Objectives: To assess the epidemiology of ALS in Austria and to evaluate the long-term effect of riluzole treatment on survival. Methods: Hospital discharge and riluzole prescription databases were used to identify ALS cases from January 2008 to June 2012. Using the capture-recapture method we evaluated the incidence and prevalence of ALS and patients' survival in dependence of age, gender and riluzole treatment. Results: The corrected incidence and prevalence of ALS were 3.13/100,000 person-years (95% CI, 2.77 to 3.50) and 9.14/100,000 persons (95% CI, 8.53 to 9.79), respectively. Median survival from diagnosis was 676 days (95% CI, 591 to 761). A younger age at diagnosis was associated with a longer survival. Gender did not appear to affect survival time. Riluzole therapy was associated with a survival advantage only for the initial treatment period. The adjusted hazard ratio of mortality for using riluzole increased continually over time resulting in an apparent reversal of its beneficial effect after 6 months of therapy. Conclusions: We report incidence and prevalence estimates that are on the upper end of the wide range discussed in literature. Riluzole seems to exert a beneficial effect only in the first 6 months of therapy.

1.
Bensimon G, Lacomblez L, Meininger V: A controlled trial of riluzole in amyotrophic lateral sclerosis. ALS/Riluzole Study Group. N Engl J Med 1994;330:585-591.
2.
Lacomblez L, Bensimon G, Leigh PN, Guillet P, Meininger V: Dose-ranging study of riluzole in amyotrophic lateral sclerosis. Amyotrophic Lateral Sclerosis/Riluzole Study Group II. Lancet 1996;347:1425-1431.
3.
Turner MR, Goldacre R, Ramagopalan S, Talbot K, Goldacre MJ: Autoimmune disease preceding amyotrophic lateral sclerosis: an epidemiologic study. Neurology 2013;81:1222-1225.
4.
Traynor BJ, Alexander M, Corr B, Frost E, Hardiman O: An outcome study of riluzole in amyotrophic lateral sclerosis - a population-based study in Ireland, 1996-2000. J Neurol 2003;250:473-479.
5.
Suissa S: Immortal time bias in pharmacoepidemiology. Am J Epidemiol 2008;167:492-499.
6.
Clark DO, Von Korff M, Saunders K, Baluch WM, Simon GE: A chronic disease score with empirically derived weights. Med Care 1995;33:783-795.
7.
Schneeweiss S, Seeger JD, Maclure M, Wang PS, Avorn J, Glynn RJ: Performance of comorbidity scores to control for confounding in epidemiologic studies using claims data. Am J Epidemiol 2001;154:854-864.
8.
Quail JM, Lix LM, Osman BA, Teare GF: Comparing comorbidity measures for predicting mortality and hospitalization in three population-based cohorts. BMC Health Serv Res 2011;11:146.
9.
Hook EB, Regal RR: Internal validity analysis: a method for adjusting capture-recapture estimates of prevalence. Am J Epidemiol 1995;142:S48-S52.
10.
Wittie M, Nelson LM, Usher S, Ward K, Benatar M: Utility of capture-recapture methodology to assess completeness of amyotrophic lateral sclerosis case ascertainment. Neuroepidemiology 2013;40:133-141.
11.
Putter H, Sasako M, Hartgrink HH, van de Velde CJ, van Houwelingen JC: Long-term survival with non-proportional hazards: results from the Dutch Gastric Cancer Trial. Stat Med 2005;24:2807-2821.
12.
Chio A, Mora G, Calvo A, Mazzini L, Bottacchi E, Mutani R: Epidemiology of ALS in Italy: a 10-year prospective population-based study. Neurology 2009;72:725-731.
13.
Murphy M, Quinn S, Young J, Parkin P, Taylor B: Increasing incidence of ALS in Canterbury, New Zealand: a 22-year study. Neurology 2008;71:1889-1895.
14.
Huisman MH, de Jong SW, van Doormaal PT, Weinreich SS, Schelhaas HJ, van der Kooi AJ, de Visser M, Veldink JH, van den Berg LH: Population based epidemiology of amyotrophic lateral sclerosis using capture-recapture methodology. J Neurol Neurosurg Psychiatry 2011;82:1165-1170.
15.
Chio A, Logroscino G, Traynor BJ, Collins J, Simeone JC, Goldstein LA, White LA: Global epidemiology of amyotrophic lateral sclerosis: a systematic review of the published literature. Neuroepidemiology 2013;41:118-130.
16.
