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ALSSeptember 2022Summary reviewed June 2026

What the VALOR Trial Found — Tofersen for SOD1 ALS

Researchers tested tofersen, a drug designed to lower levels of a harmful protein in people with ALS caused by SOD1 gene mutations. The drug successfully reduced the protein in spinal fluid, but didn't improve muscle function or breathing over 28 weeks. People who started the drug earlier showed hints of better outcomes at one year.

What the trial was testing

The VALOR enrolled 139 patients with als. The study was sponsored by Biogen and tracked outcomes across the full group of patients who matched the trial's eligibility profile.

It was a large trial designed to confirm whether the treatment works well enough for wider use. Trials at this stage are designed to produce evidence regulators and physicians can act on — not just observations to follow up later.

What the results showed

Tofersen lowered harmful SOD1 protein levels in spinal fluid but didn't improve physical function in the first 28 weeks.

The New England journal of medicine · 2022 · NCT03070119

These findings — that people who started tofersen right away had slightly better muscle function after one year than those who waited six months — were published in the The New England journal of medicine and represent the headline result of the study.

Researchers tracked outcomes across 139 patients enrolled in the trial. The result was consistent enough across the group that the team felt confident reporting it.

What this means for patients

For patients with als, this result changes the calculus on what to ask their care team about. Whether it changes day-to-day care depends on factors like disease subtype, prior treatments, and where the patient is in their care journey.

What you can do now

Tofersen was FDA-approved in 2023 for adults with ALS linked to SOD1 mutations, though it works differently than traditional treatments. The drug requires spinal injections and can cause side effects including headaches and falls. If you have SOD1 ALS, talk with your doctor about whether tofersen is right for you and what to expect from treatment.

Eligibility for the treatments mentioned above depends on specific test results and clinical history. Bring this summary, the trial name, and your most recent labs or pathology report to your next visit.

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