This study will examine what happens when patients with amyotrophic lateral sclerosis (ALS) are given an investigational medication (study drug) known as LTX-002. Specifically, the researchers will be looking at safety, tolerability (if someone has any side effects from the drug), pharmacokinetics (what the body does to the study drug) and pharmacodynamics (what the study drug does to the body). The study will also investigate the effect of the drug on indicators of the severity of ALS, such as markers in blood and in the cerebrospinal fluid (the fluid that surrounds the brain and spinal cord, CSF) and on measures of the participant's ability to move, speak, and breathe.
Eligible participants will be asked to visit the study site 9 times and stay overnight once. In addition, there will be telephone or video calls with the study staff on 8 separate occasions. Procedures will include: * A review of medical history and medications * Physical exams, including a neurologic (nervous system) assessment * Electrocardiograms (a measure of the heart's electrical activity) * Blood, urine and cerebrospinal fluid (CSF) collection * Measures of lung function * Measures of speech * Measures of muscle strength * Scales to assess ALS symptoms and overall health, and feelings about suicide * Administration of the study drug (or placebo) by injection into the CSF through a lumbar (lower spinal area) injection
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
56
LTX-002 is an antisense oligonucleotide (ASO) targeting SPTLC1 messenger RNA (mRNA). Several dose levels will be tested.
Sterile aCSF solution formulation intended for intrathecal administration.
University Hospital Schleswig-Holstein, Campus Lübeck
Lübeck, Germany
RECRUITINGIstituto Neurologico "Carlo Besta"
Milan, Italy
NOT_YET_RECRUITINGAOU Città della Salute e della Scienza di Torino
Torino, Italy
RECRUITINGUniversitair Medisch Centrum Utrecht
Utrecht, Netherlands
RECRUITINGKarolinska Universitetssjukhuset
Stockholm, Sweden
RECRUITINGSafety and Tolerability (Adverse Events)
Incidence and severity of adverse events (AEs), treatment-emergent adverse events (TEAEs) and serious adverse events
Time frame: Screening to Day 169
Safety and Tolerability (Clinical Laboratory Tests)
Clinical laboratory tests including serum chemistry and hematology; urinalysis
Time frame: Screening to Day 169
Safety and Tolerability (Vital Signs)
Vital signs will be collected, including blood pressure (mm Hg), heart rate (beats per minute), respiratory rate (breaths per minute), body temperature (°C or °F), total body weight (kilograms), and height (centimeters). Body Mass Index (BMI) will be calculated using the values of total body weight and height, with the formula BMI = weight in kg/(height in cm)\^2.
Time frame: Screening to Day 169
Safety and Tolerability (Physical and Neurological exams)
Physical and neurological exams will be performed periodically to ensure participant safety. Height (centimeters or inches), weight (kilograms or pounds) and body mass index (BMI; kilograms/meters\^2) will be measured.
Time frame: Screening to Day 169
Safety and Tolerability (ECGs - heart rate)
Cardiovascular safety will be monitored by performing electrocardiogram (ECG) assessments, including heart rate
Time frame: Screening to Day 169
Safety and Tolerability (ECGs - QRS)
Cardiovascular safety will be monitored by performing electrocardiogram (ECG) assessments, including the QRS complex (normally 70-100 ms)
Time frame: Time Frame: Screening to Day 169
Safety and Tolerability (ECGs - QT)
Description: Cardiovascular safety will be monitored by performing electrocardiogram (ECG) assessments, including the QT interval measure
Time frame: Screening to Day 169
Safety and Tolerability (ECGs - QTc)
Cardiovascular safety will be monitored by performing electrocardiogram (ECG) assessments, including QTc (heart rate-corrected QT interval)
Time frame: Screening to Day 169
Safety and Tolerability (ECGs - PR intervals)
Cardiovascular safety will be monitored by performing electrocardiogram (ECG) assessments, including PR intervals (normally 120-200 ms)
Time frame: Screening to Day 169
Pharmacokinetics of LTX-002 (CSF and plasma levels)
The amount of LTX-002 in the cerebrospinal fluid (CSF) and plasma will be measured.
Time frame: Day 1 to Day 169
Pharmacokinetics of LTX-002 (Cmax)
The maximum observed plasma concentration (Cmax) of LTX-002 will be calculated.
Time frame: Day 1 to Day 169
Pharmacokinetics of LTX-002 (Tmax)
The time to maximum observed plasma concentration (Tmax) of LTX-002 will be calculated.
Time frame: Day 1 through Day 169
Pharmacokinetics of LTX-002 (AUC0-∞)
The area under the plasma-time concentration curve from time 0 extrapolated to infinity (AUC0-∞) of LTX-002 will be calculated.
Time frame: Day 1 to Day 169
Pharmacokinetics of LTX-002 (AUC0-t)
The area under the plasma concentration-time curve from time 0 to the last measurable concentration (AUC0-t) of LTX-002 will be calculated.
Time frame: Day 1 to Day 169
Pharmacokinetics of LTX-002 (Tlag)
The delay between the time of dosing and the time of appearance of the first measurable concentration (Tlag) of LTX-002 in plasma will be calculated.
Time frame: Day 1 to Day 169
Pharmacokinetics of LTX-002 (Vd/F)
The apparent volume of distribution (Vd/F) of LTX-002 in plasma, if applicable, will be calculated.
Time frame: Day 1 to Day 169
Pharmacokinetics of LTX-002 (λz)
The apparent terminal elimination rate constant (λz) of LTX-002 in plasma, if applicable, will be calculated.
Time frame: Day 1 to Day 169
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Pharmacokinetics of LTX-002 (T1/2)
The half-life (T1/2) of LTX-002 in plasma, if applicable, will be calculated.
Time frame: Day 1 to Day 169
Pharmacokinetics of LTX-002 (CL/F)
The apparent clearance (CL/F) of LTX-002 in plasma, if applicable, will be calculated.
Time frame: Day 1 to Day 169