Phase 1 Dose Escalation and PK Study of Cu(II)ATSM in ALS/MND
Primary Purpose
Amyotrophic Lateral Sclerosis, Motor Neuron Disease
Status
Completed
Phase
Phase 1
Locations
Australia
Study Type
Interventional
Intervention
Cu(II)ATSM
Sponsored by
About this trial
This is an interventional treatment trial for Amyotrophic Lateral Sclerosis
Eligibility Criteria
Inclusion Criteria:
- Signed informed consent prior to initiation of any study-specific procedures;
- Familial or sporadic ALS/MND defined as clinically possible, probable, or definite by Awaji-shima Consensus Recommendations;
- First ALS/MND symptoms occurred no more than 2 years prior to screening visit;
- Seated FVC ≥ 70% and SNP ≥ 50% of predicted value;
- Not taking riluzole or on a stable dose of riluzole for at least 4 weeks prior to screening visit (participants are not allowed to start taking riluzole during the study);
- Age between 18 and 75 years at time of informed consent;
- Patient has a competent caregiver who can and will be responsible for administration of study drug;
Adequate bone marrow reserve, renal and liver function:
- absolute neutrophil count ≥ 1500/µL
- lymphocyte count < 48%
- platelet count ≥ 150,000/µL
- hemoglobin ≥ 11 g/dL
- creatinine clearance ≥ 60 mL/min (Cockroft & Gault formula)
- ALT and/or AST ≤ 2 x ULN
- total bilirubin ≤ 1.5 x ULN
- serum albumin ≥ 2.8 g/dL
- Women and men with partners of childbearing potential must take effective contraception while on study and women of childbearing potential must have a negative pregnancy test and be non-lactating at screening
Exclusion Criteria:
- Inability to swallow oral medications or presence of GI disorder deemed to jeopardize intestinal absorption of Cu(II)ATSM
- Dependence of mechanical ventilation (non-invasive or invasive) for any part of day or night
- Exposure to any other investigational agent within 3 months or two investigational agents within 6 months prior to screening visit
- Active GI disease (except gastrointestingal reflux disease) within 30 days of screening visit
- Known immune compromising illness or treatment
Presence of any of the following clinical conditions
- drug abuse or alcoholism
- unstable cardiac, pulmonary, renal, hepatic, endocrine or hematologic disorder
- active infectious disease
- AIDS or AIDS-related complex
- current malignancy
- unstable psychiatric illness, defined as psychosis or untreated major depression within 90 days of screening visit
- neuromuscular disease other than ALS/MND
- Dementia that may affect either outcome measures or patient understanding and/or compliance with study requirements and procedures
- Use of anticoagulants at therapeutic doses within 7 days prior to screening visit
- Current use of strong inducers or inhibitors of CYPs 2C19 and 2D6
Sites / Locations
- Macquarie University
- Calvary Health Care Bethlehem
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
Cu(II)ATSM
Arm Description
Cu(II)ATSM capsules, administered orally once daily
Outcomes
Primary Outcome Measures
recommended phase 2 dose as determined by the number of participants at each dose level with dose limiting toxicities
Secondary Outcome Measures
Treatment-related change in disease severity by ALS Functional Rating Scale - Revised (ALSFRS-R)
Treatment-related change in cognitive function by Edinburgh Cognitive and Behavioral Assessment (ECAS) score
Treatment-related change in respiratory function by seated forced vital capacity (FCV)
Treatment-related change in quality of life by ALSSQOL-R score
Treatment-related change in disease severity by transcranial magnetic stimulation (TMS) response
Peak Cu(II)ATSM plasma concentration following administration of a single dose based on blood draws taken at 1, 2, 4, 8 and 24 hours after dosing
Area under the Cu(II)ATSM plasma concentration versus time curve (AUC) following administration of a single dose based on blood draws taken at 1, 2, 4, 8 and 24 hours after dosing
Treatment-related change in respiratory function by sniff nasal pressure (SNP) test
Full Information
NCT ID
NCT02870634
First Posted
August 10, 2016
Last Updated
March 15, 2020
Sponsor
Collaborative Medicinal Development Pty Limited
1. Study Identification
Unique Protocol Identification Number
NCT02870634
Brief Title
Phase 1 Dose Escalation and PK Study of Cu(II)ATSM in ALS/MND
Official Title
A Phase 1 Single and Multiple Dose Escalation and Pharmacokinetic Study of Cu(II)ATSM Administered Orally to Patients With Amyotrophic Lateral Sclerosis/Motor Neuron Disease
Study Type
Interventional
2. Study Status
Record Verification Date
March 2020
Overall Recruitment Status
Completed
Study Start Date
November 16, 2016 (Actual)
Primary Completion Date
October 30, 2019 (Actual)
Study Completion Date
January 30, 2020 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Collaborative Medicinal Development Pty Limited
4. Oversight
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
Multicenter, open-label , single and multiple dose-escalation and pharmacokinetic study
Detailed Description
Multicenter, open-label, phase 1 study of Cu(II)ATSM administered orally to patients wit amyotrophic lateral sclerosis/motor neuron disease. The study will be conducted in three phases. In the first two phases, dose cohorts of six patients each will participate in a single dose pharmacokinetic study followed by a 28-day repeated daily dose study to establish the recommended phase 2 dose (RP2D). The first dose cohort will be treated at 3 mg/day; planned dose escalations are 6, 12, 24, and 48 mg/day, subject to observed safety assessments. In the third phase of the study, participants will be treated at the RP2D to confirm tolerability and assess preliminary evidence of efficacy.
