← Back to Drug List

EDARAVONE INJ,SOLN

Clinical Criteria Summary

Exclusion Criteria

  • Notably decreased respiratory function and dyspnea (total score of 3 or less points on ALSFRS-R items for dyspnea, orthopnea, or respiratory insufficiency)
  • Bilevel positive airway pressure (BiPAP) dependent (use 24 hours per day)
  • Other medical illness that will limit evaluation of motor function and efficacy (e.g., Parkinson’s disease, schizophrenia, significant dementia, other major medical morbidity)
  • Other possible causes for current symptoms as applicable not ruled out (e.g., cervical spondylosis or multifocal motor neuropathy)

Inclusion Criteria

  • Care provided by a VA/VA Community Care neurologist or locally designated ALS expert
  • Diagnosis of ALS made or confirmed by a VA/VA Community Care neurologist or locally designated ALS expert
  • Documentation of an itemized ALSFRS-R score in the electronic medical record
  • Preserved function in either upper limbs (e.g., self-feed, self-dressing, typing) or lower limbs (e.g., walking)
  • Discussion with patient/caregiver/family regarding realistic treatment expectations and discontinuation of therapy documented in the patient’s medical record

Source Documents