The goal of this two-part clinical trial is: 1\) to evaluate the safety and efficacy of Debamestrocel - MSC-NTF (NurOwn) compared to placebo in participants with early symptomatic ALS and moderate disease presentation in ALS; followed by 2) further evaluation by providing NurOwn to all participants in an open label extension period. Researchers will compare NurOwn to a placebo (a look-alike substance that contains no drug) to evaluate the efficacy of NurOwn compared to placebo in the treatment of participants with ALS. Participants will: Receive NurOwn or a placebo every 8 weeks for 24 weeks. After that, every participant will receive NurOwn every 8 weeks for an additional 24 weeks. They will visit the clinic approximately every 8 weeks for checkups and tests.
This is a multicenter, Phase 3b study to assess the efficacy and safety of NurOwn in participants with early symptomatic ALS and moderate disease presentation in ALS. The study comprises two parts: a 24-week randomized, double blind placebo controlled period (Part A) followed by a 24-week open label expansion period (Part B). Up to approximately 200 participants are planned to be enrolled and randomized 1:1 to the NurOwn and placebo groups in Part A. All eligible participants who complete Part A will have the option of entering Part B. The trial includes a 9-week screening period. After the first screening visit (Screening Visit 1), there will be a Screening Visit 2, during which randomization 1:1 to the NurOwn and placebo groups will occur after confirming that all entry criteria are met. Following randomization, bone marrow aspiration will be scheduled. Stem cells from the bone marrow of all participants will be isolated, and then cryopreserved. Prior to each intrathecal (IT) dose administration, cells will be thawed, propagated, and induced into MSC-NTF cells (NurOwn). In Part A, participants will receive NurOwn or placebo via IT injection every eight weeks at Weeks 0, 8, and 16. In Part B, participants will receive NurOwn via IT injection every eight weeks at Weeks 24, 32, and 40. All participants will be offered the option to participate in the collection and storage of blood/serum, CSF, and buccal samples for future analysis of biomarkers and genetic testing.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
200
MSC-NTF cells suspended in excipient Dulbecco Modified Eagle Medium (DMEM).
Dulbecco Modified Eagle Medium (DMEM).
Barrow Neurological Institute
Phoenix, Arizona, United States
University of California San Diego Medical Center
La Jolla, California, United States
University of Southern California
Los Angeles, California, United States
California Pacific Medical Center
San Francisco, California, United States
University of California, San Francisco
San Francisco, California, United States
University of Colorado Anschutz Medical Campus School of Medicine
Aurora, Colorado, United States
Nova Southeastern University
Davie, Florida, United States
Mayo Clinic
Jacksonville, Florida, United States
University of South Florida
Tampa, Florida, United States
Northwestern Medicine
Chicago, Illinois, United States
...and 5 more locations
Change in the ALSFRS-R total score from baseline to Week 24
To evaluate the efficacy of NurOwn compared to placebo in the treatment of participants with ALS based on the Revised Amyotrophic Lateral Sclerosis Functional Rating Scale (ALSFRS-R) which is a 12-item clinician-administered questionnaire. Each item is scored between 0 and 4, with the total ALSFRS-R score between 0 and 48 where a higher score reflects a better outcome.
Time frame: From baseline to Week 24
Frequency and severity of adverse events including treatment-emergent adverse events (TEAEs), serious adverse events (SAEs), death, abnormalities in laboratory evaluations, physical examinations, vital signs and electrocardiogram (ECG) assessments
To evaluate the safety and tolerability of NurOwn in the treatment of participants with ALS throughout the study including the DBPC period (Part A) to Week 24 and the Open Label Extension (Part B).
Time frame: From baseline to Week 48
Change in SVC (%predicted) from baseline to Week 24
To evaluate the efficacy of NurOwn compared to placebo on respiratory function based on slow vital capacity (SVC)
Time frame: From baseline to Week 24
Change in HHD from baseline to Week 24
To evaluate the efficacy of NurOwn compared to placebo on upper limb muscle strength based on the hand-held dynamometry (HHD) measurement
Time frame: From baseline to Week 24
Chief Medical Officer, Brainstorm Cell Therapeutics, MD
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