search
Back to results

Extension Study Evaluating The Safety And Tolerability of AMX0035

Primary Purpose

Amyotrophic Lateral Sclerosis

Status
Enrolling by invitation
Phase
Phase 3
Locations
International
Study Type
Interventional
Intervention
AMX0035
Sponsored by
Amylyx Pharmaceuticals Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Amyotrophic Lateral Sclerosis

Eligibility Criteria

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

Inclusion Criteria: Previous participation in Study A35-004 (PHOENIX), including completion of the randomized controlled phase through Week 48 (this timepoint may be upcoming at the time of screening). Participants who do not complete randomized-controlled phase through Week 48 for medical reasons may be included on a case-by-case basis, in consultation with the Sponsor; Capable of providing informed consent; Capable and willing to follow trial procedures including visits to the trial clinic, remote visits, and survival status reporting requirements; Women of childbearing potential (WOCBP; e.g., not post-menopausal for at least one year or surgically sterile must agree to use adequate birth control for the duration of the trial and 3 months after the last dose of AMX0035; 12 months of spontaneous amenorrhea or 6 months of spontaneous amenorrhea with serum Follicle-stimulating hormone (FSH) levels > 40 mIU/ml (milli-international units per milliliter) or 6 weeks postsurgical bilateral oophorectomy with or without hysterectomy. Acceptable contraception methods for use in this trial are: Hormonal methods, such as birth control pills, patches, injections, vaginal ring, or implants; Barrier methods (such as a condom or diaphragm) used with a spermicide (a foam, cream, or gel that kills sperm); Intrauterine device (IUD); Abstinence (no heterosexual sex); Unique partner who is surgically sterile (men) or not of childbearing potential (female). Women must not be pregnant or planning to become pregnant for the duration of the trial and 3 months after last dose of AMX0035; Men must agree to practice contraception for the duration of the trial and for at least 3 months after last dose of AMX0035; Men must not plan to father a child or to provide sperm for donation for the duration of the trial and 3 months after the last dose of AMX0035 Exclusion Criteria: History of known allergy to phenyl butyrate or bile salts; Abnormal liver function defined as bilirubin levels and/or aspartate aminotransferase (AST) and/or alanine aminotransferase (ALT) > 5 times the upper limit of the normal (obtained within 12 weeks from first dose); Renal insufficiency as defined by estimated glomerular filtration rate (eGFR) <60 mL/min/1.73m2 normal (obtained within 12 weeks from first dose); Pregnant women or women currently breastfeeding; Current severe biliary disease which may result in the Investigator medical judgement in biliary obstruction including for example active cholecystitis, primary biliary cirrhosis, sclerosing cholangitis, gallbladder cancer, gangrene of the gallbladder, abscess of the gallbladder; History of Class III/IV heart failure (per New York Heart Association - NYHA); Participant under severe salt restriction where the added salt intake due to treatment would put the participant at risk, in the Investigator clinical judgment; Presence of unstable psychiatric disease, cognitive impairment, dementia or substance abuse that would impair ability of the participant to provide informed consent, according to Investigator judgment; Clinically significant unstable medical condition (other than ALS) (e.g., cardiovascular instability, systemic infection, untreated thyroid dysfunction, severe laboratory test anomaly or clinically significant electrocardiogram [ECG] changes) that would pose a risk to the participant if he/she were to participate in the trial, according to Investigator judgment; Currently enrolled in another trial (excluding Study A35-004 (PHOENIX)) involving use of an investigational therapy (or within 5 plasma half-lives) prior to first dose at Baseline Visit; Implantation of Diaphragm Pacing System (DPS); Currently or previously treated within the last 30 days (or 5 half-lives, whichever is longer) from first dose at the Baseline Visit or planned exposure during the treatment period to any prohibited medications listed in Section 6.7 of the protocol.

