Reduced glutathione in amyotrophic lateral sclerosis: an open, crossover, randomized trial

The present study set out to define the possible effect of reduced glutathi one (GSH), the substrate of glutathione peroxidase (GSH-Px), a free radical inactivating enzyme, in amyotrophic lateral sclerosis (ALS). Thirty-two pa tients affected by definite ALS seen in our institution between August 1993 and July 1994 were admitted to the study. The effect of GSH was studied in an open, crossover, randomized study. GSH was given at the dose of 600 mg each day intramuscularly for 12 weeks. The patients, taken sequentially, we re randomly assigned to two groups. The first group received the drug while the second received only symptomatic therapies for 12 weeks. After a week of washout, the second group received GSH and the first only symptomatic th erapies for 12 weeks. The rate of progression of the diseases was compared in the two groups. Clinical evaluation included manual test for muscle stre ngth, Norris scale, bulbar scale, and forced vital capacity (FVC) percent. No significant difference was found in the progression of ALS in the two pe riods, although a slight slowing of the disease progression rate was found during the period of treatment, probably related to the open design of the study. Our data do nor show any significant effect of reduced glutathione i n modifying the progression of ALS.