A possible explanation of these negative results may be that these tests didn’t use doses that enhance head phosphocreatine levels, as preliminary results demonstrated that treatment with 20 g/day increases maximal isometric energy in ALS patients. 88 As an alternative, the mix of higher doses of creatine with other drugs could be used to maximise its benefit, as indicated by results from recent animal studies. Confirming these observations, a modern stage II collection test, in which creatine at 20 g/day was used in conjunction with either minocycline or celecoxib, Chk2 inhibitor discovered that the mean drop in ALS Functional Rating Scale score was lower within the celecoxib creatine group compared to the minocycline creatine group and an historical cohort. The celecoxib creatine may be consequently a combination for further examination. Two clinical studies with celecoxib creatine connection and with high dose creatine are underway. Vitamin E Vitamin E may be the most important lipidsoluble antioxidant and shields cell membranes Immune system from oxidation by reacting with lipid radicals. Pre-clinical studies showed that treatment with vitamin E decreases the onset and progression of the paralysis in SOD 1 transgenic mice. Two double blind, placebo controlled, clinical trials on ALS people from Germany and France examined the efficacy and safety of high-dose e Vitamin when given included with riluzole, over a follow-up amount of 18 and 12 months, respectively. No significant difference between placebo and treatment group might be found both in the main or the secondary outcome measures, although the French trial observed that patients receiving alpha tocopherol were less likely to advance from the milder state to the more severe state, according to the ALS Health State level. In a recent retrospective case control study, a high intake of vitamin E was related to a C60% decreased risk of developing ALS. Further clinical studies with longer follow up or larger sample sizes are expected. Edavarone Edaravone is definitely an agent popular for cerebral Icotinib ischemia in Japan that acts as a free of charge radical scavenger. In a randomized blind trial, intraperitoneally administration of multiple doses of edaravone within an ALS mice product somewhat slowed the motor drop and motor neuron degeneration of the transgenic mice, even though given after the beginning of the disease. Moreover, high dose edavarone therapy was associated with a significant decline in the area of mutant SOD1 deposit in the spinal-cord. In an open-label phase II study of 20 patients with ALS, the intravenous administration of edavarone was safe and well-tolerated and there was a suggestion of slowed infection progression, measured by the ALS FRS degree during the six-month therapy period, compared with the si months before the administration of edavarone.