Marin B, Hamidou B, Couratier P, Nicol M, Delzor A, Raymondeau M, Druet-Cabanac M, Lautrette G, Boumediene F, Preux PM: Population-based epidemiology of amyotrophic lateral sclerosis (ALS) in an ageing Europe - the French register of ALS in Limousin (FRALim register). Eur J Neurol 2014;21:1292-1300.e78-e79.
17.
Uenal H, Rosenbohm A, Kufeldt J, Weydt P, Goder K, Ludolph A, Rothenbacher D, Nagel G: Incidence and geographical variation of amyotrophic lateral sclerosis (ALS) in Southern Germany - completeness of the ALS registry Swabia. PLoS One 2014;9:e93932.
18.
Pradas J, Puig T, Rojas-Garcia R, Viguera ML, Gich I, Logroscino G: Amyotrophic lateral sclerosis in Catalonia: a population based study. Amyotroph Lateral Scler Frontotemporal Degener 2013;14:278-283.
19.
Logroscino G, Traynor BJ, Hardiman O, Chio A, Mitchell D, Swingler RJ, Millul A, Benn E, Beghi E: Incidence of amyotrophic lateral sclerosis in Europe. J Neurol Neurosurg Psychiatry 2010;81:385-390.
20.
Ragonese P, Cellura E, Aridon P, D'Amelio M, Spataro R, Taiello AC, Maimone D, La Bella V, Savettieri G: Incidence of amyotrophic lateral sclerosis in Sicily: a population based study. Amyotroph Lateral Scler 2012;13:284-287.
21.
Coffman CJ, Horner RD, Grambow SC, Lindquist J: Estimating the occurrence of amyotrophic lateral sclerosis among Gulf War (1990-1991) veterans using capture-recapture methods. Neuroepidemiology 2005;24:141-150.
22.
Logroscino G, Traynor BJ, Hardiman O, Chio A, Couratier P, Mitchell JD, Swingler RJ, Beghi E: Descriptive epidemiology of amyotrophic lateral sclerosis: new evidence and unsolved issues. J Neurol Neurosurg Psychiatry 2008;79:6-11.
23.
Ray WA: Improving automated database studies. Epidemiology 2011;22:302-304.
24.
de Jong S, Huisman M, Sutedja N, van der Kooi A, de Visser M, Schelhaas J, van der Schouw Y, Veldink J, van den Berg L: Endogenous female reproductive hormones and the risk of amyotrophic lateral sclerosis. J Neurol 2013;260:507-512.
25.
Rudnicki SA: Estrogen replacement therapy in women with amyotrophic lateral sclerosis. J Neurol Sci 1999;169:126-127.
26.
Manjaly ZR, Scott KM, Abhinav K, Wijesekera L, Ganesalingam J, Goldstein LH, Janssen A, Dougherty A, Willey E, Stanton BR, Turner MR, Ampong MA, Sakel M, Orrell RW, Howard R, Shaw CE, Leigh PN, Al-Chalabi A: The sex ratio in amyotrophic lateral sclerosis: a population based study. Amyotroph Lateral Scler 2010;11:439-442.
27.
Vivekananda U, Manjalay ZR, Ganesalingam J, Simms J, Shaw CE, Leigh PN, Turner MR, Al-Chalabi A: Low index-to-ring finger length ratio in sporadic ALS supports prenatally defined motor neuronal vulnerability. J Neurol Neurosurg Psychiatry 2011;82:635-637.
28.
Sorenson EJ, Stalker AP, Kurland LT, Windebank AJ: Amyotrophic lateral sclerosis in Olmsted County, Minnesota, 1925 to 1998. Neurology 2002;59:280-282.
29.
Zoccolella S, Beghi E, Palagano G, Fraddosio A, Guerra V, Samarelli V, Lepore V, Simone IL, Lamberti P, Serlenga L, Logroscino G: Riluzole and amyotrophic lateral sclerosis survival: a population-based study in southern Italy. Eur J Neurol 2007;14:262-268.
30.
Lee CT, Chiu YW, Wang KC, Hwang CS, Lin KH, Lee IT, Tsai CP: Riluzole and prognostic factors in amyotrophic lateral sclerosis long-term and short-term survival: a population-based study of 1149 cases in Taiwan. J Epidemiol 2013;23:35-40.
31.
Bensimon G, Lacomblez L, Delumeau JC, Bejuit R, Truffinet P, Meininger V: A study of riluzole in the treatment of advanced stage or elderly patients with amyotrophic lateral sclerosis. J Neurol 2002;249:609-615.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.