Edaravone (Daiichi Sankyo) vs Ammonaps (sodium phenylbutyrate)

Edaravone (Daiichi Sankyo) vs Ammonaps (sodium phenylbutyrate)

Edaravone (marketed by Daiichi Sankyo) is an antioxidant used primarily for the treatment of amyotrophic lateral sclerosis (ALS), a neurodegenerative disease, and it works by relieving oxidative stress. Ammonaps, which is sodium phenylbutyrate, is used to treat urea cycle disorders, a completely different condition that involves the body's removal of ammonia. When deciding between these medications, it is crucial to consider the specific condition being treated, as Edaravone is not suitable for urea cycle disorders, and Ammonaps is not indicated for ALS.

Difference between Edaravone and Ammonaps

Metric Edaravone (Daiichi Sankyo) Ammonaps (sodium phenylbutyrate)
Generic name Edaravone Sodium phenylbutyrate
Indications Amyotrophic lateral sclerosis (ALS) Urea cycle disorders
Mechanism of action Free radical scavenger Adjunct in the chronic management of urea cycle disorders involving deficiencies of ureagenesis enzymes
Brand names Radicava, Radicut Buphenyl, Ammonaps
Administrative route Intravenous Oral
Side effects Bruising, gait disturbance, headache, skin inflammation, eczema Body odor, headache, nausea, vomiting, rash
Contraindications Hypersensitivity to edaravone or any of the excipients Hypersensitivity to sodium phenylbutyrate or any of the excipients, hyperammonemia
Drug class Neuroprotective agent Ammonia scavenger
Manufacturer Daiichi Sankyo Horizon Pharma

Efficacy

Edaravone and its Efficacy in Amyotrophic Lateral Sclerosis (ALS)

Edaravone, marketed by Daiichi Sankyo, is a medication that has shown efficacy in the treatment of Amyotrophic Lateral Sclerosis (ALS), a progressive neurodegenerative disease. The drug works as a free radical scavenger, potentially reducing oxidative stress which is believed to be a contributing factor in the neuronal cell damage seen in ALS. Clinical trials have demonstrated that Edaravone can slow the decline in physical function in patients with ALS, particularly in the early stages of the disease and in those with a relatively preserved lung function.

The pivotal trial that led to the approval of Edaravone for ALS was a six-month, placebo-controlled study that showed a smaller decline in the ALS Functional Rating Scale-Revised (ALSFRS-R) score in patients treated with Edaravone compared to those who received a placebo. This scale is a commonly used measure of disability in ALS, assessing patients' capacity to carry out activities of daily living. The results suggest that Edaravone may provide a therapeutic benefit in preserving motor function in individuals with ALS.

Ammonaps (Sodium Phenylbutyrate) and ALS

Ammonaps, known generically as sodium phenylbutyrate, is a drug that has been explored for its potential off-label use in ALS. While Ammonaps is primarily approved for the treatment of urea cycle disorders, its mechanism of action, which involves the reduction of ammonia levels and modulation of glutamine synthesis, has led researchers to investigate its efficacy in neurodegenerative diseases like ALS. The hypothesis is that sodium phenylbutyrate may help mitigate the effects of neurotoxicity and cellular stress, which are factors implicated in ALS pathogenesis.

However, the efficacy of Ammonaps in the treatment of ALS is less established compared to Edaravone. Clinical studies and trials are necessary to determine the therapeutic potential of sodium phenylbutyrate in ALS patients. As of now, its use in this context remains investigational, and further research is required to ascertain its safety and effectiveness for ALS patients. Physicians considering off-label use of Ammonaps for ALS should do so with careful consideration and in the context of clinical trials or with comprehensive patient monitoring.

Regulatory Agency Approvals

Edaravone
  • Pharmaceuticals and Medical Devices Agency (PMDA), Japan
Ammonaps
  • European Medical Agency (EMA), European Union
  • Food and Drug Administration (FDA), USA
  • Therapeutic Goods Administration (TGA), Australia

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If Edaravone or Ammonaps are not approved or available in your country (e.g. due to supply issues), you can access them via Everyone.org.

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