Amyotrophic lateral sclerosis (ALS) is a fatal degenerative disease of
the anterior horn cells. Most therapeutic agents used in its treatmen
t have failed to show substantial benefit. Riluzole is the first drug
that has been shown to improve survival in patients with ALS. This rev
iew analyzes the clinical trials of riluzole in patients with ALS and
interprets the results and their implications. Relevant questions and/
or issues arising from these trials are posed, and their probable solu
tions, as well as areas of clinical trial methodology which require ev
aluation and development, are discussed.