Phase II/III Randomized, Placebo-controlled Trial of Arimoclomol in SOD1 Positive Familial Amyotrophic Lateral Sclerosis
Primary Purpose
Amyotrophic Lateral Sclerosis
Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Arimoclomol
Placebo
Sponsored by
About this trial
This is an interventional treatment trial for Amyotrophic Lateral Sclerosis focused on measuring Hereditary ALS, Hereditary neurological disease, Lou Gehrig's Disease, Motor Neuron Disease, Amyotrophic Lateral Sclerosis (ALS), Familial ALS, Neuromuscular disease, SOD1 mutation, Superoxide dismutase, SOD1 positive ALS, inherited ALS
Eligibility Criteria
Inclusion Criteria:
- Type of ALS that is hereditary (runs in families) only.
- El Escorial criteria for familial ALS and a family history of a pathogenic mutation in a gene known to be associated with ALS, such as the SOD1 gene.
- Willingness to undergo genetic testing and to learn the results.
- Demonstrable mutation in the SOD1 gene that is reported to be associated with a rapid rate of disease progression (i.e. A4V, A4T, C6F, C6G, V7E, L8Q, G10V, G41S, H43R, H48Q, D90V, G93A, D101H, D101Y, L106V, I112M, I112T, R115G, L126X, G127X, A145T, V148G, V148I) or possibly associated with rapidly progressive disease (E21G, G37R, L38V, D76Y, L84F, L84V, N86S, D90A het, G93R, I104F, I113T, L144F, L144S).
- Age 18 years or older; male or female.
- Capable of providing informed consent and complying with trial procedures.
- Diagnosis within less than 9 months of the anticipated date of the baseline visit AND study participants' subjective evaluation that they expect their physical condition to permit travel to the study site for both the baseline and 2-month study visits.
- Women must not be able to become pregnant (e.g. post menopausal for at least one year, surgically sterile, or practicing adequate birth control methods) for the duration of the study. Adequate contraception includes: oral contraception, implanted contraception, intrauterine device in place for at least 3 months, or barrier method in conjunction with spermicide.
- Women of childbearing potential must have a negative pregnancy test at screening visit and be non-lactating.
- Willing to remain on a stable dose of Riluzole or to remain off Riluzole for the duration of the trial.
- Identifiable local medical doctor to assist with urgent care of any medical complications that may arise.
- Absence of any of the exclusion criteria.
Exclusion Criteria:
- History of known sensitivity or intolerability to Arimoclomol or to any other related compound.
- Exposure to any investigational drug within 30 days of the screening visit.
Presence of any of the following clinical conditions:
- Substance abuse within the past year.
- Unstable cardiac, pulmonary, renal, hepatic, endocrine, hematologic, or active infectious disease.
- AIDS or AIDS-related complex.
- Unstable psychiatric illness defined as psychosis (hallucinations or delusions), untreated major depression within 90 days of the screening visit.
- Positive pregnancy test at screening visit.
Screening laboratory values:
- Creatinine greater than 1.5.
- Alanine aminotransferase (ALT) or Aspartate aminotransferase (AST). greater than 3.0 times the upper limit of normal.
- Total bilirubin greater than 2.0 times the upper limit of normal.
- White blood cell (WBC) count less than 3,500/mm3.
- Platelet concentration less than 100,000/ul.
- Hematocrit level less than 33 for female or less than 35 for male.
- Female patients who are breast-feeding.
Sites / Locations
- University of Miami Miller School of Medicine
- Massachusetts General Hospital
Arms of the Study
Arm 1
Arm 2
Arm Type
Placebo Comparator
Active Comparator
Arm Label
1
2
Arm Description
Outcomes
Primary Outcome Measures
Time to death, tracheostomy or permanent assisted ventilation will be the primary outcome measure.
Secondary Outcome Measures
Rate of decline of ALSFRS-R (ALS functional rating scale-revised) over a period of up to 12 months.
Disease progression as measured by the rate of decline of FEV6.
Safety and tolerability of arimoclomol will be evaluated by using vital signs and weight, clinical laboratory measures, physical examination, report of adverse events, and the proportion of subjects completing the study on assigned treatment.
