Huoling Shengji granule in amyotrophic lateral sclerosis: A multicenter, randomized, double-blind, riluzole-controlled trial.

In mITT participants aged ≤65 years, HLSJ consistently showed a favorable trend over riluzole across multiple subgroups, including those with disease duration >1 year, forced vital capacity (FVC) ≥80%, baseline ALSFRS-R score of 41–47, definite or laboratory-supported probable ALS diagnosis, non-bulbar onset, prior use (or non-use) of riluzole or edaravone, female sex, and faster disease progression rate ( Fig.

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