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Genge A, Cedarbaum JM, Shefner J, Chio A, Al-Chalabi A, Van Damme P, McDermott C, Glass J, Berry J, van Eijk RPA, Fournier C, Grosskreutz J, Andrews J, Bertone V, Bunte TM, Couillard M, Cummings C, Kittle G, Polzer J, Salmon K, Straub C, van den Berg LH. The ALSFRS-R Summit: a global call to action on the use of the ALSFRS-R in ALS clinical trials. Amyotroph Lateral Scler Frontotemporal Degener 2024; 25:382-387. [PMID: 38396337 DOI: 10.1080/21678421.2024.2320880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 02/12/2024] [Indexed: 02/25/2024]
Abstract
The Amyotrophic Lateral Sclerosis Functional Rating Scale (ALSFRS) was developed more than 25 years ago as an instrument to monitor functional change over time in patients with ALS. It has since been revised and extended to meet the needs of high data quality in ALS trials (ALSFRS-R), however a full re-validation of the scale was not completed. Despite this, the scale has remained a primary outcome measure in clinical trials. We convened a group of clinical trialists to discuss and explore opportunities to improve the scale and propose alternative measures. In this meeting report, we present a call to action on the use of the ALSFRS-Revised scale in clinical trials, focusing on the need for (1) harmonization of the ALSFRS-R administration globally, (2) alignment on a set of recommendations for clinical trial design and statistical analysis plans (SAPs), and (3) use of additional outcome measures.
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Affiliation(s)
- Angela Genge
- Montreal Neurological Institute-Hospital, ALS Center of Excellence, Montreal, Quebec, Canada
| | - Jesse M Cedarbaum
- Yale School of Medicine, Section of Movement Disorders, Coeruleus Clinical Sciences LLC, Woodbridge, CT, USA
| | | | - Adriano Chio
- Department of Neuroscience, University of Turin, Torino, Italy
| | - Ammar Al-Chalabi
- Department of Basic and Clinical Neuroscience, King's College London, Institute of Psychiatry Psychology and Neuroscience, Maurice Wohl Clinical Neuroscience Institute, London, UK
| | | | - Chris McDermott
- Department of Neurology, The University of Sheffield, Sheffield, UK
| | - Jonathan Glass
- Department of Neurology, Emory University, Atlanta, GA, USA
| | - James Berry
- Massachusetts General Hospital, Neurology, Boston, MA, USA
| | - Ruben P A van Eijk
- Department of Neurology and Biostatistics, UMC Utrecht Hersencentrum Rudolf Magnus, Utrecht, Netherlands
| | | | - Julian Grosskreutz
- Precision Neurology of Neuromuscular and Motoneuron Diseases, University of Lübeck, Lübeck, Germany
| | - Jinsy Andrews
- Columbia Presbyterian Medical Center, Neurology, New York, NY, USA
| | - Vanessa Bertone
- Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada
| | - Tommy M Bunte
- Department of Neurology, UMC Utrecht Hersencentrum Rudolf Magnus, Utrecht, Netherlands
| | - Mathias Couillard
- Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada
| | - Cathy Cummings
- International Alliance of ALS/MND Associations, Northampton, Northamptonshire, UK, and
| | - Gale Kittle
- Barrow Neurological Institute, Phoenix, AZ, USA
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