Key Information
ALA has several plausible mechanisms for slowing ALS progression, including enhancing energy production, reducing oxidative stress as a potent antioxidant and anti inflammation. Preclinical studies demonstrated better motor function and improved survival. One open label study suggested improved QOL and fatigue when administered as a palladium lipoic acid complex, but motor function was not assessed. Several PALS in the ALS online community reported improved muscle strength when taking ALA as part of extensive supplement regimens, but most did not. Therefore, it is unclear whether the reported improvement was directly related to ALA. Although one clinical trial was completed in PALS, the result has not been published. ALA was safe and well-tolerated based on self report from PALS and in clinical trials for other disease conditions at 600 mg daily. Given the above, we cannot endorse ALA as an effective therapy for PALS. We support more research on the efficacy of ALA in slowing ALS progression.
Mechanistic plausibility
Mechanistic plausibility
Mechanistic plausibility - C
Mechanistic plausibility
Mechanistic plausibility
Mechanistic plausibility
Pre-clinical models (animal or cell models recognized by ALSUntangled reviewers to be relevant to ALS)
Grade A: Two or more peer-reviewed publications reporting benefits in well-designed studies.
Animal studies are assumed to be ‘well designed’ when they follow published guidelines. When they deviate from these they are considered ‘flawed’.
Pre-clinical models (animal or cell models recognized by ALSUntangled reviewers to be relevant to ALS)
Grade B: One peer-reviewed publication reporting benefits in a well-designed study.
Animal studies are assumed to be ‘well designed’ when they follow published guidelines. When they deviate from these they are considered ‘flawed’.
Pre-clinical models (animal or cell models recognized by ALSUntangled reviewers to be relevant to ALS)
Grade C: One or more peer-reviewed publication(s) reporting benefits in flawed studies.
Animal studies are assumed to be ‘well designed’ when they follow published guidelines. When they deviate from these they are considered ‘flawed’.
Pre-clinical models (animal or cell models recognized by ALSUntangled reviewers to be relevant to ALS)
Pre-clinical models (animal or cell models recognized by ALSUntangled reviewers to be relevant to ALS)
Pre-clinical models (animal or cell models recognized by ALSUntangled reviewers to be relevant to ALS)
Patient case reports
Patient case reports
Patient case reports
Patient case reports
Patient case reports
Patient case reports
Patient trials
Patient trials
Patient trials
Grade D: One or more peer-reviewed publications reporting benefits in a flawed trial.
Flawed trials means those in which there are identifiable problems with patient selection, randomization, blinding, controls or follow-up. These have ‘high or unclear risk of bias’ according to published criteria. Well-designed trials are those that have ‘low risk of bias’.
Patient trials
Patient trials
Risks (harms that occurred on this treatment)
Risks (harms that occurred on this treatment)
Risks (harms that occurred on this treatment)
Grade B (oral): More than 0% but less than10% of exposed patients experienced harms (no hospitalizations or deaths)
Grade D (intravenous): More than 0% but less than 5% of exposed patients experienced death or hospitalizations
Risks (harms that occurred on this treatment)
Risks (harms that occurred on this treatment)
Risks (harms that occurred on this treatment)
Grade D: More than 0% but less than 5% of exposed patients experienced death or hospitalizations
Grade F: At least 5% of exposed patients experienced death or hospitalization