Effect of MD1003 in Amyotrophic Lateral Sclerosis (MD1003-ALS)
Primary Purpose
ALS, Amyotrophic Lateral Sclerosis, Motor Neuron Disease
Status
Completed
Phase
Phase 2
Locations
France
Study Type
Interventional
Intervention
MD1003
Placebo oral capsule
Sponsored by
About this trial
This is an interventional other trial for ALS focused on measuring Biotin, MD1003, ALSFRS-R
Eligibility Criteria
Inclusion Criteria:
- Age: 25 to 80 years, inclusive
- Male or female subjects with probable or confirmed ALS (revised international El Escorial criteria, Forbes et al., 2001).
- Patients presenting first motor deficits due to ALS for a maximum of three years at the first consultation in an ALS centre.
- Patients monitored for at least 6 months in an ALS centre or for whom the previous monitoring parameters are available (excepted for MIP and SNIP).
- Patients who have lost at least 5 points on the ALSFRS-R (ALS functional rating scale) during the last 12 months or at least 2 points during the preceding 6 months
- Patients who have been treated with riluzole for at least 3 months at a stable dose. In case of intolerance to this product or refusal for this treatment, patients who have not been treated with riluzole for at least 1 month before inclusion
- For patients with spinal form (onset of the disease affecting limbs) or respiratory form, slow vital capacity > 60% of predicted value.
- For patients with a bulbar form, slow vital capacity > 60% of theoretical value or, if spirometry not assessable (severe bulbar disability), patient should not have significant abnormality in both nocturnal capnography and nocturnal oximetry (median pCO2 (carbon dioxide partial pressure ) < 52 mmHg, SaO2 (arterial oxygen saturation ) < 90% less than 5% of the time during night) less than 3 months prior inclusion.
- Patients who are willing to give written consent (or oral consent in the presence of a trusted person if the patient is no longer able to write)
- Patients likely to be able to participate in all scheduled evaluation and complete all required study procedures (except for spirometry in bulbar patients with severe disability).
Exclusion Criteria:
- Patients on non-invasive ventilation for respiratory insufficiency due to ALS for more than 10 hours a day
- Patients with an ALSFRS-R score at inclusion of < 20 (maximum score without disability = 48)
- Patients who have lost less than 5 points on the ALSFRS-R during the last year or less than 2 points during the preceding 6 months
- Patients with a gastrostomy
- Patients who have lost more than 15% of their reference weight (defined as weight before disease onset)
- Patient with dyspnoea at rest or with the least effort (score < 3 on the dyspnoea item of the ALSFRS-R)
- Patients with dementia
- Patient with severe or rapidly progressive form of ALS for whom the investigator estimates the life expectancy less than 3 months
- Patients with another progressive disease that has not been stabilized at the time of inclusion
- Patients with cancer, except basal cell carcinoma, for less than 5 years, or who require continuous treatment for cancer even if it is older
- Pregnant women.
- Subject who are not covered by a social security scheme.
- Subject under temporary or permanent Judicial Protection.
- Contraception: Both male subjects, and female subjects who are not either surgically sterile (tubal ligation/obstruction or removal of ovaries or uterus) or post-menopausal (no spontaneous menstrual periods for at least one year confirmed by a negative hormone panel), must commit to using two highly effective method of birth control for the duration of the study and for two months after the treatment termination.
Sites / Locations
- Hopital Gui De Chauliac
Arms of the Study
Arm 1
Arm 2
Arm Type
Active Comparator
Placebo Comparator
Arm Label
MD1003
PLACEBO
Arm Description
The investigational drug will consist in capsules of 100 mg biotin and excipients (lactose, magnesium stearate, croscarmellose sodium, Silica) tid during 12 months
This formulation consists in lactose powder and other excipients (magnesium stearate, croscarmellose sodium, Silica) as placebo, tid during 6 months and then switch to MD1003 tid during 6 additional months.
Outcomes
Primary Outcome Measures
Recording of adverse events
All adverse events in two groups will be recorded.
