Multicenter, multinational, double-blind, randomized (2:1), placebo-controlled Phase III study to investigate the efficacy and safety of 100 mg FAB122 once daily as oral formulation in ALS patients.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
313
Change From Baseline in Amyotrophic Lateral Sclerosis Functional Rating Scale - Revised (ALSFRS-R) Score After 48 Weeks.
Revised Amyotrophic Lateral Sclerosis Functional Rating Scale (ALSFRS-R), Maximum value is 48 points and represents better outcome. Minimum value is 0 and represents worse outcome.
Time frame: 48 weeks
Combined Assessment of Function and Survival (CAFS) at 48 and 72 Weeks.
The CAFS (Combined assessment of function and survival) combined information on survival time and ALSFRS-R (ALS Functional Rating Scale-Revised) scores. For this endpoint, each subject's outcome was ranked: the worst subject outcomes received the lowest rank numbers such that a higher CAFS score indicates a better outcome. CAFS rankings are computed using: Survival data: Patients who die earlier are ranked lower than those who survive longer. ALSFRS-R scores: For patients with the same survival duration, ranks are determined by their functional decline (change in ALSFRS-R from baseline). For this study the range could go from 1 to 302. Better Outcome: Higher CAFS rank, indicating prolonged survival and/or less functional decline. Worse Outcome: Lower CAFS rank, indicating shorter survival and/or greater functional decline.
Time frame: 48 weeks and 72 weeks
Survival Probability
Results are based on the overall survival over 72 weeks of treatment, the result is the survival probability estimated over 72 weeks. Survival probability is calculated considering time to death, tracheostomy or initiation of non-invasive ventilation for more than 20 hours a day for more than 10 consecutive days, over 72 weeks.
Time frame: 72 weeks
Change From Baseline in ALSFRS-R Score After 24 and 72* Weeks
Revised Amyotrophic Lateral Sclerosis Functional Rating Scale (ALSFRS-R), Maximum value is 48 points and represents better outcome. Minimum value is 0 and represents worse outcome.
Time frame: 24 weeks, 72 weeks
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University Hospitals Leuven
Leuven, Belgium
CHRU de Lille - Hôpital Roger Salengro
Lille, France
CHU de Limoges - Hôpital Dupuytren
Limoges, France
Centre Hospitalo-Universitaire La Timone
Marseille, France
CHU de Montpellier
Montpellier, France
CHU Nice
Nice, France
Hôpital de la Salpêtrière
Paris, France
CHRU de Tours
Tours, France
Universitätsmedizin Berlin
Berlin, Germany
Universitätsklinikum Carl Gustav Carus
Dresden, Germany
...and 28 more locations
The Slope of the Decrease in ALSFRS-R Score Over Time at 24, 48 and 72* Weeks;
Revised Amyotrophic Lateral Sclerosis Functional Rating Scale (ALSFRS-R), Maximum value is 48 points and represents better outcome. Minimum value is 0 and represents worse outcome. For this outcome, measures on the ALSFRS-R were used to determine the slope of the decrease.
Time frame: 24, 48, 72 weeks
Change From Baseline in ALSFRS-R Score on Bulbar Function (Question 1-3 of the ALSFRS-R) After 24, 48 and 72* Weeks;
Revised Amyotrophic Lateral Sclerosis Functional Rating Scale (ALSFRS-R), Maximum value is 48 points and represents better outcome. Minimum value is 0 and represents worse outcome. In this outcome, the Bulbar function (as part of ALSFRS-R) is evaluated, it is related to Speech, Salivation and Swallowing. The maximum score on Bulbar function is 12, and the minimum is 0. Higher score better outcome.
Time frame: 24, 48 and 72 weeks
Change From Baseline ALS Functional Rating Scale - Revised Score - Fine Motor Function
Revised Amyotrophic Lateral Sclerosis Functional Rating Scale (ALSFRS-R), Maximum value is 48 points and represents better outcome. Minimum value is 0 and represents worse outcome. In this outcome, the fine motor function (as part of ALSFRS-R) is evaluated, it is related to Handwriting, Eating and Cutting food, Dressing and hygiene. The maximum score on fine motor function is 12, and the minimum is 0. Higher score better outcome.
Time frame: 24, 48 and 72 weeks
Change From Baseline ALS Functional Rating Scale - Revised Score - Gross Motor Function
Revised Amyotrophic Lateral Sclerosis Functional Rating Scale (ALSFRS-R), Maximum value is 48 points and represents better outcome. Minimum value is 0 and represents worse outcome. In this outcome, the gross motor function (as part of ALSFRS-R) is evaluated, it is related to Climbing stairs, Walking, Rising from a chair. The maximum score on gross motor function is 12, and the minimum is 0. Higher score better outcome.
Time frame: 24, 48, 72 weeks
Change From Baseline ALS Functional Rating Scale - Revised Score - Respiratory Function
Revised Amyotrophic Lateral Sclerosis Functional Rating Scale (ALSFRS-R), Maximum value is 48 points and represents better outcome. Minimum value is 0 and represents worse outcome. In this outcome, the respiratory function (as part of ALSFRS-R) is evaluated, it is related to Dyspnea, Orthopnea, Breathing insufficiency. The maximum score on respiratory function is 12, and the minimum is 0. Higher score better outcome.
