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First in Human (FIH) Study of ALN-SOD in Adult Participants With Amyotrophic Lateral Sclerosis Associated With Mutation in the SOD1 Gene (SOD1-ALS)

Phase 1
Recruiting
Conditions
Mutation in the Superoxide Dismutase-1 (SOD1) Gene
Amyotrophic Lateral Sclerosis (ALS)
Interventions
Other: Diluent
Drug: Placebo (PB)
Registration Number
NCT06351592
Lead Sponsor
Regeneron Pharmaceuticals
Brief Summary

This study is researching an experimental drug called ALN-SOD (called "study drug"). This study is focused on people with amyotrophic lateral sclerosis (ALS) caused by a change in a gene called the superoxide dismutase-1 (SOD1) gene. This type of ALS is known as "SOD1-ALS". This is the first time that ALN-SOD will be given to people. The aim of the study is to see how safe and tolerable the study drug is.

The study is looking at several other research questions, including:

* The effect the study drug has on specific biomarkers, which are substances in the blood or in the fluid that surrounds the brain and spinal cord, known as cerebrospinal fluid (CSF)

* How much study drug is in the blood and in the CSF, at different times

* Whether the body makes antibodies against the study drug (which could make the drug less effective or could lead to side effects)

* What effects the study drug has on ALS symptoms

Detailed Description

Not available

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
42
Inclusion Criteria
  1. Weakness attributable to ALS and a SOD1 mutation that has been previously described as associated with ALS or is considered likely to cause ALS, as defined in the protocol
  2. Slow vital capacity (SVC) ≥50% predicted value based on age, gender and height, measured in upright position
  3. Body Mass Index (BMI) ≤35 kg/m2 at time of screening
  4. If participants are taking riluzole or edaravone, they must be on a stable dose for at least 4 weeks prior to initial dosing visit and are expected to remain at that dose until the end of the study
  5. Platelet count >50,000/microliter
  6. Has normal blood pressure readings, as defined in the protocol

Key

Exclusion Criteria
  1. Concurrent participation in another interventional clinical trial
  2. Has had a tracheostomy
  3. Has dementia, as assessed by the investigator
  4. Has uncontrolled psychiatric disease, including psychosis, active or recent suicidal ideation, untreated major depression, in the past 30 days
  5. Has a medical history of brain or spinal disease/injury that would interfere with the lumbar puncture (LP) process, CSF circulation or safety assessment, as defined in the protocol
  6. Presence of an implanted shunt for the drainage of CSF or an implanted central nervous system (CNS) catheter
  7. Presents any concern to the study investigator that might confound the results of the study or poses an additional risk to the participant by their participation in the study
  8. Was hospitalized (ie, >24 hours) for any reason other than ALS within 30 days of screening
  9. Has received treatment with tofersen within 6 months prior to screening

NOTE: Other protocol defined inclusion / exclusion criteria apply

Study & Design

Study Type
INTERVENTIONAL
Study Design
SEQUENTIAL
Arm && Interventions
GroupInterventionDescription
Cohort 2 - Mid DoseALN-SODPlacebo during double-blind treatment period
Cohort 4 (Optional) ≤ High DosePlacebo (PB)Placebo during double-blind treatment period
Cohort 3 - High DoseDiluentPlacebo during double-blind treatment period
Cohort 1 - Low DoseDiluentPlacebo during double-blind treatment period
Cohort 1 - Low DosePlacebo (PB)Placebo during double-blind treatment period
Cohort 2 - Mid DoseDiluentPlacebo during double-blind treatment period
Cohort 3 - High DoseALN-SODPlacebo during double-blind treatment period
Cohort 3 - High DosePlacebo (PB)Placebo during double-blind treatment period
Cohort 4 (Optional) ≤ High DoseALN-SODPlacebo during double-blind treatment period
Cohort 4 (Optional) ≤ High DoseDiluentPlacebo during double-blind treatment period
Cohort 2 - Mid DosePlacebo (PB)Placebo during double-blind treatment period
Cohort 1 - Low DoseALN-SODPlacebo during double-blind treatment period
Primary Outcome Measures
NameTimeMethod
Incidence of treatment-emergent adverse event (TEAEs) in participants treated with ALN-SODAt week 4 and week 124
Severity of TEAEs in participants treated with ALN-SODAt week 4 and week 124
Secondary Outcome Measures
NameTimeMethod
Concentration of neurofilament light chain (NfL) in plasma over timeUp to approximately week 124
Change in concentration of NfL in plasma over timeUp to approximately week 124
Concentration of SOD1 protein in cerebrospinal fluid (CSF) over timeUp to approximately week 124
Change in concentration of SOD1 protein in CSF over timeUp to approximately week 124
Concentration of NfL in CSF over timeUp to approximately week 124
Change in concentration of NfL in CSF over timeUp to approximately week 124
Change in Amyotrophic Lateral Sclerosis Functional Rating Scale-Revised (ALSFRS-R) over timeUp to approximately week 124
Concentration of ALN-SOD in plasma over timeUp to approximately week 124
Concentration of ALN-SOD in CSF over timeUp to approximately week 124
Incidence of anti-drug antibodies (ADAs) to ALN-SOD in serum over timeUp to approximately week 124
Titer of ADAs to ALN-SOD in serum over timeUp to approximately week 124

Trial Locations

Locations (10)

University Hospital - London Health Sciences Centre

🇨🇦

London, Ontario, Canada

University of Alberta Hospital, Edmonton

🇨🇦

Edmonton, Alberta, Canada

Sunnybrook Research Institute

🇨🇦

Toronto, Ontario, Canada

Montreal Neurological Institute and Hospital

🇨🇦

Montreal, Quebec, Canada

Hokkaido University Hospital

🇯🇵

Sapporo, Hokkaido, Japan

Tokushima University Hospital

🇯🇵

Tokushima-shi, Tokushima, Japan

Toho University Omori Medical Center

🇯🇵

Ota-ku, Tokyo, Japan

Kyoto University Hospital

🇯🇵

Kyoto, Japan

Hanyang University Seoul Hospital

🇰🇷

Seoul, Korea, Republic of

Seoul National University Hospital

🇰🇷

Seoul, Korea, Republic of

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