Levosimendan for amyotrophic lateral sclerosis

Muscle weakness is the main characteristic of amyotrophic lateral sclerosis, which eventually leads to functional impairment and respiratory insufficiency. Progressive derives from a loss motor units active muscle fibres. Striated contraction depends on interaction between intracellular calcium protein troponin. Troponin made up three subunits—troponin C especially important for binding promoting dynamic interplay troponin tropomyosin, with consequent contraction. 1 Fusi L Brunello E Sevrieva IR Sun YB Irving M Structural dynamics during activation skeletal muscle. Proc Natl Acad Sci USA. 2014; 111: 4626-4631 Crossref PubMed Scopus (27) Google Scholar It has been suggested that drug able increase affinity (a sensitiser) would stimulate stronger contractions. 2 Lee JA Allen DG Calcium sensitisers. BMJ. 1990; 300: 551-552 In patients surviving fibres might compensate originating reduced number units. Safety efficacy oral levosimendan in people sclerosis (the REFALS study): randomised, double-blind, placebo-controlled phase 3 trialLevosimendan was not superior placebo maintaining function broad population sclerosis. Although generally well tolerated, increased heart rate headache occurred more frequently than placebo. The possibility clinically relevant subgroup responsive individuals requires further evaluation. Full-Text PDF