A Study to Evaluate the Efficacy and Safety of Reldesemtiv in Patients With Amyotrophic Lateral Sclerosis (ALS) (COURAGE-ALS)
Amyotrophic Lateral Sclerosis
About this trial
This is an interventional treatment trial for Amyotrophic Lateral Sclerosis focused on measuring Amyotrophic Lateral Sclerosis, ALS, CK-2127107, Reldesemtiv, COURAGE-ALS
Eligibility Criteria
Key Inclusion Criteria:
- Males or Females between the ages of 18 and 80 years of age, inclusive
- Diagnosis of familial or sporadic ALS (defined as meeting the laboratory-supported probable, probable, or definite criteria for ALS according to the World Federation of Neurology El Escorial criteria). Patients who meet the possible criteria are eligible if they have lower motor neuron findings; those who have purely upper motor neuron findings are ineligible.
- First symptom of ALS ≤ 24 months prior to screening. The qualifying first symptoms of ALS are limited to manifestations of weakness in extremity, bulbar, or respiratory muscles.
- ALSFRS-R total score ≤ 44 at screening. Patients with a total score of 45 or higher may be rescreened 60±7 days following the original screening date.
- Upright FVC ≥ 65.0% of predicted for age, height, sex and ethnicity at screening according to Global Lung Initiative equation
- Must be either on riluzole for ≥ 30 days prior to screening or have not taken it for at least 30 days prior to screening
- Must have completed at least 2 cycles of edaravone at the time of screening or have not received it for at least 30 days prior to screening
- Able to swallow whole tablets
Exclusion Criteria:
- eGFRCysC < 45.0 mL/min/1.73 m2 at screening
- Urine protein/creatinine ratio > 1 mg/mg (113 mg/mmol) at screening
- Alanine aminotransferase (ALT) or aspartate aminotransferase (AST) ≥ 3-times the upper limit of normal (ULN)
- Total bilirubin (TBL), direct or indirect bilirubin above the ULN.
- Cognitive impairment, related to ALS or otherwise that impairs the patient's ability to understand and/or comply with study procedures and provide informed consent
- Other medically significant neurological conditions that could interfere with the assessment of ALS symptoms, signs or progression.
- Has a tracheostomy
Sites / Locations
- St. Joseph's Hospital & Medical Center - Barrow Neurological Institute
- Cedars-Sinai Medical Center
- University of California Irvine - ALS & Neuromuscular Center
- California Pacific Medical Center - Forbes Norris MDA/ALS Research Center
- Stanford Hospital and Clinics
- University of Colorado Hospital Anschutz Outpatient Pavilion
- GW Medical Faculty Associates
- University of Florida Jacksonville
- Mayo Clinic Florida
- University of South Florida - Carol and Frank Morsani Center for Advanced Health Care
- Duchossois Center for Advanced Medicine
- Indiana University
- University of Iowa Hospitals and Clinics
- The University of Kansas Medical Center
- Johns Hopkins Outpatient Center
- Massachusetts General Hospital - Neurological Clinical Research Institute
- University of Massachusetts Memorial Medical Center/Medical School
- Michigan Medicine
- Henry Ford Health System
- Washington University School of Medicine - Center for Advance Medicine
- Neurology Associates, PC
- Hospital for Special Surgery
- Columbia University Medical Center
- University of Rochester Medical Center
- SUNY Upstate Medical University
- Atrium Health Neuroscience Institute - Charlotte
- Cleveland Clinic
- Providence ALS Center
- Oregon Health and Science University
- Penn State Health Milton S. Hershey Medical Center
- Lewis Katz School of Medicine at Temple University
- Vanderbilt University Medical Center - Clinical Research Center
- Texas Neurology, P.A.
- University of Vermont Medical Center
- VCU Neuroscience Orthopaedic and Wellness Center (NOW)
- Froedtert Hospital
- Brain and Mind Centre
- Concord Repatriation General Hospital
- Royal Brisbane and Women's Hospital
- Flinders Medical Centre
- The Perron Institute
- UZ Leuven Gasthuisberg, Department of Neurology
- University of Calgary - Heritage Medical Research Clinic
- University of Alberta
- Stan Cassidy Centre for Rehabilitation
- McMaster University Medical Centre
- London Health Sciences Centre
- Ottawa Hospital Research Institute - Civic Campus
- Sunnybrook Research Institute
- Centre de recherche du CHUM
- McGill University, Montreal Neurological Institute & Hospital
- CHU de Quebec-Université Laval
- Saskatoon City Hospital
- Deparment of Neurology Bispebjerg University Hospital
- CRC SLA de Lyon
- CHRU de Lille Hopital Roger Salengro
- CHU de Limoges - Hopital Dupuytren
- CHU de la Timone
- CHU de Nice - Hôpital Pasteur 2
- Hopital La Pitie Salpetriere
- CHRU de Tours, Hopital Bretonneau, Clinical Research Center
- Charité - Universitätsmedizin Berlin
- Universitatsklinikum Bonn
- Medical School Hannover - Department of Neurology
- Universitatsklinikum Jena
- Universitätsklinikum Schleswig Holstein
- Universitatsklinikum Ulm
- RSCI Education and Research Centre, Beaumont Hospital
- Instituti Clinici Scientifici Maugeri
- Ospedale San Luca
- Centro Clinical Nemo - Fondazione Serena Onlus
- AOU Città della Salute e Scienza (Molinette),
- UMC Utrecht, Department of Neurology, ALS Center
- City Clinic Research
- Centro Hospitalar Universitario Lisboa Norte, Department of Neurology
- Hospital Universitari de Bellvitge
- Hospital Universitario Basurto
- Hospital San Rafael
- Hospital Universitari i Politecnic La Fe
- Neurologimottagningen Skane University Hospital
- Studieenheten Akademiskt Specialistcentrum, Sabbatsberg Hospital
- Muskelzentrum/ALS Clinic
- The Walton Centre NHS Foundation Trust
- Maurice Wohl Clinical Neuroscience Institute
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm 4
Experimental
Placebo Comparator
Experimental
Experimental
300 mg reldesemtiv twice daily for a 600 mg total daily dose, from Day 1 until Week 24
Placebo twice daily, from Day 1 until Week 24
300 mg reldesemtiv twice daily for a 600 mg total daily dose, from Week 24 until Week 48
150 mg reldesemtiv twice daily for a 300 mg total daily dose, from Week 24 until Week 48
Patients in this arm take 2 reldesemtiv 150 mg oral tablets twice a day for a 600 mg total daily dose from Day 1 until Week 24.
Patients in this arm take 2 placebo oral tablets twice a day from Day 1 until Week 24.
Patients in this arm take 2 reldesemtiv 150 mg oral tablets twice a day for a 600 mg total daily dose from Week 24 until Week 48 for patients who were not down titrated during the 24 weeks of blinded dosing.
Patients in this arm take 1 reldesemtiv 150 mg oral tablet twice a day for a 300 mg total daily dose from Week 24 until Week 48 for patients who were down titrated for any reason during the 24 weeks of blinded dosing.