Antioxidant treatment for amyotrophic lateral sclerosis or motor neuron disease
Open accessAbstract
BACKGROUND: Free radical accumulation and oxidative stress have been proposed as contributing to the progression of amyotrophic lateral sclerosis (or motor neuron disease). A range of antioxidant medications are available, and have been studied. OBJECTIVES: To examine the effects of antioxidant medication in the treatment of people with amyotrophic lateral sclerosis. SEARCH STRATEGY: We searched the Cochrane Neuromuscular Disease Group Trials register (August 2005), MEDLINE (from January 1966 to August 2005), EMBASE (from January 1980 to August 2005) and other sources. SELECTION CRITERIA: All randomized or quasi-randomized controlled trials of antioxidant treatment for amyotrophic lateral sclerosis. DATA COLLECTION AND ANALYSIS: The authors independently applied the selection criteria, assessed study quality and two authors performed independent data extraction. MAIN RESULTS: The search identified 23 studies for consideration but only nine studies met the inclusion criteria. Only two studies used our predetermined primary outcome measure as the primary outcome measure, (survival at 12 months treatment). However, sufficient data were available from four studies to allow analysis of this outcome measure, and a meta-analysis was performed. In the individual studies no significant effect was observed for vitamin E 500 mg twice daily; vitamin E 1 g five times daily; acetylcysteine 50 mg/kg daily subcutaneous infusion; or a combination of L-methionine 2 g, vitamin E 400 International Units, and selenium 3 x 10-5g three times daily (Alsemet). No significant effect on the primary outcome measure was observed in a meta-analysis of all antioxidants combined. No significant differences were demonstrated in any of the secondary outcome measures. AUTHORS' CONCLUSIONS: There is insufficient evidence of efficacy of individual antioxidants, or antioxidants in general, in the treatment of people with amyotrophic lateral sclerosis. One study reported a mild positive effect, but this was not supported by the analysis we used. Generally the studies were poorly designed, and underpowered, with low numbers of participants and of short duration. Further well-designed trials of medications such as vitamin C and E are unlikely to be performed. If future trials of antioxidant medications are performed, careful attention should be given to sample size, outcome measures, and duration of the trial. The high tolerance and safety, and relatively low cost of vitamins C and E, and other considerations related to the lack of other effective treatments for amyotrophic lateral sclerosis, explain the continuing use of these vitamins by physicians and people with amyotrophic lateral sclerosis. While there is no substantial clinical trial evidence to support their clinical use, there is no clear contraindication.
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Numerous studies have shown that intake of exogenous CoQ10 could help prevent progression of illness such as heart failure, metabolic syndrome, NAFLD, diabetes mellitus, and several neurodegenerative diseases.
“Numerous studies have shown that the intake of exogenous CoQ10 could help to prevent the progression of illness, such as heart failure, metabolic syndrome, NAFLD, diabetes mellitus, and several neurodegenerative diseases177,181–186.”
From Key points for the development of antioxidant cocktails to prevent cellular stress and damage caused by reactive oxygen species (ROS) during manned space missions (2021) · cites this paper as [185]
The Discussion (page unavailable) concludes that there is no significant evidence antioxidants benefit people with ALS, a neurodegenerative disease, contrary to presenting this review as evidence that CoQ10 helps prevent disease progression. The Background (page unavailable) describes CoQ10 as a suggested treatment, not an established one. The review does not assess heart failure, metabolic syndrome, NAFLD, or diabetes. (LLM, conf=0.84)
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“sc le ro si s Vitamin E Trial in progress CN-00442211 Creatin No effect on survival [213] Minocyclin Trials in progress CN-01616430; CN-01259752; CN-01381473 CN-00730827 Riluzole Probably prolongs survival [214] Celecoxib Trial in progress CN-00566124 Curcumin Might improve survival probability [215] Antioxidants Insu…”
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“Antioxidants were also thought to have neuroprotective effects; however, several of them showed no significant effect in clinical trial for this disease [59].”
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“R tually resul rdiman et al rs of diagnos is sporadic. lear (Al-Chal D and ALS a y proteins. ases are m eins such a ein and F functions are ALS.”
BackgroundInfluentialOxidative stress modulation in neurodegenerative diseases
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Dementia, onset, development of the disease, prevention
Koprivica, M., & Mikov, M. (2025) · Hospital Pharmacology - International Multidisciplinary Journal · doi:10.5937/hpimj2503710k
- Authors
- Orrell, R. W., Lane, R. J., & Ross, M.
- Affiliations
- The Royal Free Hospital (GB)
- Charing Cross Hospital (GB)
- Mayo Clinic (US)
- Venue
- Cochrane Database of Systematic Reviews
- Publisher
- Wiley
- Published
- 2007-01-24
- Volume
- 2011
- Issue
- 6
- Pages
- CD002829-CD002829
- ISSN
- 1361-6137 (ISSN-L)
- 1465-1858
- PMC
- PMC8985756
- OpenAlex
- W2097738254
- Cited by
- 98
- References
- 50
- Citations by year
- 2025: 2 · 2024: 1 · 2023: 4 · 2022: 5 · 2021: 3 · 2020: 5 · 2019: 1 · 2017: 4 · 2016: 3 · 2015: 7 · 2014: 6 · 2013: 8 · 2012: 8
- FWCI
- 0.87
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Cochrane Database of Systematic Reviews (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Wellcome Trust
- Topics
- Health Sciences › Medicine › Neurology › Amyotrophic Lateral Sclerosis Research
- Health Sciences › Medicine › Biochemistry › Antioxidant Activity and Oxidative Stress
- Health Sciences › Medicine › Genetics › Neurogenetic and Muscular Disorders Research
- Keywords
- amyotrophic lateral sclerosis, motor neuron disease, antioxidant therapy, oxidative stress, free radicals, vitamin E, N-acetylcysteine, methionine, selenium, survival, treatment efficacy
- MeSH terms
- Amyotrophic Lateral Sclerosis, Antioxidants, Humans, Randomized Controlled Trials as Topic
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