Researchers say the findings may also help test new ALS drugs. Italian researchers report that a simple blood test may be able to help predict survival and the course of the disease in ALS patients. The components of blood that may reveal clues to the rate of ALS progression are called albumin and creatinine. Tests for these components are typically used to look at the health of the kidneys and liver, according to the U.S. National Library of Medicine (source). But now it appears that new research shows that these substances may help measure the health of ALS patients. ”Assessment of albumin and creatinine in the blood can accurately predict ALS prognosis at the time of diagnosis,” said the study’s lead investigator, Adriano Chio, PhD, professor of neurology in the Department of Neuroscience at the University of Turin’s Rita Levi Montalcini. According to the study’s background information, the average survival of ALS patients after diagnosis is only one to three years. Finding simple ways to predict disease progression could help doctors with treatment and researchers evaluate new drugs, the study authors said. ”Currently, clinical trials rely on two main outcome measures (metrics): 1, survival, which is considered too crude and has a large degree of bias in clinical practice conducted in different ALS centers; and 2, the ALS Functional Rating Scale, which has several limitations and is at least partially (content) subjective. Researchers are actively looking for more objective ways to predict disease progression,” said Dr. Adriano Chio. Albumin and creatinine levels have the potential to be tools for neurologists to predict the prognosis of patients early in the disease, he said. ”In the field of ALS research, albumin and creatinine can also be used to track disease progression in clinical trials, leading to the discovery of new effective drugs for ALS,” Dr. Adriano Chio added. The study was published online July 21, 2014, in the Journal of the American Medical Association – Neurology (JAMA Neurology). Dr. Ronald Kanner, chairman of neurology at North Shore University Hospital and Long Island Jewish Medical Center, said the disease course of ALS is highly variable, with “some patients surviving less than a year and others progressing very slowly, with 5 percent of patients surviving more than 20 years. For therapies designed to slow the progression of ALS, the enormous variability of the disease can make it difficult to judge the effectiveness of therapies, he said. “This study identifies readily measurable substances in the blood that could provide clues for assessing disease severity and treatment impact,” he added. In the study, Chio and colleagues looked at levels of albumin, creatinine, leukocytes, sugar, cholesterol and thyroid hormones in the blood of more than 600 ALS patients. They later repeated their findings in an additional 122 ALS patients to verify their findings. According to the study, only albumin and creatinine levels were associated with survival, in both men and women. Lower levels of these substances were associated with worse survival and muscle function. Lower levels of creatinine were associated with loss of muscle mass, the researchers found. Lower levels of albumin were associated with increased inflammation. The researchers believe that long-term studies tracking creatinine and albumin levels throughout the course of the disease will help better define their relationship with ALS symptoms and disease progression.