Study Suggests Diaphragm Pacing May be Detrimental in ALS

Diaphragm Pacing Systems (DPS) deliver electrical impulses to the diaphragm to stimulate muscle contraction and improve respiratory function. In 2011, the NeuRX DPS gained Humanitarian Device Exemption approval by the United States FDA to treat respiratory failure in ALS patients, and has since been widely introduced in ALS clinics (see May 2012 news). According to the report in the July 30 Lancet Neurology, the first randomised, controlled clinical trial to evaluate efficacy of DPS with non-invasive ventilation (NIV) as compared to NIV alone has yielded disappointing results. The multi-center clinical trial in the UK, called DiPALS, found that survival was on average 11 months shorter in the group of patients using DPS. These findings suggest that diaphragm pacing is not generally beneficial in ALS patients, and merit further analysis of the reasons for the discrepant findings with prior studies.

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Reference:

DiPALS Writing Committee; DiPALS Study Group Collaborators. Safety and efficacy of diaphragm pacing in patients with respiratory insufficiency due to amyotrophic lateral sclerosis (DiPALS): a multicentre, open-label, randomised controlled trial. Lancet Neurol. 2015 Jul 30. [Pubmed].
diaphragm pacing systems DiPALS disease-als topic-clinical
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