Sites / Locations

  • University Hospitals Leuven
  • Hospices Civils de Lyon Hôpital Neurologique Pierre Wertheimer Cellule Mutualisée de Recherche Clinique (CMRC)
  • Hopital Gabriel Montpied Service de Neurologie
  • CHRU de Lille - Hôpital Roger Salengro
  • CHU de Limoges - Hôpital Dupuytren
  • Hôpitaux Universitaires de Marseille Timone
  • Gui de Chauliac
  • CHU de Montpellier
  • CHU Nice
  • Hôpital de la Salpêtrière
  • Le Centre Hospitalier Régional Universitaire de Tours
  • Uniklinikum Dresden
  • Hannover Medical School
  • Jena University Hospital
  • Medizinische Fakultät Mannheim der Universität Heidelberg
  • University Medical Center Rostock
  • Ulm University Medical Centre
  • Trinity College Dublin/Beaumont Hospital
  • Università degli Studi di Bari Aldo Moro
  • IRCCS - Istituto Auxologico italiano
  • Centro Clinico NEMO
  • IRCCS - Ospedale San Raffaele
  • University of Milan Medical School
  • Azienda Ospedaliero Universitaria Di Modena
  • Università degli Studi della Campania Luigi Vanvitelli
  • University of Padua
  • Università degli Studi di Bari Aldo Moro
  • University of Torino
  • University Medical Center Utrecht
  • Centrum Medyczne Linden
  • City Clinic Warsaw
  • Centro Hospitalar Universitário Lisboa-Norte
  • Hospital del Mar
  • Hospital Universitari de Bellvitge-IDIBELL
  • Hospital Universitario de Basurto
  • Hospital San Rafael
  • Biodonostia Health Research Institute; Hospital Universitario Donostia
  • Hospital Universitario y Politécnico La Fe
  • Karolinska Institutet
  • Umeå University Hospital
  • The Walton Centre NHS Trust
  • King's College London
  • UCL Queen Square Institute of Neurology
  • University of Plymouth
  • Salford Royal Hospital Barnes Clinical Research Team
  • Sheffield Institute for Translational Neuroscience (SITraN)

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Active

Arm Description

All participants will be treated with oral (or feeding tube) AMX0035 (a fixed-dose combination of Sodium Phenylbutyrate (PB) and taurursodiol). All participants will take 2 sachets daily (one morning dose and one evening dose) starting on Day 1, for the duration of the study (if twice a day dosing is poorly tolerated, dosing interruptions and reductions are further discussed in section 6.3) AMX0035 will be supplied by Amylyx as a carton box containing approximately 1 month supply of single use sachets. Each AMX0035 sachet contains active ingredients in a powder formulation with 3 g PB and 1 g taurursodiol. AMX0035 powder is mixed with water and taken orally (or via feeding tube).

Outcomes

Primary Outcome Measures

To assess the Incidence of Treatment-Emergent Adverse Events during treatment with AMX0035
Incidence of all adverse events (AE)s; AEs leading to treatment discontinuation or study withdrawal, and all serious adverse events (SAE)s in participants treated with AMX0035

Secondary Outcome Measures

To assess the impact of long-term treatment with AMX0035 on survival
Overall survival of all-cause mortality Ventilation free survival (defined as death, tracheostomy for respiratory distress or permanent non-invasive ventilation [>22 hours per day for 7 consecutive days])

Full Information

First Posted
October 27, 2022
Last Updated
May 5, 2023
Sponsor
Amylyx Pharmaceuticals Inc.
search

1. Study Identification

Unique Protocol Identification Number
NCT05619783
Brief Title
Extension Study Evaluating The Safety And Tolerability of AMX0035
Official Title
A Phase IIIb, Open Label Extension Study Evaluating The Safety And Tolerability of AMX0035 Up To 108 Weeks In Adult Participants With Amyotrophic Lateral Sclerosis (ALS) Previously Enrolled In Study A35-004 (PHOENIX)
Study Type
Interventional

2. Study Status

Record Verification Date
May 2023
Overall Recruitment Status
Enrolling by invitation
Study Start Date
December 29, 2022 (Actual)
Primary Completion Date
March 2026 (Anticipated)
Study Completion Date
August 2026 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Amylyx Pharmaceuticals Inc.

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 primary objective is to evaluate the safety and tolerability of AMX0035 over 108 weeks of open label treatment for participants previously enrolled in Study A35-004 (PHOENIX).
Detailed Description
All participants will receive open-label treatment with AMX0035, starting on Day 1 with twice a day oral dosing (once in the morning and once in the evening) for the duration of the study. After the Baseline Visit (Day 1), enrolled participants will complete visits approximately every 12 weeks (± 2 weeks), until Week 108 or the end of treatment (EOT) visit, followed by a safety follow-up approximately 28 days after the last dose. A survival follow-up assessment will be completed every 12 weeks following the EOT visit until time of death or end of study (EOS).

