Amyotrophic Lateral Sclerosis (ALS) MedDRA version: 17.0 Level: PT Classification code 10002026 Term: Amyotrophic lateral sclerosis System Organ Class: 10029205 - Nervous system disorders
Conditions
Interventions
Sponsors
Eligibility
Inclusion criteria
Inclusion criteria: 1. Male or female study subjects fulfilling the probable or higher criteria for ALS according to the revised El-Escorial criteria 2. First documented symptom of ALS = 24 months before screening 3. The sum of the 3 respiratory items on the ALSFRS-R, 10: dyspnoea, 11: orthopnoea and 12: respiratory insufficiency, must total at least 10 points 4. Ability to walk without other walking aids than a crutch 5. 18 – 80 years at the time of screening 6. FEV% =70% 7. Study subjects with or without pharmacological treatment, i.e. Riluzole for ALS (study subjects with ongoing pharmacological treatment for ALS shall have received unchanged treatment as regards drug(s) and dose(s) for at least 1 month) Are the trial subjects under 18? no Number of subjects for this age range: F.1.2 Adults (18-64 years) yes F.1.2.1 Number of subjects for this age range 20 F.1.3 Elderly (>=65 years) yes F.1.3.1 Number of subjects for this age range 20
Exclusion criteria
Exclusion criteria: 1. Women in fertile age with a positive pregnancy blood test, or planning to become pregnant during the period of the trial. Fertile women include any female who has experienced menarche, who has not undergone tubal ligation, and who is not postmenopausal. Postmenopausal is defined as amenorrhea = 12 consecutive months without another cause 2. Sexually active men and women without highly effective contraceptive treatment, e.g. sterilisation, condoms and diaphragms with spermicide; oral contraceptives (including Progesterone-only pills in high dose) in combination with a barrier method; hormonal contraceptives alone are not sufficient 3. Active hepatitis B, active hepatitis C, or HIV infection 4. Serious cardiac disease including unstable or uncontrolled cardiac disease during the last 6 months and/or a previous history or present clinical signs of deep venous thrombosis 5. Major surgical procedure within 4 weeks prior to start of treatment 6. Participation in any other clinical trial within 30 days of inclusion (randomisation) in the trial or patients with unresolved investigational treatment-related adverse events 7. Other chronic disease or previous organ transplantation judged by the Investigator to interfere with the assessment of treatment success and/or ability to fully participate in the trial 8. Impaired kidney function with an absolute GFR calculated from cystatin C <60 mL/min 9. Known blood disease or Anaemia Haemoglobin <120 g/L for women and <130 g/L for men 10. Known haemoglobinopathy (e.g. thalassemia and sickle cell anaemia) 11. Patients that require immunosuppressive treatments including azathioprine, cyclosporine, systemic steroid treatment (e.g. prednisolone at doses of =10 mg/day or hydrocortisone) or has received such treatment within the last 6 months prior to randomization 12. Patients that are treated with drugs that can interact significantly with APO-P001; ethinylestradiol and/or ribavirin; azathioprine, didanosine, zidovudine, mercaptopurine, stavudine 13. Lack of suitability for participation in the trial, for any reason, as judged by the Investigator 14. Patients with clinical or other signs of frontal temporal lobe dementia (FTLD) or known heredity for FTLD
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Main Objective: SAFETY OBJECTIVE To investigate the safety and tolerability of the combination therapy of Apovir in patients with ALS PRIMARY EFFICACY OBJECTIVE To investigate the effect of Apovir on 12-months disease progression of ALS as assessed by ALSFRS-R score from baseline compared to placebo ;Secondary Objective: SECONDARY EFFICACY OBJECTIVES To investigate the effect of Apovir on disease progression of ALS assessed by ALSFRS-R score at the 4-weeks, 3-, 6-, 9-months, and Follow-up visits, and forced vital capacity (FVC), vital capacity (VC) and maximal voluntary ventilation (MVV) at the 4-weeks, 3-, 6-, 9-, 12-months, and Follow-up visits To investigate the combined effect of Apovir on ALSFRS-R, and death or the use of definitive life supporting breathing assistance and death as assessed by Combined assessment of function and survival (CAFS) at the 4-weeks, 3-, 6-, 9-, 12-months, and follow-up visits To investigate the effect of Apovir on time from onset of ALS symptoms to the use of definitive life supporting breathing assistance, or Death To investigate the plasma concentrations of Apovir in patients with ALS Refer to the protocol for further secondary objectives. ;Primary end point(s): Primary Safety Endpoint • Frequency and intensity of adverse events Primary efficacy Endpoints • Change in ALSFRS-R from baseline to 12 months using mean change of slope ;Timepoint(s) of evaluation of this end point: Primary Safety Endpoint Evaluations will be analysed throughout the whole CT. Primary efficacy Endpoints 12 months | — |
Secondary
| Measure | Time frame |
|---|---|
| Secondary end point(s): Change in disease progression of ALS as assessed by: • Change in ALSFRS-R score from baseline to the 4-weeks, 3-, 6-, 9-, 12-months, and Follow-up visits • Change in FVC, VC and MVV from baseline to the 4-weeks, 3-, 6-, 9-, 12-months, and Follow-up visits • Change in CAFS from baseline to the 4-weeks, 3-, 6-, 9-, 12-months, and Follow-up visits • Time from study inclusion and time of ALS symptoms onset to the use of definitive life supporting breathing assistance, or Death Plasma concentrations of Apovir: • Plasma concentrations Cpre dose of Apovir at the 4-weeks, 3-, 6-, and 12-months visits. Concentrations at 3 months will be compared to published data [Rhodes and Liu 2001 ; Khakoo et al 1998 ]. ;Timepoint(s) of evaluation of this end point: Refer to section 5.2 | — |
Countries
Sweden
Contacts
Apodemus AB