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Al-Chalabi et al report the findings of a post-hoc analysis of edaravone study 19 to explore the performance of two clinical staging systems.1 2 This interesting work is not intended to settle the efficacy debate around edaravone which requires further prospective studies but it does demonstrate that the information provided by the staging systems may compliment current outcome measures.
The amyotrophic lateral sclerosis functional rating scale - revised (ALSFRS-R) is increasingly being chosen over survival as the primary outcome measure in trials of amyotrophic lateral sclerosis (ALS) to enable faster and smaller trials. This is strategy that is not without its pitfalls as the edaravone situation with patchy worldwide regulatory approval demonstrates; therefore, it is important that the clinical …
Contributors CJM is the sole author of the work.
Funding This study was supported by National Institute for Health Research and NIHR Sheffield Biomedical Research Centre.
Competing interests None declared.
Patient consent for publication Not required.
Provenance and peer review Commissioned; internally peer reviewed.