NIV Improves Quality of Life For All,
Longevity for Most With ALS

A multi-year study of the effects of noninvasive ventilation (NIV) for patients with amyotrophic lateral sclerosis (ALS) shows that it improves both survival and quality of life in people with moderate or no mouth and throat (bulbar) weakness, and that it improves quality of life even in those with severe bulbar weakness.

Stephen Bourke and colleagues at the University of Newcastle Upon Tyne (UK) and Newcastle Hospitals Trust, who published their findings in the February issue of The Lancet Neurology, studied 22 people with ALS who were randomly assigned to standard care plus NIV, and 19 assigned to standard care alone. Quality of life was measured by a battery of questionnaires.

The NIV group survived 48 days (28 percent) longer on average than the non-NIV group.

When the results from patients with good bulbar function were segregated from the total, there was a dramatic difference, with NIV users surviving an average of 216 days (more than seven months) and non-NIV users surviving an average of 11 days.

Participants with poor bulbar function showed no survival benefit, and the investigators speculate that these patients may have been unable to use NIV effectively.

The investigators emphasize that quality of life measurements showed improvements for all NIV users and that, while more investigation of NIV in people with bulbar weakness should be undertaken, NIV should not be withheld from them in the meantime.