Full Information
NCT ID
NCT00706147
First Posted
June 24, 2008
Last Updated
January 9, 2019
Sponsor
University of Miami
Collaborators
Massachusetts General Hospital
1. Study Identification
Unique Protocol Identification Number
NCT00706147
Brief Title
Phase II/III Randomized, Placebo-controlled Trial of Arimoclomol in SOD1 Positive Familial Amyotrophic Lateral Sclerosis
Official Title
Phase II/III Randomized, Placebo-Controlled Trial of Arimoclomol in SOD1 Positive Familial Amyotrophic Lateral Sclerosis (ALS)
Study Type
Interventional
2. Study Status
Record Verification Date
January 2019
Overall Recruitment Status
Completed
Study Start Date
January 2009 (undefined)
Primary Completion Date
December 2014 (Actual)
Study Completion Date
November 2016 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
University of Miami
Collaborators
Massachusetts General Hospital
4. Oversight
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
The purpose of this study will be to demonstrate the safety, tolerability, and efficacy of arimoclomol in subjects with SOD1 positive familial Amyotrophic Lateral Sclerosis (ALS). This type of ALS is HEREDITARY (runs in families), and at least one other person in the family must have had ALS.
Study hypotheses: Arimoclomol, taken at a dose of 200 mg three times daily will improve survival as defined by time to death, tracheostomy or permanent assisted ventilation. In addition, it will be safe and well tolerated in subjects with SOD1 positive familial ALS.
Funding Source - FDA-OOPD
Detailed Description
Using a seamless, adaptive, phase II/III design, the investigators will determine the safety and efficacy of arimoclomol in patients with SOD1 positive familial ALS. Both stage-1 and stage-2 are randomized, double-blind and placebo-controlled in a population of patients with rapidly progressive SOD1 positive familial ALS. Patients with ALS, a history of a relative affected with ALS (i.e. familial ALS) and the presence of a demonstrable mutation in the SOD1 gene that is known to be associated with rapidly progressive disease, will be eligible for inclusion in this study. Potentially eligible subjects will undergo screening via telephone and, if necessary, review of outside medical records. The intervention will continue for up to 12 months. In the event that a participant reaches a study endpoint (e.g. tracheostomy or permanently assisted ventilation) study drug will be terminated. Subjects who meet all eligibility criteria will travel a study site for final eligibility determination, baseline evaluation and will then be randomized 1:1 to receive either placebo or arimoclomol at a dose of 200 mg t.i.d. Participants will then be evaluated again in person at a study site at Month-2. Telephonic evaluations at Month-1, 3, 4, 5, 6, 8, and 10 will be performed in participants' homes. Safety and tolerability evaluations will be performed at each of these visits. Collection of blood samples for safety laboratory analyses and measurement of blood pressure, heart rate, respiratory rate, temperature and weight will be performed at Months-1, 3, 4, 5, 6, 8, and 10 in the participant's home by a representative of a medical monitoring company. A study coordinator may perform an in-person visit at Month-12, or this visit may occur telephonically. A final evaluation will be performed via telephone at Month-13 (30 days after the last dose of study medication).
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Amyotrophic Lateral Sclerosis
Keywords
Hereditary ALS, Hereditary neurological disease, Lou Gehrig's Disease, Motor Neuron Disease, Amyotrophic Lateral Sclerosis (ALS), Familial ALS, Neuromuscular disease, SOD1 mutation, Superoxide dismutase, SOD1 positive ALS, inherited ALS
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 2, Phase 3
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigator
Allocation
Randomized
Enrollment
38 (Actual)
8. Arms, Groups, and Interventions
Arm Title
1
Arm Type
Placebo Comparator
Arm Title
2
Arm Type
Active Comparator
Intervention Type
Drug
Intervention Name(s)
Arimoclomol
Other Intervention Name(s)
Arimoclomol (BRX-345)
Intervention Description
Drug: Arimoclomol capsules given three times per day
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Drug: Placebo capsules given three times per day
Primary Outcome Measure Information:
Title
Time to death, tracheostomy or permanent assisted ventilation will be the primary outcome measure.
