The Evidence for Symptomatic Treatments in ALS

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The Evidence for Symptomatic Treatments in ALS

Prevention of Deep Vein Thrombosis


Low molecular weight heparin and compression stockings reduce deep vein thrombosis (DVT) incidence in hospital inpatients overall, and all-cause mortality was also lower in one study. However, thromboprophylaxis may not necessarily be suitable for all, for example, compression stockings appear detrimental in stroke patients and existing data may not necessarily apply to older patients. No mortality data or treatment RCTs exist in ALS.

A prospective study of 50 ALS outpatients estimated DVT incidence at 11%/year, increasing to 36%/year in patients with significant leg weakness. We routinely prescribe prophylactic dose low molecular weight heparin to ALS inpatients in the absence of contraindications. We do not currently routinely treat ALS outpatients with thromboprophylaxis and await a RCT.

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