Its hard to know without more details, however, effectiveness does normally drop as the disease progresses. This is normal with all medications (FDA approved and others). As someone mentioned this is not a cure but a drug to help in slowing the progression of ALS.
The slight drop off in the reduction of Risk of death is very encouraging in my opinion (80.1% vs 78.1%) shows that 27 months on this is still a very promising drug.
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