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Amylyx Pharmaceuticals will take its ALS drug Relyvrio off the market in the U.S. and Canada, ending a multi-year saga for patients with the rare neurodegenerative disease.

Relyvrio was approved by the Food and Drug Administration in 2022, based on data that showed a modest slowing of disease progression. The approval was contentious — regulators initially advised Amylyx not to file for approval until it had conducted another test, but ultimately cleared the drug. Amylyx’s co-CEOs Joshua Cohen and Justin Klee also publicly promised that they would withdraw the drug if further testing failed to show a benefit.

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That exact scenario came to bear last month, when Amylyx announced that a Phase 3 study involving 664 people failed.

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