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They assessed treatment efficacy in delaying functional decline, using the change in Revised Amyotrophic Lateral Sclerosis Functional Rating Scale (ALSFRS-R) as a primary endpoint

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The first step is the unusual coupling of the gamma-carboxylic acid of glutamic acid to cysteine by the enzyme gamma-glutamylcysteine synthase to form gamma-glutamylcysteine

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Sometimes a second agent can be rational

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