69 subjects with ALS will be enrolled in the study and randomized at a 2:1 ratio to receive the study drug or placebo tablets. Randomization sequences will be in random block sizes and stratified for ENCALS risk category \[high risk ≥ -4.5 vs. low risk \< -4.5\], and for background ALS treatment (riluzole and/or edaravone and/or sodium phenylbutyrate and/or taurursodiol) vs. no background ALS treatment. All subjects will be administered the drug/placebo twice daily (BID), two tablets each time, for 6 months. Subjects will be allowed to receive standard of care (SOC) treatment of approved products (i.e., riluzole and edaravone). Additionally, subjects will be allowed to receive treatment with off-label sodium phenylbutyrate and taurursodiol, which are accepted for ALS treatment. Subjects will be evaluated every 2 months for safety, tolerability (adverse events, safety laboratory, vital signs, ECG, withdrawal rates and reasons) and efficacy (e.g. biomarkers, clinical outcomes (ALSFRS-R and SVC, quality of life and survival). All subjects who complete the 6 months dosing will be switched to the active arm for a 12-month open label extension (OLE).
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
69
Lawson Health Research Institute
London, Ontario, Canada
Tel Aviv Sourasky Medical Center
Tel Aviv, Israel
IRCCS Istituti clinici Maugeri
Milan, Italy
A.O.U. Citta della Salute e della Scienza di Torino
Torino, Italy
Incidence and severity of treatment-emergent adverse events (TEAEs)
Treatment emergent adverse event is any medical event associated with the drug
Time frame: 6 months
Number of subjects who discontinued treatment prematurely
Number of subjects whose treatment is stopped prematurely for any reason
Time frame: 6 months
Number of patients who discontinued treatment prematurely due to adverse events
Number of patients whose treatment is stopped prematurely specifically due to adverse events
Time frame: 6 months
Number of patients with clinically significant abnormal laboratory values
Time frame: 6 months
The mean difference between PrimeC and Placebo in serum concentration of NDE TDP-43 at month 6
Time frame: 6 months
The mean difference between PrimeC and placebo in serum concentration of NDE PgJ2 at month 6
Time frame: 6 months
Change from baseline to 6 months in ALS functional rating scale - revised (ALSFRS-R)
Time frame: 6 months
Change from baseline to 6 months in slow vital capacity (SVC)
Time frame: 6 months
Change from baseline to 6 months in quality of life ALSSQOL-SF
Time frame: 6 months
Change from baseline to 6 months in PROMIS-10 quality of life questionnaire
Time frame: 6 months
Survival at 6 months of treatment
Overall Survival defined as time to death from any cause at 6 months of treatment
Time frame: 6 months
Composite survival at 6 months of treatment
Composite of overall survival, defined as time to death from any cause, or respiratory insufficiency (defined as tracheostomy or the use of non-invasive ventilation for ≥22 h per day for ≥10 consecutive days) at 6 months of treatment
Time frame: 6 months
Composite survival at 6 months of treatment
Composite of overall survival, defined as time to death from any cause, or respiratory insufficiency (defined as tracheostomy or the use of non-invasive ventilation for ≥22 h per day for ≥10 consecutive days), or time to hospitalization due to ALS-related complications at 6 months of treatment
Time frame: 6 months
Joint Assessment of Function and Survival after 6 months of treatment
Time frame: 6 months
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