A review of therapeutics targeting excitotoxicity in amyotrophic lateral sclerosis

Abstract

Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disease that affects between 14,000 to 15,000 Americans. The upper and lower motor neurons degenerate, which eventually causes muscle paralysis, atrophy, and ultimately death from respiratory failure. It has a high treatment cost as well as a high toll on the patient and their families and friends. Currently, there are only two drugs approved by the FDA for the treatment of ALS: riluzole and edaravone. Research is constantly being conducted to understand and develop further treatment modalities, however, many drugs have failed to demonstrate significant improvement in phase III trials. One of the pathophysiology that these drugs, including riluzole, target is excitotoxicity of the motor neurons.

This review will briefly expand upon the different trials that were conducted targeting the excitotoxicity pathway. Although they may have not been successful in prolonging survival in ALS patients, we can learn from these studies and build upon them.