The goal of this clinical trial is to learn if the drug pridopidine works to treat amyotrophic lateral sclerosis in adults. It will also help to learn about the safety of pridopidine. The main question it aims to answer is: Does pridopidine slow disease progression of ALS? Researchers will compare pridopidine to a placebo (a look-alike substance that contains no drug) to see if pridopidine works to treat ALS. Participants will: Take pridopidine or a placebo by mouth every day for 48 weeks. Afterwards, all participants will take pridopidine for another 48 weeks. Visit the clinic once every 1-3 months for checkups and tests
This is a Phase 3, randomized study consisting of a double-blind placebo-controlled (DBPC) period followed by an open-label extension (OLE) to evaluate the efficacy and safety of pridopidine administered orally at a dose of 45 mg twice a day in adult participants with early and rapidly progressing ALS. Standard of care treatments (e.g. riluzole, edaravone and Nuedexta) will be allowed as long as participants are on a stable dose for at least 4 weeks prior to dosing. In the DBPC period, participants will be randomized in a 3:2 ratio to the pridopidine and placebo arms. In the DBPC period, participants will receive pridopidine or placebo for 48 weeks. In the OLE period, all participants will receive pridopidine for 48 weeks, while maintaining the blind to their original randomization for both the participant as well as the Investigator and other clinical staff. The total study duration per participant will be 102 weeks including screening and follow up. Throughout the study, participants will be assessed through on-site clinic visits and virtual visits (via telephone).
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
500
Pridopidine hard gelatin capsule.
Placebo hard gelatin capsule.
Barrow Neurological Institute
Phoenix, Arizona, United States
RECRUITINGCalifornia Pacific Medical Center
San Francisco, California, United States
RECRUITINGUniversity of Colorado CU Anschutz Neurology
Aurora, Colorado, United States
RECRUITINGMayo Clinic
Jacksonville, Florida, United States
Change from baseline through Week 26 and Week 48 in the Revised ALS Functional Rating Scale (ALSFRS-R) total score adjusted for mortality
The ALSFRS-R encompasses 12 questions grouped into 4 domains to assess bulbar symptoms, limb and trunk functionality, respiratory symptoms, and the need for percutaneous endoscopic gastrostomy (PEG), non-invasive ventilation, or tracheostomy with invasive ventilation. Each function is scored from 0 (no ability) to 4 (normal), with a minimum total score of 0 and maximum total score of 48. Higher scores indicate better functioning.
Time frame: Baseline to Week 48
Overall survival at Week 96
Time to death in days from baseline as assessed at the end of open-label extension (OLE) period
Time frame: Baseline to Week 96
Change from baseline through Week 26 and Week 48 in speaking rate as measured by quantitative speech assessment in the clinic
Time frame: Baseline to Week 48
Change from baseline through Week 48 in intelligibility of speech by quantitative speech assessment in the clinic.
Time frame: Baseline to Week 48.
Change from baseline through Week 48 in percent predicted slow vital capacity (SVC)
SVC measures the maximal amount of air exhaled in a relaxed expiration from full inspiration to residual volume. SVC is assessed in the sitting position with a spirometer.
Time frame: Baseline to Week 48
Change from baseline through Week 48 in the Bulbar subdomain of the ALSFRS-R
Measures decline in bulbar function.
Time frame: Baseline to Week 48
Change from baseline through Week 48 in the Amyotrophic Lateral Sclerosis Assessment Questionnaire - 40 (ALSAQ-40)
ALSAQ-40 includes 40 items/questions with 5 discrete scales including 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). The questions refer to two weeks prior to the day of the application and the answers are given according to the following variables: never, rarely, sometimes, frequently and always. The score ranges from 0 to 100; the higher the score, the worse the quality of life.
Time frame: Baseline to Week 48
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University of South Florida
Tampa, Florida, United States
RECRUITINGEmory University
Atlanta, Georgia, United States
RECRUITINGNorthwestern University
Chicago, Illinois, United States
RECRUITINGUniversity of Kansas
Fairway, Kansas, United States
RECRUITINGJohns Hopkins University
Baltimore, Maryland, United States
RECRUITINGSean M. Healey & AMG Center for ALS
Boston, Massachusetts, United States
RECRUITING...and 45 more locations