Laboratory testing (haematology and biochemistry panel)
RBC (red blood cell), WBC (white blood cell ), platelets
Ferritin, CPK (creatine phosphokinase )
Electrolytes, creatinine, glycaemia
AST (aspartate aminotransferase ), ALT (alanine aminotransferase) , bilirubin, GGT (gamma-glutamyltransferase), alkaline phosphatase
Triglyceride, cholesterol
Haemostasis: APPT (activated partial thromboplastin time), PT (prothrombin time )
Secondary Outcome Measures
Motor disability
this is evaluated using the ALSFRS-R scale (score of 48 points). Among the criteria used to evaluate the severity of ALS, the rate of the decline in the ALSFRS-R is the one that correlates most closely with the risk of death (Kimura et al., 2006).
Severity
The severity of the disease defined as the ratio between the number of points lost on the ALSFRS-R score and the number of months that have elapsed (Kollewe et al., 2008).
Slow vital capacity (SVC)
in liters
Maximal inspiratory pressure (MIP)
in cm H2O
Sniff nasal inspiratory pressure (SNIP)
in cm H20
Weight
weight in kg
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT03114215
Brief Title
Effect of MD1003 in Amyotrophic Lateral Sclerosis
Acronym
MD1003-ALS
Official Title
Effect of MD1003 in Amyotrophic Lateral Sclerosis: a Randomized Double Blind Placebo Controlled Pilot Study
Study Type
Interventional
2. Study Status
Record Verification Date
June 2019
Overall Recruitment Status
Completed
Study Start Date
June 29, 2016 (Actual)
Primary Completion Date
June 12, 2017 (Actual)
Study Completion Date
December 2017 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
MedDay Pharmaceuticals SA
4. Oversight
Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
This is a 6-month double blind randomized 2:1 placebo-controlled study with two arms (placebo, biotin 300 mg/day). The study will be followed by a 6-month extension phase during which all patients will receive biotin 300 mg/day.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
ALS, Amyotrophic Lateral Sclerosis, Motor Neuron Disease
Keywords
Biotin, MD1003, ALSFRS-R
7. Study Design
Primary Purpose
Other
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Model Description
The primary objective of the study is to evaluate the safety of biotin at 300 mg/day over placebo in patients with amyotrophic lateral sclerosis.
This is a 6-month double blind randomized 2:1 placebo-controlled study with two arms (placebo, biotin 300 mg/day). The study will be followed by a 6-month extension phase during which all patients will receive biotin 300 mg/day.
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
30 (Actual)
8. Arms, Groups, and Interventions
Arm Title
MD1003
Arm Type
Active Comparator
Arm Description
The investigational drug will consist in capsules of 100 mg biotin and excipients (lactose, magnesium stearate, croscarmellose sodium, Silica) tid during 12 months
Arm Title
PLACEBO
Arm Type
Placebo Comparator
Arm Description
This formulation consists in lactose powder and other excipients (magnesium stearate, croscarmellose sodium, Silica) as placebo, tid during 6 months and then switch to MD1003 tid during 6 additional months.
Intervention Type
Drug
Intervention Name(s)
MD1003
Other Intervention Name(s)
BIOTIN
Intervention Description
capsules 100mg 3 times per day
Intervention Type
Drug
Intervention Name(s)
Placebo oral capsule
Intervention Description
capsules 100mg lactose 3 times per day
Primary Outcome Measure Information:
Title
Recording of adverse events
Description
All adverse events in two groups will be recorded.
Time Frame
6 months
Title
Laboratory testing (haematology and biochemistry panel)
Description
RBC (red blood cell), WBC (white blood cell ), platelets
Ferritin, CPK (creatine phosphokinase )
Electrolytes, creatinine, glycaemia
AST (aspartate aminotransferase ), ALT (alanine aminotransferase) , bilirubin, GGT (gamma-glutamyltransferase), alkaline phosphatase
Triglyceride, cholesterol
Haemostasis: APPT (activated partial thromboplastin time), PT (prothrombin time )
Time Frame
6 months
Secondary Outcome Measure Information:
Title
Motor disability
Description
this is evaluated using the ALSFRS-R scale (score of 48 points). Among the criteria used to evaluate the severity of ALS, the rate of the decline in the ALSFRS-R is the one that correlates most closely with the risk of death (Kimura et al., 2006).