In both the dose escalation and expansion cohorts, once the first 28 days of treatment and assessments are completed, at the discretion of the investigator a patient may continue to receive Cu(II)ATSM treatment for a maximum of six 28-day treatment cycles.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Amyotrophic Lateral Sclerosis, Motor Neuron Disease
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
50 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
Cu(II)ATSM
Arm Type
Experimental
Arm Description
Cu(II)ATSM capsules, administered orally once daily
Intervention Type
Drug
Intervention Name(s)
Cu(II)ATSM
Other Intervention Name(s)
diacetylbis(N(4)-methylthiosemicarbazonato) copper(II)
Intervention Description
copper-containing synthetic small molecule
Primary Outcome Measure Information:
Title
recommended phase 2 dose as determined by the number of participants at each dose level with dose limiting toxicities
Time Frame
24 months
Secondary Outcome Measure Information:
Title
Treatment-related change in disease severity by ALS Functional Rating Scale - Revised (ALSFRS-R)
Time Frame
24 months
Title
Treatment-related change in cognitive function by Edinburgh Cognitive and Behavioral Assessment (ECAS) score
Time Frame
24 months
Title
Treatment-related change in respiratory function by seated forced vital capacity (FCV)
Time Frame
24 months
Title
Treatment-related change in quality of life by ALSSQOL-R score
Time Frame
24 months
Title
Treatment-related change in disease severity by transcranial magnetic stimulation (TMS) response
Time Frame
24 months
Title
Peak Cu(II)ATSM plasma concentration following administration of a single dose based on blood draws taken at 1, 2, 4, 8 and 24 hours after dosing
Time Frame
12 months
Title
Area under the Cu(II)ATSM plasma concentration versus time curve (AUC) following administration of a single dose based on blood draws taken at 1, 2, 4, 8 and 24 hours after dosing
Time Frame
12 months
Title
Treatment-related change in respiratory function by sniff nasal pressure (SNP) test
Time Frame
24 months
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Signed informed consent prior to initiation of any study-specific procedures;
Familial or sporadic ALS/MND defined as clinically possible, probable, or definite by Awaji-shima Consensus Recommendations;
First ALS/MND symptoms occurred no more than 2 years prior to screening visit;
Seated FVC ≥ 70% and SNP ≥ 50% of predicted value;
Not taking riluzole or on a stable dose of riluzole for at least 4 weeks prior to screening visit (participants are not allowed to start taking riluzole during the study);
Age between 18 and 75 years at time of informed consent;
Patient has a competent caregiver who can and will be responsible for administration of study drug;
Adequate bone marrow reserve, renal and liver function:
absolute neutrophil count ≥ 1500/µL
lymphocyte count < 48%
platelet count ≥ 150,000/µL
hemoglobin ≥ 11 g/dL
creatinine clearance ≥ 60 mL/min (Cockroft & Gault formula)
ALT and/or AST ≤ 2 x ULN
total bilirubin ≤ 1.5 x ULN
serum albumin ≥ 2.8 g/dL
Women and men with partners of childbearing potential must take effective contraception while on study and women of childbearing potential must have a negative pregnancy test and be non-lactating at screening
Exclusion Criteria:
Inability to swallow oral medications or presence of GI disorder deemed to jeopardize intestinal absorption of Cu(II)ATSM
Dependence of mechanical ventilation (non-invasive or invasive) for any part of day or night
Exposure to any other investigational agent within 3 months or two investigational agents within 6 months prior to screening visit
Active GI disease (except gastrointestingal reflux disease) within 30 days of screening visit
Known immune compromising illness or treatment
Presence of any of the following clinical conditions
drug abuse or alcoholism
unstable cardiac, pulmonary, renal, hepatic, endocrine or hematologic disorder
active infectious disease
AIDS or AIDS-related complex
current malignancy
unstable psychiatric illness, defined as psychosis or untreated major depression within 90 days of screening visit
neuromuscular disease other than ALS/MND
Dementia that may affect either outcome measures or patient understanding and/or compliance with study requirements and procedures
Use of anticoagulants at therapeutic doses within 7 days prior to screening visit
Current use of strong inducers or inhibitors of CYPs 2C19 and 2D6
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Dominic Rowe, MD
Organizational Affiliation
Macquarie University
Official's Role
Principal Investigator
Facility Information:
Facility Name
Macquarie University
City
Sydenham
State/Province
New South Wales
ZIP/Postal Code
2109
Country
Australia
Facility Name
Calvary Health Care Bethlehem
City
Caulfield
State/Province
Victoria
ZIP/Postal Code
3162
Country
Australia
12. IPD Sharing Statement
Plan to Share IPD
Undecided
Learn more about this trial
Phase 1 Dose Escalation and PK Study of Cu(II)ATSM in ALS/MND
We'll reach out to this number within 24 hrs