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Marc Riviere, MD; Vincent Meininger, MD; Phillipe Zeisser, MD; Theodore Munsat, MD

Arch Neurol. 1998;55:526-528.

Background  In an attempt to better understand and define the progression of amyotrophic lateral sclerosis (ALS), we developed a classification of 5 discrete health states that reflect patients' activities of daily living. These health states were used to determine whether patients with ALS who are treated with riluzole differed from those treated with placebo.

Setting  Clinics for patients with ALS.

Design  Placebo-controlled trial of riluzole treatment in 959 patients with ALS.

Interventions  Treatment with riluzole or placebo.

Main Dependent Measures  A Cox model was used to assess whether, from the initial randomization to the end of an 18-month follow-up, there was a difference in the times of transition into subsequent health states between patients treated with riluzole and those treated with placebo.

Results  Our analysis showed a significant difference in the time to transit between the riluzole and the placebo groups in less severely affected cases, ie, state 2 and state A (the milder states) of ALS.

Conclusion  Patients receiving riluzole remained in the milder health states longer (P<.05).

From Benefit Canada Inc, Montreal, Quebec (Dr Riviere), Hôpital Pitie Salpetriere, Paris, France (Dr Meininger), Rhone-Poulenc Rorer, Antony, France (Dr Zeisser), and Neuromuscular Research Unit, New England Medical Center, Boston, Mass (Dr Munsat).

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