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Tolerability and Efficacy of L-Serine in Patients With Amyotrophic Lateral Sclerosis (ALS) (ALS)

Primary Purpose

Amyotrophic Lateral Sclerosis (ALS)

Status
Terminated
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
L-Serine
Sponsored by
Elijah W. Stommel
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Amyotrophic Lateral Sclerosis (ALS)

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Diagnosis of probable or definite ALS
  • ALSFRS-R score >25 and FVC score ≥ 60% predicted
  • If currently taking Riluzole and/or Edaravone/Radicava must be on stable dose for 3 months prior to Baseline/Screening. If the dosing has not been stable for 3 months prior to Baseline/Screening or if stopped due to an adverse event, the waiting period off the medication will be 7 days. If not on either of these medications may start if desired either or both medications after enrollment into study.

Exclusion Criteria:

  • Diagnosis of probable or definite ALS more than 3 years prior to study enrollment
  • Diagnosis or previous history of ischemic stroke, brain tumor, uncontrolled diabetes, renal insufficiency, or severe hypertension.
  • Diagnosis or previous history of comorbid progressive neurodegenerative disease such as Alzheimer's disease, Parkinson's disease, Lewy Body disease, Pick's disease, Huntington's disease, Progressive Supranuclear palsy. ALS patients diagnosed with frontotemporal dementia will not be excluded from this study.
  • Diagnosis or previous history of symptomatic peripheral neuropathy. Patients with findings of peripheral neuropathy on electrodiagnostic tests only but no clinical symptoms at the time of enrollment are eligible.
  • Undergoing any chemotherapy or radiation therapy for any cancer
  • Any medical condition likely to interfere with the conduct of the trial or survival of the patient during this study period
  • Pregnant women or women who are breast feeding
  • Has taken L-Serine supplement within 30 days prior to start of study drug

Sites / Locations

  • Dartmouth-Hitchcock Medical Center

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

L-Serine

Arm Description

L-Serine 15 grams orally twice a day as tolerated for 6 months

Outcomes

Primary Outcome Measures

Dose tolerability based on subject reporting
Dose tolerability is based on subject interviews and diary assessment evaluating the presence or absence of adverse events

Secondary Outcome Measures

Efficacy based on ALS Functional Rating Scale - Revised (ALSFRS-R)
Change in ALSFRS-R questionnaire scale. The ALSFRS-R provides a physician-generated estimate of the patient's degree of functional impairment, which can be evaluated serially to objectively assess any response to treatment or progression of disease. The ALSFRS includes ten questions that ask the physician to rate his/her impression of the patients level of functional impairment in performing one of ten common tasks, e.g. climbing stairs. Each task is rated on a five-point scale from 0 = can't do, to 4 = normal ability. Individual item scores are summed to produce a reported score of between 0=worst and 40=best.
Efficacy based on neurological exam
Change in neurological exams with testing of muscle flexion and extension (scale: 0 to 5 with 0 being the most impaired) reflexes (scale: absent to brisk with absent being the most impaired), and sensation (scale: normal to abnormal), cranial nerves (scale: normal to abnormal on ocular movement, yes to no on Ptosis, normal to atrophy on tongue, and normal to abnormal on tongue movement).
Efficacy based on pulmonary forced vital capacity
Change in % predicted in forced vital capacity

Full Information

First Posted
June 26, 2018
Last Updated
September 6, 2023
Sponsor
Elijah W. Stommel
Collaborators
Brain Chemistry Labs, Institute for Ethnomedicine
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1. Study Identification

Unique Protocol Identification Number
NCT03580616
Brief Title
Tolerability and Efficacy of L-Serine in Patients With Amyotrophic Lateral Sclerosis (ALS)
Acronym
ALS
Official Title
Tolerability and Efficacy of L-Serine in Patients With Amyotrophic Lateral Sclerosis: A Phase IIa Study
Study Type
Interventional

2. Study Status

Record Verification Date
August 2023
Overall Recruitment Status
Terminated
Why Stopped
Study was terminated by the IRB due to continued noncompliance.
Study Start Date
October 24, 2018 (Actual)
Primary Completion Date
August 3, 2022 (Actual)
Study Completion Date
December 20, 2022 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor-Investigator
Name of the Sponsor
Elijah W. Stommel
Collaborators
Brain Chemistry Labs, Institute for Ethnomedicine