6. Conditions and Keywords

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

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
600 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Active
Arm Type
Experimental
Arm Description
All participants will be treated with oral (or feeding tube) AMX0035 (a fixed-dose combination of Sodium Phenylbutyrate (PB) and taurursodiol). All participants will take 2 sachets daily (one morning dose and one evening dose) starting on Day 1, for the duration of the study (if twice a day dosing is poorly tolerated, dosing interruptions and reductions are further discussed in section 6.3) AMX0035 will be supplied by Amylyx as a carton box containing approximately 1 month supply of single use sachets. Each AMX0035 sachet contains active ingredients in a powder formulation with 3 g PB and 1 g taurursodiol. AMX0035 powder is mixed with water and taken orally (or via feeding tube).
Intervention Type
Drug
Intervention Name(s)
AMX0035
Other Intervention Name(s)
RELYVRIO
Intervention Description
Combination of 3 g phenylbutyrate and 1 g taurursodiol
Primary Outcome Measure Information:
Title
To assess the Incidence of Treatment-Emergent Adverse Events during treatment with AMX0035
Description
Incidence of all adverse events (AE)s; AEs leading to treatment discontinuation or study withdrawal, and all serious adverse events (SAE)s in participants treated with AMX0035
Time Frame
108 weeks
Secondary Outcome Measure Information:
Title
To assess the impact of long-term treatment with AMX0035 on survival
Description
Overall survival of all-cause mortality Ventilation free survival (defined as death, tracheostomy for respiratory distress or permanent non-invasive ventilation [>22 hours per day for 7 consecutive days])
Time Frame
108 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Previous participation in Study A35-004 (PHOENIX), including completion of the randomized controlled phase through Week 48 (this timepoint may be upcoming at the time of screening). Participants who do not complete randomized-controlled phase through Week 48 for medical reasons may be included on a case-by-case basis, in consultation with the Sponsor; Capable of providing informed consent; Capable and willing to follow trial procedures including visits to the trial clinic, remote visits, and survival status reporting requirements; Women of childbearing potential (WOCBP; e.g., not post-menopausal for at least one year or surgically sterile must agree to use adequate birth control for the duration of the trial and 3 months after the last dose of AMX0035; 12 months of spontaneous amenorrhea or 6 months of spontaneous amenorrhea with serum Follicle-stimulating hormone (FSH) levels > 40 mIU/ml (milli-international units per milliliter) or 6 weeks postsurgical bilateral oophorectomy with or without hysterectomy. Acceptable contraception methods for use in this trial are: Hormonal methods, such as birth control pills, patches, injections, vaginal ring, or implants; Barrier methods (such as a condom or diaphragm) used with a spermicide (a foam, cream, or gel that kills sperm); Intrauterine device (IUD); Abstinence (no heterosexual sex); Unique partner who is surgically sterile (men) or not of childbearing potential (female). Women must not be pregnant or planning to become pregnant for the duration of the trial and 3 months after last dose of AMX0035; Men must agree to practice contraception for the duration of the trial and for at least 3 months after last dose of AMX0035; Men must not plan to father a child or to provide sperm for donation for the duration of the trial and 3 months after the last dose of AMX0035 Exclusion Criteria: History of known allergy to phenyl butyrate or bile salts; Abnormal liver function defined as bilirubin levels and/or aspartate aminotransferase (AST) and/or alanine aminotransferase (ALT) > 5 times the upper limit of the normal (obtained within 12 weeks from first dose); Renal insufficiency as defined by estimated glomerular filtration rate (eGFR) <60 mL/min/1.73m2 normal (obtained within 12 weeks from first dose); Pregnant women or women currently breastfeeding; Current severe biliary disease which may result in the Investigator medical judgement in biliary obstruction including for example active cholecystitis, primary biliary cirrhosis, sclerosing cholangitis, gallbladder cancer, gangrene of the gallbladder, abscess of the gallbladder; History of Class III/IV heart failure (per New York Heart Association - NYHA); Participant under severe salt restriction where the added salt intake due to treatment would put the participant at risk, in the Investigator clinical judgment; Presence of unstable psychiatric disease, cognitive impairment, dementia or substance abuse that would impair ability of the participant to provide informed