**5.3.5 Antioxidants**

In a systematic review, no evidence for a benefit of anti-oxidant treatment with regard to survival, neither alone, nor in combination, has been described (Orrell et al., 2008). The antioxidants administered in ALS patients included vitamin E, acetylcysteine, L-methionine, and selenium.

### **5.3.6 Arimoclomol (BRX-220)**

The small molecule arimoclomol is a co-inducer of heat-shock proteins (Phukan, 2010), namely of HSP70 (Brown, 2007). Thus it may be used to increase endogenous cellular protein repair and to prevent misfolding, or aggregation, of proteins by activating molecular chaperones (Kalmar & Greensmith, 2009).

Arimoclomol was tested in two phase II studies to evaluate safety and efficacy in ALS patients (NCT00561366) and to find a dose range and to determine pharmacokinetic parameters (NCT00244244) (Cudkowicz et al., 2008; Lanka et al., 2009).

Currently, arimoclomol is tested in a phase II/III trial in patients with SOD1-positive fALS (NCT00706147).
