Fig. 1.

Participant flow through study analysis. Cases and controls of the ERRALS study population are shown through the flowchart. 761 patients were diagnosed with ALS between January, 1st, 2015 and June, 30th, 2021 in the Emilia Romagna region and recorded in ERRALS. Last follow-up date was fixed on February 1st, 2022. All patients with ALS with insufficient baseline or follow-up data on the ERRALS registry were excluded from propensity score-matching analysis; TUDCA-exposed patients who took less than three consecutive months of therapy were similarly excluded. ALS: Amyotrophic Lateral Sclerosis; ERRALS: Emilia Romagna Region ALS registry; TUDCA: tauroursodeoxycholic acid.