Time Frame
6 months
Title
Severity
Description
The severity of the disease defined as the ratio between the number of points lost on the ALSFRS-R score and the number of months that have elapsed (Kollewe et al., 2008).
Time Frame
6 months
Title
Slow vital capacity (SVC)
Description
in liters
Time Frame
6 months
Title
Maximal inspiratory pressure (MIP)
Description
in cm H2O
Time Frame
6 months
Title
Sniff nasal inspiratory pressure (SNIP)
Description
in cm H20
Time Frame
6 months
Title
Weight
Description
weight in kg
Time Frame
6 months
10. Eligibility
Sex
All
Minimum Age & Unit of Time
25 Years
Maximum Age & Unit of Time
80 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Age: 25 to 80 years, inclusive
Male or female subjects with probable or confirmed ALS (revised international El Escorial criteria, Forbes et al., 2001).
Patients presenting first motor deficits due to ALS for a maximum of three years at the first consultation in an ALS centre.
Patients monitored for at least 6 months in an ALS centre or for whom the previous monitoring parameters are available (excepted for MIP and SNIP).
Patients who have lost at least 5 points on the ALSFRS-R (ALS functional rating scale) during the last 12 months or at least 2 points during the preceding 6 months
Patients who have been treated with riluzole for at least 3 months at a stable dose. In case of intolerance to this product or refusal for this treatment, patients who have not been treated with riluzole for at least 1 month before inclusion
For patients with spinal form (onset of the disease affecting limbs) or respiratory form, slow vital capacity > 60% of predicted value.
For patients with a bulbar form, slow vital capacity > 60% of theoretical value or, if spirometry not assessable (severe bulbar disability), patient should not have significant abnormality in both nocturnal capnography and nocturnal oximetry (median pCO2 (carbon dioxide partial pressure ) < 52 mmHg, SaO2 (arterial oxygen saturation ) < 90% less than 5% of the time during night) less than 3 months prior inclusion.
Patients who are willing to give written consent (or oral consent in the presence of a trusted person if the patient is no longer able to write)
Patients likely to be able to participate in all scheduled evaluation and complete all required study procedures (except for spirometry in bulbar patients with severe disability).
Exclusion Criteria:
Patients on non-invasive ventilation for respiratory insufficiency due to ALS for more than 10 hours a day
Patients with an ALSFRS-R score at inclusion of < 20 (maximum score without disability = 48)
Patients who have lost less than 5 points on the ALSFRS-R during the last year or less than 2 points during the preceding 6 months
Patients with a gastrostomy
Patients who have lost more than 15% of their reference weight (defined as weight before disease onset)
Patient with dyspnoea at rest or with the least effort (score < 3 on the dyspnoea item of the ALSFRS-R)
Patients with dementia
Patient with severe or rapidly progressive form of ALS for whom the investigator estimates the life expectancy less than 3 months
Patients with another progressive disease that has not been stabilized at the time of inclusion
Patients with cancer, except basal cell carcinoma, for less than 5 years, or who require continuous treatment for cancer even if it is older
Pregnant women.
Subject who are not covered by a social security scheme.
Subject under temporary or permanent Judicial Protection.
Contraception: Both male subjects, and female subjects who are not either surgically sterile (tubal ligation/obstruction or removal of ovaries or uterus) or post-menopausal (no spontaneous menstrual periods for at least one year confirmed by a negative hormone panel), must commit to using two highly effective method of birth control for the duration of the study and for two months after the treatment termination.
Facility Information:
Facility Name
Hopital Gui De Chauliac
City
Montpellier
ZIP/Postal Code
34000
Country
France
12. IPD Sharing Statement
Plan to Share IPD
No
Citations:
PubMed Identifier
32140672
Citation
Juntas-Morales R, Pageot N, Bendarraz A, Alphandery S, Sedel F, Seigle S, Camu W. High-dose pharmaceutical grade biotin (MD1003) in amyotrophic lateral sclerosis: A pilot study. EClinicalMedicine. 2020 Jan 27;19:100254. doi: 10.1016/j.eclinm.2019.100254. eCollection 2020 Feb.
Results Reference
derived
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Effect of MD1003 in Amyotrophic Lateral Sclerosis
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