Glentek/Riluzol (riluzole) vs Qalsody (tofersen)

Glentek (also known as Riluzole) is an FDA-approved medication primarily used to slow the progression of amyotrophic lateral sclerosis (ALS), and it works by modulating glutamate neurotransmission. Qalsody (tofersen), on the other hand, is an investigational antisense oligonucleotide designed to reduce the production of a specific protein, superoxide dismutase 1 (SOD1), which is associated with a genetic form of ALS. When deciding on the appropriate medication, it is crucial to consider the specific type of ALS diagnosed, as Riluzole is used more broadly for ALS, while Tofersen targets a specific genetic mutation and is still under investigation for safety and efficacy.

Difference between Glentek/Riluzol and Qalsody

Metric	Glentek/Riluzol (riluzole)	Qalsody (tofersen)
Generic name	Riluzole	Tofersen
Indications	Amyotrophic lateral sclerosis (ALS)	Treatment of amyotrophic lateral sclerosis (ALS) with a confirmed SOD1 mutation
Mechanism of action	Reduces glutamate release, may also inhibit voltage-dependent sodium channels	Antisense oligonucleotide that targets SOD1 mRNA, reducing SOD1 protein production
Brand names	Glentek, Rilutek, Teglutik	Qalsody
Administrative route	Oral	Intrathecal injection
Side effects	Dizziness, gastrointestinal disturbances, elevated liver enzymes, asthenia	Back pain, headache, falls, spasticity, and complications related to the lumbar puncture
Contraindications	Liver function impairment, caution in patients with a history of drug-induced liver injury	None known specifically, but caution is advised in patients with spinal deformities or coagulation disorders due to the route of administration
Drug class	Glutamate antagonist	Antisense oligonucleotide
Manufacturer	Sanofi (Rilutek), ITF Pharma (Teglutik), various generic manufacturers	Biogen

Efficacy

Efficacy of Riluzole (Rilutek/Glentek) in ALS

Riluzole, marketed under the brand names Rilutek and Glentek, is a medication that has been approved for the treatment of Amyotrophic Lateral Sclerosis (ALS). The efficacy of riluzole in ALS has been demonstrated through clinical trials, which have shown that it can modestly prolong survival in individuals with this condition. The exact mechanism through which riluzole exerts its beneficial effects in ALS is not fully understood, but it is thought to involve the inhibition of glutamate release, which can be toxic to neurons. On average, riluzole may extend survival by a few months, and it may also delay the onset of ventilator-dependence in some patients.

Despite its benefits, riluzole does not halt the progression of ALS or reverse the damage already done by the disease. Its efficacy is primarily in extending life expectancy and potentially improving quality of life. Riluzole is typically taken orally in tablet form, and the dosing regimen usually involves taking the medication twice daily. It is important to note that the efficacy of riluzole can vary from patient to patient, and it is generally more effective when started early in the course of the disease.

Efficacy of Tofersen (Qalsody) in ALS

Tofersen, sold under the brand name Qalsody, is an investigational drug that has been studied for the treatment of ALS, particularly in patients with a genetic form of the disease caused by mutations in the superoxide dismutase 1 (SOD1) gene. Tofersen is an antisense oligonucleotide designed to reduce the production of the abnormal SOD1 protein, which is believed to contribute to the neurodegeneration seen in ALS. Clinical trials are ongoing to evaluate the efficacy and safety of tofersen in patients with SOD1-ALS.

Initial results from clinical trials have suggested that tofersen can significantly reduce levels of SOD1 protein in the cerebrospinal fluid, which may correlate with a slowing of disease progression. However, more extensive and longer-term studies are needed to fully understand the efficacy of tofersen in altering the course of ALS and improving patient outcomes. As of the knowledge cutoff date, tofersen remains an experimental therapy and has not yet received regulatory approval for the treatment of ALS. It is administered through intrathecal injection, which involves delivering the medication directly into the spinal fluid.

Regulatory Agency Approvals

Glentek/Riluzol

European Medical Agency (EMA), European Union
Therapeutic Goods Administration (TGA), Australia
Medicines & Healthcare products Regulatory Agency (MHRA), United Kingdom
The Medicines Evaluation Board (MEB), The Netherlands

Qalsody

European Medical Agency (EMA), European Union
Food and Drug Administration (FDA), USA

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