh look and re-evaluation of current evidence is needed.

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Section: Effects On Survival and Quality Of Lifementioning

confidence: 96%

Non-invasive ventilation in amyotrophic lateral sclerosis

Dorst

Ludolph

2019

Ther Adv Neurol Disord

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“…NIV also improves blood gas parameters and respiratory symptoms. Recent polysomnographic studies have demonstrated improvement of oxygen saturation, apnea–hypopnea index, and transcutaneous carbon dioxide tension, 50 and also an improvement of sleep quality, daytime fatigue, depression, 51 and quality of life. 52 Although direct correlations between respiratory symptoms and blood gas parameters have not been reported in the aforementioned studies, improvement of blood gas parameters and quality of life indicators both remained stable over an observation period of 10 months.…”

Section: Noninvasive Ventilationmentioning

confidence: 99%

“… 52 Although direct correlations between respiratory symptoms and blood gas parameters have not been reported in the aforementioned studies, improvement of blood gas parameters and quality of life indicators both remained stable over an observation period of 10 months. 51 …”

Section: Noninvasive Ventilationmentioning

confidence: 99%

Disease-modifying and symptomatic treatment of amyotrophic lateral sclerosis

Dorst¹,

Ludolph²,

Huebers³

2017

Ther Adv Neurol Disord

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In this review, we summarize the most important recent developments in the treatment of amyotrophic lateral sclerosis (ALS). In terms of disease-modifying treatment options, several drugs such as dexpramipexole, pioglitazone, lithium, and many others have been tested in large multicenter trials, albeit with disappointing results. Therefore, riluzole remains the only directly disease-modifying drug. In addition, we discuss antisense oligonucleotides (ASOs) as a new and potentially causal treatment option.Progress in symptomatic treatments has been more important. Nutrition and ventilation are now an important focus of ALS therapy. Several studies have firmly established that noninvasive ventilation improves patients’ quality of life and prolongs survival. On the other hand, there is still no consensus regarding best nutritional management, but big multicenter trials addressing this issue are currently ongoing. Evidence regarding secondary symptoms like spasticity, muscle cramps or sialorrhea remains generally scarce, but some new insights will also be discussed. Growing evidence suggests that multidisciplinary care in specialized clinics improves survival.

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“…NIV may be considered at the earliest sign of nocturnal hypoventilation or respiratory insufficiency in order to improve compliance (Level C) (23 Miller, 28 Pinto, 29 Aboussouan). Orthopnea has been shown to be a strong predictor of benefit and also better compliance with NIV (24 Bourke).…”

Section: Respiratory Insufficiencymentioning

confidence: 99%

Symptom Management and End-of-Life Care in Amyotrophic Lateral Sclerosis

Jackson¹,

McVey

Rudnicki

et al. 2015

Neurologic Clinics

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Synopsis The number of available symptomatic treatments has markedly enhanced the care of patients with Amyotrophic Lateral Sclerosis (ALS). Once thought to be “untreatable”, patients with ALS today clearly benefit from multidisciplinary care. The impact of such care on the disease course, including rate of progression and mortality, has surpassed the treatment effects commonly sought in clinical drug trials. Unfortunately, there are few randomized controlled trials of medications or interventions addressing symptom management which has resulted in the need for physicians to base their selection of specific therapies upon personal experience and anecdotal reports (1 Forshew). In this review, we will provide the level of evidence, when available, for each intervention that is currently considered “standard of care” by consensus opinion.

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Cited by 11 publications

References 0 publications

Non-invasive ventilation in amyotrophic lateral sclerosis

Non-invasive ventilation in amyotrophic lateral sclerosis

Disease-modifying and symptomatic treatment of amyotrophic lateral sclerosis

Symptom Management and End-of-Life Care in Amyotrophic Lateral Sclerosis

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