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About Japan Early-stage Trial of Ultrahigh-Dose Methylcobalamin for ALS (JETALS) The Japan Early-stage Trial of Ultrahigh-Dose Methylcobalamin for ALS (JETALS) is an investigator-initiated study conducted as a multicenter, placebo-controlled, double-blind, randomized Phase III clinical trial to verify the efficacy and safety of high-dose methylcobalamin (mecobalamin) in patients with amyotrophic lateral sclerosis (ALS)