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
The purpose of this study is to determine the tolerability of L-Serine oral doses for ALS patients and assess preliminary indications of efficacy
Detailed Description
All patients will receive the same dose of the study treatment over 6 months. For each participant the study will last approximately one year with follow up visits after the treatment period of 6 months is completed. The visits will include blood draws, vital sign checks, neurological and physical exams, pulmonary testing with forced vital capacity (FVC), and questionnaires.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Amyotrophic Lateral Sclerosis (ALS)

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
43 (Actual)

8. Arms, Groups, and Interventions

Arm Title
L-Serine
Arm Type
Experimental
Arm Description
L-Serine 15 grams orally twice a day as tolerated for 6 months
Intervention Type
Drug
Intervention Name(s)
L-Serine
Intervention Description
L-Serine is a naturally occurring dietary amino acid. It is abundant in soy products, some edible seaweeds, sweet potatoes, eggs and meat.
Primary Outcome Measure Information:
Title
Dose tolerability based on subject reporting
Description
Dose tolerability is based on subject interviews and diary assessment evaluating the presence or absence of adverse events
Time Frame
6 months
Secondary Outcome Measure Information:
Title
Efficacy based on ALS Functional Rating Scale - Revised (ALSFRS-R)
Description
Change in ALSFRS-R questionnaire scale. The ALSFRS-R provides a physician-generated estimate of the patient's degree of functional impairment, which can be evaluated serially to objectively assess any response to treatment or progression of disease. The ALSFRS includes ten questions that ask the physician to rate his/her impression of the patients level of functional impairment in performing one of ten common tasks, e.g. climbing stairs. Each task is rated on a five-point scale from 0 = can't do, to 4 = normal ability. Individual item scores are summed to produce a reported score of between 0=worst and 40=best.
Time Frame
Baseline, 1 year
Title
Efficacy based on neurological exam
Description
Change in neurological exams with testing of muscle flexion and extension (scale: 0 to 5 with 0 being the most impaired) reflexes (scale: absent to brisk with absent being the most impaired), and sensation (scale: normal to abnormal), cranial nerves (scale: normal to abnormal on ocular movement, yes to no on Ptosis, normal to atrophy on tongue, and normal to abnormal on tongue movement).
Time Frame
Baseline, 6 months
Title
Efficacy based on pulmonary forced vital capacity
Description
Change in % predicted in forced vital capacity
Time Frame
Baseline, 6 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Diagnosis of probable or definite ALS ALSFRS-R score >25 and FVC score ≥ 60% predicted If currently taking Riluzole and/or Edaravone/Radicava must be on stable dose for 3 months prior to Baseline/Screening. If the dosing has not been stable for 3 months prior to Baseline/Screening or if stopped due to an adverse event, the waiting period off the medication will be 7 days. If not on either of these medications may start if desired either or both medications after enrollment into study. Exclusion Criteria: Diagnosis of probable or definite ALS more than 3 years prior to study enrollment Diagnosis or previous history of ischemic stroke, brain tumor, uncontrolled diabetes, renal insufficiency, or severe hypertension. Diagnosis or previous history of comorbid progressive neurodegenerative disease such as Alzheimer's disease, Parkinson's disease, Lewy Body disease, Pick's disease, Huntington's disease, Progressive Supranuclear palsy. ALS patients diagnosed with frontotemporal dementia will not be excluded from this study. Diagnosis or previous history of symptomatic peripheral neuropathy. Patients with findings of peripheral neuropathy on electrodiagnostic tests only but no clinical symptoms at the time of enrollment are eligible. Undergoing any chemotherapy or radiation therapy for any cancer Any medical condition likely to interfere with the conduct of the trial or survival of the patient during this study period Pregnant women or women who are breast feeding Has taken L-Serine supplement within 30 days prior to start of study drug
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Elijah W Stommel, MD,PHD
Organizational Affiliation
Dartmouth-Htichcock Medical Center
Official's Role
Principal Investigator
Facility Information:
Facility Name
Dartmouth-Hitchcock Medical Center
City
Lebanon
State/Province
New Hampshire
ZIP/Postal Code
03756
Country
United States

12. IPD Sharing Statement

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Tolerability and Efficacy of L-Serine in Patients With Amyotrophic Lateral Sclerosis (ALS)

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