Time Frame
12 months
Secondary Outcome Measure Information:
Title
Rate of decline of ALSFRS-R (ALS functional rating scale-revised) over a period of up to 12 months.
Time Frame
12 months
Title
Disease progression as measured by the rate of decline of FEV6.
Time Frame
12 months
Title
Safety and tolerability of arimoclomol will be evaluated by using vital signs and weight, clinical laboratory measures, physical examination, report of adverse events, and the proportion of subjects completing the study on assigned treatment.
Time Frame
12 months
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Type of ALS that is hereditary (runs in families) only.
El Escorial criteria for familial ALS and a family history of a pathogenic mutation in a gene known to be associated with ALS, such as the SOD1 gene.
Willingness to undergo genetic testing and to learn the results.
Demonstrable mutation in the SOD1 gene that is reported to be associated with a rapid rate of disease progression (i.e. A4V, A4T, C6F, C6G, V7E, L8Q, G10V, G41S, H43R, H48Q, D90V, G93A, D101H, D101Y, L106V, I112M, I112T, R115G, L126X, G127X, A145T, V148G, V148I) or possibly associated with rapidly progressive disease (E21G, G37R, L38V, D76Y, L84F, L84V, N86S, D90A het, G93R, I104F, I113T, L144F, L144S).
Age 18 years or older; male or female.
Capable of providing informed consent and complying with trial procedures.
Diagnosis within less than 9 months of the anticipated date of the baseline visit AND study participants' subjective evaluation that they expect their physical condition to permit travel to the study site for both the baseline and 2-month study visits.
Women must not be able to become pregnant (e.g. post menopausal for at least one year, surgically sterile, or practicing adequate birth control methods) for the duration of the study. Adequate contraception includes: oral contraception, implanted contraception, intrauterine device in place for at least 3 months, or barrier method in conjunction with spermicide.
Women of childbearing potential must have a negative pregnancy test at screening visit and be non-lactating.
Willing to remain on a stable dose of Riluzole or to remain off Riluzole for the duration of the trial.
Identifiable local medical doctor to assist with urgent care of any medical complications that may arise.
Absence of any of the exclusion criteria.
Exclusion Criteria:
History of known sensitivity or intolerability to Arimoclomol or to any other related compound.
Exposure to any investigational drug within 30 days of the screening visit.
Presence of any of the following clinical conditions:
Substance abuse within the past year.
Unstable cardiac, pulmonary, renal, hepatic, endocrine, hematologic, or active infectious disease.
AIDS or AIDS-related complex.
Unstable psychiatric illness defined as psychosis (hallucinations or delusions), untreated major depression within 90 days of the screening visit.
Positive pregnancy test at screening visit.
Screening laboratory values:
Creatinine greater than 1.5.
Alanine aminotransferase (ALT) or Aspartate aminotransferase (AST). greater than 3.0 times the upper limit of normal.
Total bilirubin greater than 2.0 times the upper limit of normal.
White blood cell (WBC) count less than 3,500/mm3.
Platelet concentration less than 100,000/ul.
Hematocrit level less than 33 for female or less than 35 for male.
Female patients who are breast-feeding.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Michael Benatar, MBChB, DPhil
Organizational Affiliation
University of Miami
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Merit Cudkowicz, MD, MSc
Organizational Affiliation
Massachusetts General Hospital
Official's Role
Principal Investigator
Facility Information:
Facility Name
University of Miami Miller School of Medicine
City
Miami
State/Province
Florida
ZIP/Postal Code
33136
Country
United States
Facility Name
Massachusetts General Hospital
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02114
Country
United States
12. IPD Sharing Statement
Citations:
PubMed Identifier
29367439
Citation
Benatar M, Wuu J, Andersen PM, Atassi N, David W, Cudkowicz M, Schoenfeld D. Randomized, double-blind, placebo-controlled trial of arimoclomol in rapidly progressive SOD1 ALS. Neurology. 2018 Feb 13;90(7):e565-e574. doi: 10.1212/WNL.0000000000004960. Epub 2018 Jan 24.
Results Reference
derived
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Phase II/III Randomized, Placebo-controlled Trial of Arimoclomol in SOD1 Positive Familial Amyotrophic Lateral Sclerosis
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