This is a multicenter, Phase 2a, randomized, double-blind, placebo-controlled pilot study to assess the biological activity, safety and pharmacokinetics of PU-AD compared to placebo in ALS. It will be conducted in approximately 20 sites in the US. Approximately 30 subjects will be enrolled in this study; subjects will be randomized 3:2 to receive either PU-AD 30 mg or matching placebo qd, added onto any current stable background treatment.
This is a multicenter, Phase 2a, randomized, double-blind, placebo-controlled pilot study to assess the biological activity, safety and pharmacokinetics of PU-AD compared to placebo in ALS. It will be conducted in approximately 20 sites in the US. Approximately 30 subjects will be enrolled in this study; subjects will be randomized 3:2 to receive either PU-AD 30 mg or matching placebo qd, added onto any current stable background treatment. Subjects who meet all inclusion criteria and none of the exclusion criteria will be eligible to participate in this study. The study consists of a Screening Period (including background treatment stabilization, if required) (4 weeks), Treatment Period (24 weeks) and a safety Follow up Visit (4 weeks \[±1 week\] after the last dose of investigational medicinal product \[IMP\]). The expected study duration is up to 32 weeks. The Screening visit will take place within 4 weeks prior to dosing, to assess eligibility of subjects. Eligible subjects will be randomized and then return to the site for baseline assessments at Week 1. During the 24 week Treatment Period, subjects will be administered 30 mg PU AD or matching placebo qd, orally, on an empty stomach (1 hour prior to food or 2 hours after), at about the same time each day.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Amyotrophic Lateral Sclerosis Functional Rating Scale-Revised (ALSFRS-R)
Clinical effect outcome assessments change from baseline (CFB)
Time frame: 12 weeks
Amyotrophic Lateral Sclerosis Functional Rating Scale-Revised (ALSFRS-R)
Clinical effect outcome assessments change from baseline (CFB)
Time frame: 24 weeks
Slow Vital Capacity (SVC)
Clinical effect outcome assessments change from baseline (CFB)
Time frame: 12 weeks
Slow Vital Capacity (SVC)
Clinical effect outcome assessments change from baseline (CFB)
Time frame: 24 weeks
Handgrip strength using hand-held dynamometry
Clinical effect outcome assessments change from baseline (CFB)
Time frame: 12 weeks
Handgrip strength using hand-held dynamometry
Clinical effect outcome assessments change from baseline (CFB)
Time frame: 24 weeks
6 Minute Walk Test (6MWT)
Clinical effect outcome assessments change from baseline (CFB)
Time frame: 12 weeks
6 Minute Walk Test (6MWT)
Clinical effect outcome assessments change from baseline (CFB)
Time frame: 24 weeks
Rasch-Built Overall Amyotrophic Lateral Sclerosis Disability Scale (ROADS)
Clinical effect outcome assessments change from baseline (CFB)
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Time frame: 12 weeks
Rasch-Built Overall Amyotrophic Lateral Sclerosis Disability Scale (ROADS)
Clinical effect outcome assessments change from baseline (CFB)
Time frame: 24 weeks
Blood biomarkers (neurofilament light chain [NfL], phosphorylated neurofilament heavy chain [pNfH], Super oxide dismutase 1 (SOD1)
Biomarker change from baseline (CFB)
Time frame: 12 weeks
Blood biomarkers (neurofilament light chain [NfL], phosphorylated neurofilament heavy chain [pNfH], Super oxide dismutase 1 (SOD1)
Biomarker change from baseline (CFB)
Time frame: 24 weeks
CSF biomarkers (total tau [t-tau], phosphorylated tau231 [p-tau231], Neurofilament light chain (NfL), phosphorylated neurofilament heavy chain (pNfH), glial fibrillary acidic protein [GFAP], Transactive DNA binding protein 43 (TDP 43)
Biomarker change from baseline (CFB)
Time frame: 12 weeks
CSF biomarkers (total tau [t-tau], phosphorylated tau231 [p-tau231], NfL, pNfH, glial fibrillary acidic protein [GFAP], TDP 43
Biomarker change from baseline (CFB)
Time frame: 24 weeks
Urinary biomarker (P75 extracellular domain [p75ECD])
Biomarker change from baseline (CFB)
Time frame: 12 weeks
Urinary biomarker (P75 extracellular domain [p75ECD])
Biomarker change from baseline (CFB)
Time frame: 24 weeks
Super oxide dismutase 1 (SOD1) (in subjects with known gene mutations: SOD1) in CSF and blood
Biomarker change from baseline (CFB)
Time frame: 12 weeks
Super oxide dismutase 1 (SOD1) (in subjects with known gene mutations: SOD1) in CSF and blood
Biomarker change from baseline (CFB)
Time frame: 24 weeks
Poly(GP) (in subjects with known gene mutations: Chromosome 9 open reading frame 72 (C9orf72) ) in CSF
Biomarker change from baseline (CFB)
Time frame: 12 weeks
Poly(GP) (in subjects with known gene mutations: Chromosome 9 open reading frame 72 (C9orf72) ) in CSF
Biomarker change from baseline (CFB)
Time frame: 24 weeks