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TCM therapies and Riluzole show no significant differences in ALS functional status outcomesAnalysis compares traditional Chinese medicine for Amyotrophic Lateral Sclerosis

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Key Takeaway
Note that TCM therapies and Riluzole combinations showed no significant differences in ALS functional status.

This Bayesian network meta-analysis evaluated the efficacy of various Traditional Chinese Medicine (TCM) therapies, including Chinese herbal medicines, preparations, and non-pharmacological treatments, for adult patients with Amyotrophic Lateral Sclerosis. The analysis compared these interventions against no intervention, placebo, conventional treatments, and various combinations.

The primary finding was that no significant differences in functional status were observed among TCM therapies, ICT, Riluzole alone, and Riluzole plus placebo. While specific SUCRA values were reported for certain combinations, such as Shenmai injection plus ICT (SUCRA 0.735) or Acupuncture plus rehabilitation exercises plus Riluzole (SUCRA 0.928), these did not translate into statistically significant differences across the primary outcome categories. Some preparations, including Jiweiling injection, Shenmai injection, Jiawei Sijunzi decoction, and Shenzhe Jiangqi powder, were identified as candidate preparations for ALS patients.

Limitations noted by the authors include the lack of significant differences in functional status across the compared groups. The clinical relevance is currently limited as the data do not establish clear superiority of one intervention over another. These findings suggest that while specific TCM preparations are candidates for further study, they do not currently demonstrate superior efficacy over standard care in this analysis.

How this fits prior evidence

This meta-analysis addresses the management of Amyotrophic Lateral Sclerosis (ALS). While prior evidence notes that ATXN2 repeat lengths of 30 or more correlate with increased ALS risk and shorter diagnosis times, and that 50% of ALS patients have sleep disorders, this study focuses on pharmacological and traditional interventions. It does not confirm or contradict the findings regarding HMGB1 as an inflammatory amplifier or the potential of MSC-derived extracellular vesicles in neurodegenerative diseases.

Living with Amyotrophic Lateral Sclerosis (ALS) means facing a condition that affects physical function and quality of life. Because of this, patients and families often look for any possible way to manage symptoms and maintain independence. A recent analysis looked at several Traditional Chinese Medicine (TCM) therapies, including herbal medicines and non-pharmacological treatments, to see how they compare to standard treatments like Riluzole.

The study looked at how these different options affected functional status. While the analysis found no significant differences in functional status between TCM therapies, acupuncture, and Riluzole alone or with a placebo, it did identify some specific combinations with higher probabilities of superiority in certain scales. For example, certain herbal decoctions and injections were identified as candidate preparations for patients.

It is important to note that while some specific treatments showed higher probabilities on certain scales, the overall data did not show a clear winner in functional status across all groups. Because the evidence is complex and the results are nuanced, these findings should be discussed with a medical provider to determine the best path for individual care.

What this means for you:
Several traditional Chinese medicines are candidate treatments for ALS, though they showed no clear advantage over standard care.

Common questions

Are traditional Chinese medicines effective for ALS?

The study found no significant differences in functional status among traditional Chinese medicine therapies, acupuncture, and Riluzole alone or with a placebo. However, specific preparations like Jiweiling injection, Shenmai injection, Jiawei Sijunzi decoction, and Shenzhe Jiangqi powder were identified as candidate preparations for patients with ALS.

How do these treatments compare to standard drugs like Riluzole?

The analysis did not find significant differences in functional status when comparing traditional Chinese medicine therapies to Riluzole alone or Riluzole combined with a placebo. While some specific combinations showed higher probabilities of superiority on certain scales, they did not show a clear overall advantage over standard care.

What specific traditional treatments were mentioned?

The study highlighted several options, including Shenmai injection, Jiawei Sijunzi decoction, Shenzhe Jiangqi powder, and Jiweiling injection. These are considered candidate preparations for ALS patients. You should talk to your doctor to see if any of these are appropriate for your specific situation.

Study Details

Study typeMeta analysis
EvidenceLevel 1
PublishedOct 2026
View Original Abstract ↓
ObjectiveTo assess the effectiveness of specific Traditional Chinese Medicine (TCM) therapies for Amyotrophic Lateral Sclerosis (ALS) using Bayesian network meta-analysis.MethodsPubMed, the Cochrane Library, EMBASE, Web of Science, and four Chinese databases up to 15th December 2024 was searched, including RCTs on adult Amyotrophic Lateral Sclerosis patients treated with TCM therapies (Chinese herbal medicine, preparations, non-pharmacological treatments) alone or combined with conventional treatments. Controls included no intervention, placebo, conventional treatments, or combinations. Primary outcomes were functional status (ALSFRS, ALSFRS-R, AALSS, m-Norris scales). Bayesian network meta-analysis compared treatment effects and calculated SUCRA values.ResultsThirty-five RCTs involving 27 TCM therapies were included. No significant differences in functional status or quality of life were found among TCM therapies, ICT, Riluzole alone, and Riluzole plus placebo. For functional status, Shenmai injection + ICT (SUCRA 0.735 for ALSFRS, 0.870 for ALSFRS-R), Jiweiling injection + placebo (SUCRA 0.868 for ALSFRS), Jiawei Sijunzi decoction alone (SUCRA 0.739 for ALSFRS-R), Acupuncture + rehabilitation exercises + Riluzole (SUCRA 0.928 for AALSS, 0.863 for m-Norris) and Shenzhe Jiangqi powder + placebo (SUCRA 0.860 for m-Norris) had the highest probabilities of being superior treatment. For quality of life, Thunder fire moxibustion + Riluzole and Jiweiling injection + placebo for ALSAQ-40 were favorable.ConclusionDespite no significant differences in functional status among TCM therapies, ICT, Riluzole alone, and Riluzole plus placebo, Jiweiling injection, Shenmai injection, Jiawei Sijunzi decoction, and Shenzhe Jiangqi powder may be regarded as candidate preparations for ALS patients. Future research should focus on real-world data to explore long-term effects and practical benefits.Systematic Review Registrationhttps://inplasy.com/inplasy-2024-8-0050/, identifier INPLASY202480050.
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