Navigation Links
ALS patients differ on treatment choices in later phases of disease
Date:4/20/2012

NEW ORLEANS Two new studies analyzing treatment decisions in late-stage amyotrophic lateral sclerosis (ALS) patients shed light onto treatments aimed to extend the duration and quality of life in this progressively debilitating neuromuscular disorder. Researchers from the Perelman School of Medicine at the University of Pennsylvania found that waiting until the last minute to receive one treatment resulted in not living long enough to experience the benefits. In a separate study, Penn researchers uncovered polarized preferences among patients regarding the value of an expensive, marginally effective disease-modifying drug. The research will be presented at the American Academy of Neurology's 64th Annual Meeting in New Orleans.

ALS, commonly known as Lou Gehrig's disease, is rare, affecting approximately 30,000 Americans. In later stages of the disease, it paralyzes ALS patients' bodies, while minds often stay sharp. Along with other treatments and supportive therapies used in later stages of the disease, many patients receive a feeding tube to ensure nourishment can be obtained when muscles are impaired.

One Penn Medicine study demonstrates that ALS patients who have feeding tubes placed before an emergency situation strikes fare better. Those having surgeries in non-emergent settings were much less likely to die within one month after surgery, compared to ALS patients receiving their feeding tubes under duress. Median survival after the feeding tube surgery was 6 months overall and longer for patients undergoing non-emergent versus emergent placement (7 months vs. 4 months). In addition, mortality rates were worse for patients having procedures done at hospitals that did not regularly perform feeding tubes placement in ALS patients.

"Timing is crucial for placement of feeding tubes in ALS patients," said the lead author of both studies, Amy Tsou, MD, MSc, a fellow in Neurology and a Robert Wood Johnson VA Clinical Scholar. "We've shown that waiting too long can be detrimental and happens too often. In general, it is important for clinicians and patients to proactively prepare and reevaluate treatment decisions as ALS patients enter into different phases of the disease."

In a second study, researchers found polarized treatment preferences regarding Riluzole, the first FDA approved treatment to slow ALS. Patients had sharply polarized preferences about this expensive treatment, which modestly prolongs length of life of ALS patients. In a survey of 98 patients with ALS or Motor Neuron Disease, nearly two-thirds of the patients ranked Riluzole as either the most important (30 percent) or least important (33 percent) treatment option.

"It is important to ask patients how they value their treatments, as in this case, we learned that patients who are older and looking for a high quality of life, valued this drug considerably more than people with impaired walking ability, who instead preferred supportive therapies like adaptive equipment," said Leo McCluskey, MD, professor of Neurology and director of the Penn ALS Center. "Overall, medical care providers should work with patients to discuss treatment options throughout the progression of the disease to ensure a high quality of end-of-life care."


'/>"/>

Contact: Kim Menard
kim.menard@uphs.upenn.edu
215-200-2312
University of Pennsylvania School of Medicine
Source:Eurekalert

Related medicine news :

1. Exercise May Help Patients With High Blood Pressure Live Longer
2. Swallowing exercises can help patients with head and neck cancer
3. 19th century therapy for Parkinsons disease may help patients today
4. Study: Insomnia takes toll on tinnitus patients
5. Kidney Cancer Patients Fare Better With Tumor Removal Only
6. Avastin No Benefit to Older Lung Cancer Patients: Study
7. Study examines drug regimen for the treatment of non-small cell lung cancer among older patients
8. Adding drug to standard chemotherapy provides no survival benefit for older lung cancer patients
9. Kidney cancer patients do better when whole kidney is not removed, U-M study shows
10. Swallowing exercises linked with short-term improvement among patients with head and neck cancer
11. Immunotherapy for elderly cancer patients finds new promise in drug combination
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:9/25/2017)... ... , ... How many things are on your average daily to-do list? If ... sane human could possibly complete,” then you’re all too familiar with daily chaos. You ... be everything to everybody all the time. , Self-proclaimed overly productive person Angela Nuttle ...
(Date:9/25/2017)... ... September 25, 2017 , ... NCPDP Foundation , a ... has awarded a $40,000 grant to Johns Hopkins Medicine to address patient safety ... prescribers to electronically cancel a prescription already submitted to a pharmacy. Studies indicate ...
(Date:9/25/2017)... ... September 25, 2017 , ... International Water Advocate Sharon ... Kleyne Hour Power of Water, Global Climate Change and Your Health on VoiceAmerica ... from a once-every-four-years series of events to a personal, daily Health Olympics. “Wouldn’t ...
(Date:9/25/2017)... ... September 25, 2017 , ... Bobbie Horowitz was hardly able to walk ... issues. As a cabaret and theater producer, Horowitz would manage to get to rehearsals ... in New York City, so she had to take a cab everywhere. , ...
(Date:9/25/2017)... ... September 25, 2017 , ... ... clinical research, today announces that 30 of its domain experts will present ... lifecycle at upcoming industry conferences and webinars. Drawing on broad and deep ...
Breaking Medicine News(10 mins):
(Date:9/19/2017)... Ky. , Sept. 19, 2017   ZirMed Inc ... predictive analytics, today announced that it has been ranked #1 ... Black Book™ Rankings 2017 User Survey. ZirMed was ... solution for large hospitals and medical centers over 200 beds ... Black Book,s healthcare technology user survey history. ...
(Date:9/12/2017)... reviews on the independent review site Consumer Affairs have ... hearing aids, ranking it higher than Miracle Ear ™, Beltone™, ... ... Aids ... that provides high performance, state-of-the-art, German-engineered hearing aids directly to consumers ...
(Date:9/7/2017)... , Sept. 7, 2017  Eli Lilly ... announced actions to streamline operations to more efficiently ... improve its cost structure. Global workforce reductions, including ... are expected to impact approximately 3,500 positions. ... company expects annualized savings of approximately $500 million ...
Breaking Medicine Technology: