A small sample double blind placebo controlled clinical trial performed on 591 patients from Europe and United States did not find any beneficial effect of TCH346 given at dosages on disease progression in patients with ALS. N benzyloxycarbonyl Val Asp fluoromethylketone N benzyloxycarbonyl Val Asp fluoromethylketone is a wide enzymatic caspase inhibitor. Intraventricular administration of zVAD fmk in the late presymptomatic stage notably late disease on-set Canagliflozin SGLT Inhibitors and extended survival in SOD1 transgenic mice. Information on ALS patients remain not available. Pentoxifylline Pentoxifylline is a phosphodiesterase inhibitor that improves cellular cyclic AMP and GMP and demonstrates antiapoptotic properties. A randomized clinical trial performed on 400 European ALS patients discovered that treatment with pentoxifylline as add on to riluzole wasn’t associated with significant effect on functional measures. Furthermore, pentoxifylline had a negative influence on survival. At the end of followup period, 51. 7% of patients were alive within the group compared to 59. 7% in the placebo group. Anti-inflammatory Cyclooxygenase inhibitors since Eumycetoma its escalation in the back influences astrocytic glutamate release The enzyme cyclooxygenase 2 is proposed as a nice-looking therapeutic target in ALS. Increased levels of prostaglandin E2 and COX 2 have already been noticed in the spinal cord of ALS patients and SOD1 mutant mice. Celecoxib, a COX 2 inhibitor is shown to be useful in pre-clinical screening, prolonging survival of SOD1 mice. A 12-month double blind placebocontrolled clinical trial was performed on 300 patients with ALS. Subjects were randomized to get celecoxib or placebo for 12 months. 121 Treatment with celecoxib showed safe effects but did not have a beneficial influence on the decline in muscle power, crucial ability, motor unit number estimates, ALS FRS score, or survival in patients with ALS. 121 Nimesulide has been indicated since the preferential COX 2 chemical because Cathepsin Inhibitor 1 of has additional antioxidant properties and could be administered via numerous channels, including orally. Preclinical observations unmasked that nimesulide management reduces prostaglandin E2 levels in the back of SOD1G93A mice and maintains motor talent integrity. But, its putative mechanism of action is the just like celecoxib and safety concerns surrounding long term administration of this treatment class may limit using COX 2 inhibitors in patients with ALS. Their mixture with other compounds such as creatine is under evaluation. Glatiramer acetate Glatiramer acetate, a combination of four amino acids, is the analogous of myelin basic protein and it’s used to lessen the frequency of episodes in patients with multiple sclerosis.