Symptomatic drug therapy impact on Amyotrophic Lateral Sclerosis survival

Identifier:  TFG:2121

Handle: https://hdl.handle.net/20.500.11797/TFG2121

Authors:  Sáez Mas, Anabel

Abstract:
Background: Due to the heterogeneity of amyotrophic lateral sclerosis (ALS) in terms of clinical manifestations and trajectories, population-based registries are important to display a picture of the different clinical phenotypes and provide useful information of incidence, prevalence, and risk factors. Currently, the lack of knowledge about the molecular bases of ALS is an obstacle to develop disease-modifying therapies, so most of the management strategies of ALS are focused on improving the symptomatology of patients. Nonetheless, drug prescription for management of ALS symptoms is based on strategies followed to treat the same symptoms in other diseases, so their effect on ALS patient’s survival specifically remains unknown. Materials and methods: Swedish Motor Neuron Disease (MND) Quality Registry has been used to perform a survival analysis using a Cox proportional hazard regression to evaluate the impact of the different symptomatic medications prescribed to ALS patients, and to provide an epidemiological description of Swedish MND patients. Results and discussion: Epidemiology traits of Swedish MND patients agree with most of European studies, except for sex prevalence, which is almost for both sexes in Sweden whereas to the rest of Europe is clearly higher in men. Data collection in the registry has several deficiencies, mainly in the register of treatments, so the results of analysis are not conclusive enough. However, our performed review of recent studies related with antibiotics, gut microbiota, and ALS points out that antibiotic prescription may have an impact on ALS survival through modification of microbiota population. Conclusions: Quality of the Swedish MND registry should be improved to aid future research. Prescription of antibiotics that impact negatively on butyrate-producer bacteria may be related with a worse survival of ALS patients.