ALS Untangled does not support pyridostigmine to slow ALS progression
Original source
Pyridostigmine (opens in a new tab)ALS Untangled reviewed pyridostigmine and does not support its use to slow amyotrophic lateral sclerosis (ALS) progression. The drug may transiently improve neuromuscular transmission early in ALS, but no clinical trials of pyridostigmine in people with ALS have been conducted. Case reports did not show benefit in people with ALS without typical myasthenia gravis symptoms, and two small trials of other cholinesterase inhibitors were unsuccessful.
Why this matters
This review does not provide evidence that pyridostigmine slows ALS or improves symptoms for people with ALS. Pyridostigmine can also cause gastrointestinal side effects and increased saliva at recommended doses, so people should discuss its use with a clinician rather than assume it is an ALS treatment.
Limitations and context
This is an independent expert review, not a new clinical trial. The evidence described consists of case reports and two small trials of different drugs; pyridostigmine itself has not been tested in clinical trials in people with ALS. Whether it could provide short-term neuromuscular benefits in selected early-stage patients remains untested.