consent, according to Investigator judgment; Clinically significant unstable medical condition (other than ALS) (e.g., cardiovascular instability, systemic infection, untreated thyroid dysfunction, severe laboratory test anomaly or clinically significant electrocardiogram [ECG] changes) that would pose a risk to the participant if he/she were to participate in the trial, according to Investigator judgment; Currently enrolled in another trial (excluding Study A35-004 (PHOENIX)) involving use of an investigational therapy (or within 5 plasma half-lives) prior to first dose at Baseline Visit; Implantation of Diaphragm Pacing System (DPS); Currently or previously treated within the last 30 days (or 5 half-lives, whichever is longer) from first dose at the Baseline Visit or planned exposure during the treatment period to any prohibited medications listed in Section 6.7 of the protocol.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Lahar Mehta, MD
Organizational Affiliation
Head, Global Clinical Development
Official's Role
Study Director
Facility Information:
Facility Name
University Hospitals Leuven
City
Leuven
Country
Belgium
Facility Name
Hospices Civils de Lyon Hôpital Neurologique Pierre Wertheimer Cellule Mutualisée de Recherche Clinique (CMRC)
City
Bron
Country
France
Facility Name
Hopital Gabriel Montpied Service de Neurologie
City
Clermont-Ferrand
Country
France
Facility Name
CHRU de Lille - Hôpital Roger Salengro
City
Lille
Country
France
Facility Name
CHU de Limoges - Hôpital Dupuytren
City
Limoges
Country
France
Facility Name
Hôpitaux Universitaires de Marseille Timone
City
Marseille
Country
France
Facility Name
Gui de Chauliac
City
Montpellier Cedex 5
Country
France
Facility Name
CHU de Montpellier
City
Montpellier
Country
France
Facility Name
CHU Nice
City
Nice
Country
France
Facility Name
Hôpital de la Salpêtrière
City
Paris
Country
France
Facility Name
Le Centre Hospitalier Régional Universitaire de Tours
City
Tours
Country
France
Facility Name
Uniklinikum Dresden
City
Dresden
Country
Germany
Facility Name
Hannover Medical School
City
Hannover
Country
Germany
Facility Name
Jena University Hospital
City
Jena
Country
Germany
Facility Name
Medizinische Fakultät Mannheim der Universität Heidelberg
City
Mannheim
Country
Germany
Facility Name
University Medical Center Rostock
City
Rostock
Country
Germany
Facility Name
Ulm University Medical Centre
City
Ulm
Country
Germany
Facility Name
Trinity College Dublin/Beaumont Hospital
City
Dublin
Country
Ireland
Facility Name
Università degli Studi di Bari Aldo Moro
City
Bari
Country
Italy
Facility Name
IRCCS - Istituto Auxologico italiano
City
Milano
Country
Italy
Facility Name
Centro Clinico NEMO
City
Milan
Country
Italy
Facility Name
IRCCS - Ospedale San Raffaele
City
Milan
Country
Italy
Facility Name
University of Milan Medical School
City
Milan
Country
Italy
Facility Name
Azienda Ospedaliero Universitaria Di Modena
City
Modena
Country
Italy
Facility Name
Università degli Studi della Campania Luigi Vanvitelli
City
Napoli
Country
Italy
Facility Name
University of Padua
City
Padova
Country
Italy
Facility Name
Università degli Studi di Bari Aldo Moro
City
Tricase
Country
Italy
Facility Name
University of Torino
City
Turin
Country
Italy
Facility Name
University Medical Center Utrecht
City
Utrecht
Country
Netherlands
Facility Name
Centrum Medyczne Linden
City
Kraków
Country
Poland
Facility Name
City Clinic Warsaw
City
Warsaw
Country
Poland
Facility Name
Centro Hospitalar Universitário Lisboa-Norte
City
Lisbon
Country
Portugal
Facility Name
Hospital del Mar
City
Barcelona
Country
Spain
Facility Name
Hospital Universitari de Bellvitge-IDIBELL
City
Barcelona
Country
Spain
Facility Name
Hospital Universitario de Basurto
City
Bilbao
Country
Spain
Facility Name
Hospital San Rafael
City
Madrid
Country
Spain
Facility Name
Biodonostia Health Research Institute; Hospital Universitario Donostia
City
San Sebastián
Country
Spain
Facility Name
Hospital Universitario y Politécnico La Fe
City
Valencia
Country
Spain
Facility Name
Karolinska Institutet
City
Stockholm
Country
Sweden
Facility Name
Umeå University Hospital
City
Umeå
Country
Sweden
Facility Name
The Walton Centre NHS Trust
City
Liverpool
Country
United Kingdom
Facility Name
King's College London
City
London
Country
United Kingdom
Facility Name
UCL Queen Square Institute of Neurology
City
London
Country
United Kingdom
Facility Name
University of Plymouth
City
Plymouth
Country
United Kingdom
Facility Name
Salford Royal Hospital Barnes Clinical Research Team
City
Salford
Country
United Kingdom
Facility Name
Sheffield Institute for Translational Neuroscience (SITraN)
City
Sheffield
Country
United Kingdom

12. IPD Sharing Statement

Learn more about this trial

Extension Study Evaluating The Safety And Tolerability of AMX0035

We'll reach out to this number within 24 hrs