4.7 Article

Trends in the clinical features of amyotrophic lateral sclerosis: A 14-year Chinese cohort study

Journal

EUROPEAN JOURNAL OF NEUROLOGY
Volume 28, Issue 9, Pages 2893-2900

Publisher

WILEY
DOI: 10.1111/ene.14943

Keywords

amyotrophic lateral sclerosis; clinical features; comorbidities; temporal trend

Funding

  1. National Natural Science Foundation of China (NSFC) [81701248]
  2. NSFC [81873784]
  3. Innovation Fund for Outstanding Doctoral Candidates of Peking University Health Science Center (China)

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This study investigated the transitional patterns in clinical characteristics, treatments, and comorbidities of amyotrophic lateral sclerosis (ALS) patients in mainland China over a 14-year period. It was found that patients with diabetes or hypertension had a delayed onset of ALS, and the use of riluzole also increased over time in the study period.
Background and purpose The aim was to determine the transitional patterns in the clinical characteristics, treatments and comorbidities in amyotrophic lateral sclerosis (ALS) patients over the past 14 years using data from a large clinical cohort in mainland China. Methods Sporadic ALS patients who visited the Peking University Third Hospital from January 2005 to December 2018 were included in this study. The 14 years were divided into three periods, and changes in the baseline characteristics of the participants were analyzed at 5-year intervals. Results In total, 3410 patients with sporadic ALS were recruited: 2181 were men and 1229 were women. The proportion of patients with bulbar-onset ALS increased from 13.0% in 2005-2009 to 19.5% in 2015-2018 (p < 0.001). The mean (standard deviation) age at onset increased from 49.5 (11.4) years in 2005-2009 to 53.0 (11.0) years in 2015-2018 (p < 0.001). ALS patients with diabetes or hypertension showed a delay in ALS onset, and the delay was even more apparent when the patients had both comorbidities. The proportion of riluzole users in 2015-2018 was approximately 2.5-fold of that in 2005-2009 (p < 0.001). Conclusions In the context of a lack of clinical data on ALS in mainland China, this study evaluated a large cohort of patients diagnosed over a 14-year period. The age at onset and percentage of patients who used riluzole both increased over the study period. Additionally, it was found that patients with comorbidities such as diabetes and hypertension had a delayed age of ALS onset.

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