The purpose of this trial is to study the effect of Memantine (uncompetitive, moderate affinity, NMDA receptor antagonist that binds to the NMDA receptor channel, and regulates the calcium influx into the neurons), a drug used to treat Alzheimer´s disease, on the progression of Amyotrophic Lateral Sclerosis (ALS). Memantine is added to riluzole (the single drug approved to treat ALS).
Phase 2/3 trial in ALS patients Double-blinded, parallel, randomized (2 blocs, bulbar/spinal onset) Memantine + riluzole x Placebo + Memantine Inclusion criteria: * \< 75 years at disease onset * \< 3 years of disease progression * ALS-FRS \> 24 * FVC \> 60 * Probable or definite disease (revised El Escorial criteria) * No other medical condition * Normal blood tests * Regular medication on riluzole \> 1 month * Nerve conduction studies ruling out conduction block * EMG with widespread loss of motor units (revised El Escorial criteria) * At least one hand with ADM strength \> 2 on MRC scale Duration - 2 years Evaluation - every 3 months Primary outcome - ALS-FRS Secondary -SF36, Hamilton depression scale, motor unit number estimation, neurophysiological index, strength (clinical evaluation); side-effects Intention to treat analysis 60 patients number estimated for 50% change in decline rate of ALS-FRS
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
63
Department of Neurology - Hospital de Santa Maria
Lisbon, Portugal
ALS-FRS
Time frame: 12 months
QoL, depression scale, strength (clinical evaluation), forced vital capacity
Time frame: 12 months
neurophysiology (motor unit counting, neurophysiological index)
Time frame: 12 months
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