Novas abordagens terapêuticas na Esclerose Lateral Amiotrófica: uma revisão sistemática
DOI:
https://doi.org/10.5327/prmj.1067Palavras-chave:
doenças neurodegenerativas, esclerose lateral amiotrófica, Estado Funcional, medicina baseada em evidênciaResumo
Objetivo: Compilar estudos da literatura que investiguem novas abordagens terapêuticas emergentes para o tratamento da Esclerose Lateral Amiotrófica (ELA) quanto a sua eficácia na sobrevida dos pacientes. Método: Trata-se de um estudo de revisão sistemática seguindo as diretrizes PRISMA. Foram incluídos estudos originais que apresentassem ao menos um desfecho clínico e dentro do intervalo de 2020 a 2025. As bases de dados utilizadas nas buscas foram PubMed, SciELO e LILACS. A análise do risco de viés foi feita pela ferramenta RoB 2.0 e a qualidade dos estudos foi avaliada pelo GRADE. Resultados: Foram incluídos 26 estudos clínicos randomizados. As intervenções analisadas incluíram fármacos anti-inflamatórios, imunomoduladores e terapias combinadas. Observou-se viés de publicação favorável a resultados positivos em parte dos estudos, enquanto a qualidade das evidências variou entre baixa e moderada. A expressiva heterogeneidade metodológica sugeriu que a maioria dos tratamentos emergentes apresentou resultados clínicos incertos, além de perda significativa de seguimento em alguns ensaios. A complexidade da ELA permanece evidente, assim como a desigualdade no acesso às terapias, especialmente no contexto do Sistema Único de Saúde (SUS). Conclusão: Faz-se necessário mais ensaios clínicos multicêntricos, que levem em consideração as particularidades genéticas e clínicas de cada paciente, com políticas e avaliações rigorosas, a fim de embasarem evidências robustas de terapias inovadoras no tratamento da ELA.
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