Time frame: 24, 48, 72 weeks
Time to a 3, 6, 9 and 12 Points Change or Death From Baseline in ALSFRS-R Score Over 72* Weeks;
Revised Amyotrophic Lateral Sclerosis Functional Rating Scale (ALSFRS-R), Maximum value is 48 points and represents better outcome. Minimum value is 0 and represents worse outcome. For this outcome, the time a 3, 6, 9 and 12 points change or death from baseline in ALSFRS-R.
Time frame: 72 weeks (+/-1 week visit window)
Change in Clinical Staging (King's Staging System and MiToS) Over 72 Weeks
The King's staging system is a simple clinical staging system, which defines 4 stages of ALS. The 1st 3 stages are defined by functional involvement of a region: bulbar, upper limbs, and lower limbs. The number of regions involved gives the stage. Stage 4 is reached if swallowing (4A) or respiratory (4B) difficulty is severe enough to require intervention. The outcome of this measure shows the number of patients which staging decline of 1 point or more or No decline.
Time frame: 72 weeks
Overall Survival: Proportion of Subjects Alive (Survival Rate) After 24, 48 and 72* Weeks;
Time frame: 24, 48 and 72* weeks;
Proportion of Subjects Alive and no Tracheostomy, or no Initiation of Non-invasive Ventilation for More Than 20 Hours a Day for More Than 10 Consecutive Days After 24, 48 and 72* Weeks
Time frame: 24, 48 and 72* weeks
Change From Baseline in Slow Vital Capacity (SVC, Liters) at 24, 48 and 72* Weeks;
Time frame: 24, 48 and 72* weeks
Change From Baseline in the Overall Mega Score for the Hand-held Dynamometer (HHD) at 24, 48 and 72* Weeks.
HHD is a procedure for quantitative strength testing performed in the upper and lower extremities bilaterally. The overall mega score are derived as z-scores of average muscle HHD assessments, percent changes from Baseline are used to derive individual muscle scores. Muscle strength is expressed as the percent change from baseline: (post-baselinevalue-baselinevalue)/baselinevalue×100(post-baseline value - baseline value) / baseline value \\times 100(post-baselinevalue-baselinevalue)/baselinevalue×100. If the baseline value is zero, the data is considered missing. The HDD mega-score averages strength across four muscle locations. It is calculated by averaging the non-missing transformed values. Maximum muscle strength is then standardized using a z-score, based on data from a healthy population. Z-score of 0 represents the healthy population mean. Negative z-score value means worse outcome.
Time frame: 24, 48 and 72* weeks
Change From Baseline in the Total Score on the ALS Assessment Questionnaire-40-Item (ALSAQ-40) Form at 24, 48 and 72* Weeks;
ALS Assessment Questionnaire-40-Item. The ALSAQ-40 is specifically used to measure the subjective wellbeing of patients with ALS. There are 40 items/questions in the long form, the ALSAQ-40, with 5 discrete scales: physical mobility (10 items), activities of daily living and independence (10 items), eating and drinking (3 items), communication (7 items), and emotional reactions (10 items). Range is from 0 to 100 scale, where 0 indicates the best quality of life and 100 the worst.
Time frame: 24, 48 and 72* weeks
Change From Baseline in EuroQoL - 5 Dimensions-5 Levels (EQ-5D-5L) Questionnaire Score 24, 48 and 72* Weeks.
European Quality of Life 5 levels and 5 dimensions is a generic questionnaire of health-related quality of life. 5 Domains: Mobility, Self-care, Usual activities, Pain/Discomfort and Anxiety/Depression. Scale range is from 0 to 100, being 0 the worst and 100 the best.
Time frame: 24, 48 and 72* weeks
Change From Baseline in Visual Analogue Scale (VAS) Score at 24, 48 and 72* Weeks.
The Health-Related Quality of Life (HR-QoL) is a questionnaire using a Visual Analog Scale (VAS) ranging from 0 (bad) to 100 (very good).
Time frame: 24, 48 and 72* weeks
Proportion of Subjects With a Change of ≥8, ≥4, and ≥9 for ALS Specific, ALS Non-Specific, and ECAS (Edinburgh Cognitive and Behavioural ALS Screen) Total Score;
The ECAS (Edinburgh Cognitive and behavioural ALS Screen) is a brief multidomain assessment originally designed for people with ALS. Total Score Range: 0 to 136 points. Higher scores indicate better cognitive function. For ALS-Specific (Assesses cognitive domains most often affected in ALS) Score Range: 0 to 100 points. Higher scores indicate better cognitive function. And ALS Non-Specific (Evaluates broader cognitive abilities unrelated to ALS pathology) Score Range: 0 to 36 points. Higher scores indicate better cognitive function.
Time frame: 72 weeks