Prognostic Factors for Survival in Patients with Amyotrophic Lateral Sclerosis: Analysis of a Multi-Centre Clinical Trial (P1.139)

Objectives: The study has the following objectives: 1) to determine the characteristics of ALS patients with better survival and 2) to determine which physical factors are associated with poor quality of life (QoL) and what impact supportive interventions have on QoL. Background: Information regarding factors influencing prognosis and QoL in patients with amyotrophic lateral sclerosis (ALS) are useful to clinicians and also for patients and their carers. Being aware of the specific clinical factors which significantly influence survival would help clinicians in scheduling appropriate interventions and also in terms of advising patients as to what to expect as their disease progresses. Methods: This study is a retrospective analysis of a cohort of 512 patients who participated in the phase II/III clinical trial of Olesoxime. Results: Cox multivariate regression analysis found older age, bulbar onset disease, low baseline forced vital capacity (FVC), low baseline manual muscle test (MMT) scores and a shorter diagnostic delay to be independently associated with poor survival outcome. Physical factors shown to have the strongest correlation with poor QoL were low weight and a reduced ability to climb stairs. Therapeutic interventions including gastrostomy and non-invasive ventilation (NIV) had no positive impact on QoL in this cohort. Conclusions: The prognostic factors for survival identified here are consistent with other studies of ALS patients, with the additional identification of baseline MMT score as another predictor of prognosis. Furthermore the correlation between both weight and poor lower limb function with QoL is novel and underlines the importance of careful nutritional management in this hypercatabolic condition. Disclosure: Dr. Rafiq has nothing to disclose. Dr. Yates has nothing to disclose.