ALSUntangled #65: glucocorticoid corticosteroids

Jill Ann Goslinga, Mark Terrelonge, Richard Bedlack, Paul Barkhaus, Benjamin Barnes, Tulio Bertorini, Mark Bromberg, Gregory Carter, Amy Chen, Jesse Crayle, Mazen Dimachkie, Leanne Jiang, Gleb Levitsky, Isaac Lund, Sarah Martin, Christopher Mcdermott, Gary Pattee, Kaitlyn Pierce, Dylan Ratner, Lenka SlachtovaYuyao Sun, Paul Wicks

Research output: Contribution to journalReview articlepeer-review

Abstract

ALSUntangled reviews alternative and off-label treatments for people with amyotrophic lateral sclerosis (PALS). Here we review glucocorticoids. Neuroinflammation plays a prominent role in amyotrophic lateral sclerosis (ALS) pathogenesis, so some hypothesize that glucocorticoids might be an effective ALS therapy through their immunosuppressive effects. In this paper, we review the available evidence for glucocorticoids in ALS, including one pre-clinical study with a genetic mouse model of ALS, nine case reports (ranging from 1 to 26 patients each), and four clinical trials. We also review the possible side effects (including steroid myopathy) and the costs of therapy. We graded the level of evidence as follows: Mechanism, D; Pre-Clinical, F; Cases, B; Trials, F; Risks, C. Our review of the current evidence concludes that glucocorticoids do not offer clinical benefit in ALS and confer serious risks. Thus, ALSUntangled does not recommend glucocorticoids as a treatment for ALS.

Original languageEnglish (US)
JournalAmyotrophic Lateral Sclerosis and Frontotemporal Degeneration
DOIs
StateAccepted/In press - 2022
Externally publishedYes

Keywords

  • alternative therapy
  • Amyotrophic lateral sclerosis (ALS)
  • excitotoxicity
  • glucocorticoids
  • neuroinflammation
  • neuropathology
  • SOD1
  • steroids

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

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