43 The combined analysis from both trials performed by the Cochrane Group showed a trend towards for beneficial effect favoring the treated group. 45 A third placebo-controlled trial has been recently completed. 44 There was no difference between treatment groups in the primary and secondary outcome measures after a two-year follow-up period. 44 In conclusion, r-IGF-I is well tolerated but, although so far is the only agent other than riluzole to show on any ALS markers of disease progression, can not be considered beneficial for patients with ALS.
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