A Phase IIa, Randomized, Open-label, Multi-Center, Multi-Dose Study to Evaluate the Effects of ALZT-OP1a in Subjects With Mild-Moderate Stage Amyotrophic Lateral Sclerosis (ALS)
Overview
- Phase
- Phase 2
- Intervention
- ALZT-OP1a (cromolyn)
- Conditions
- Amyotrophic Lateral Sclerosis
- Sponsor
- AZTherapies, Inc.
- Enrollment
- 12
- Locations
- 6
- Primary Endpoint
- Plasma Biomarkers
- Status
- Terminated
- Last Updated
- 4 years ago
Overview
Brief Summary
This is a Phase IIa, randomized, open-label, multi-center, multi-dose study for subjects with mild to moderate ALS. The protocol is designed to determine whether ALZT-OP1a treatment will positively impact neuro-inflammatory biomarkers and slow down or arrest functional decline in subjects with mild to moderate ALS.
Detailed Description
This Phase IIa study is designed as a randomized, open-label, multi-center, multi-dose study for subjects with mild to moderate ALS. The study will evaluate 1) safety, 2) tolerability, 3) changes in physical function measured using the ALSFRS-R, 4) two doses of ALZT-OP1a in order to determine an optimal and effective dose that could positively impact neuro-inflammatory biomarkers, and 5) to demonstrate preliminary evidence if this treatment could potentially slow down or arrest functional decline in subjects with mild to moderate ALS. Up to 80 evaluable subjects will be randomly assigned to one of two treatment groups: Group I (n=40) will consist of low dose ALZT-OP1a, administered via dry powder inhalation; OR Group II (n=40), which will consist of high dose ALZT-OP1a, administered via dry powder inhaler. Subjects will dose for 12 weeks and will be asked to return to the site for scheduled visits and biomarker collection at Week 4, Week 8, and Week 12.
Investigators
Eligibility Criteria
Inclusion Criteria
- •Male or female subjects aged 18-75 years, both inclusive;
- •Must provide written informed consent before any study related procedures;
- •Should be capable to complete all trial related procedures, assessments and visits in the judgement of Investigator;
- •Familial or sporadic ALS diagnosed as possible, laboratory-supported probable, probable, or definite as defined by revised El Escorial criteria;
- •Disease duration from ALS diagnosis ≤24 months;
- •ALSFRS-R total score ≥ 36 at screening visit;
- •ALSFRS-R Breathing sub-score should be ≥9 at the time of screening;
- •ALSFRS-R Bulbar sub-score should be ≥9 at the time of screening;
- •Peak inspiratory flow rate (PIFR) ≥ 100 L/minute;
- •Forced vital capacity (FVC) \>70% of predicted value;
Exclusion Criteria
- •Subjects with bulbar-onset ALS;
- •Any use of non-invasive ventilation (e.g., continuous positive airway pressure, non-invasive bi-level positive airway pressure or non-invasive volume ventilation) for any portion of the day, or mechanical ventilation via tracheostomy, or on any form of oxygen supplementation;
- •Any other significant neurological disorder which can interfere with study assessments, e.g., significant cognitive impairment and/or clinical dementia;
- •Significant psychiatric illness like schizophrenia, bipolar disorder etc. Subjects with depression can be included, only if the depression has been stable and no episode of major depression has occurred in past one year;
- •Severe cardiac disease (e.g.,corrected QT interval \> 500ms), Torsade de Pointes, evidence of significant heart failure (New York Heart Association \[NYHA\] Class 3 or greater, myocardial infarction or unstable angina in the 6 months prior to screening);
- •Any moderate-to-severe pulmonary disease or difficulty taking inhaled drugs;
- •Inability to tolerate the administration of an oral inhaled powder via dry powder inhaler (DPI);
- •Has taken any investigational study drug within 30 days or five half-lives of the drug, whichever is longer, prior to dosing;
- •Currently taking cromolyn, or has taken cromolyn, within the past 12 months;
- •Allergy to cromolyn or cromolyn products, such as Intal®, Nasalcrom®, Opticrom®, Gastrocrom®, etc.;
Arms & Interventions
Group I (Low Dose)
Group I (n=40) will receive treatment regimen of ALZT-OP1a (cromolyn) 17.1 mg/twice a day (bid) (total of 34.2 mg/day)
Intervention: ALZT-OP1a (cromolyn)
Group II (High Dose)
Group II (n=40) will receive treatment regimen of ALZT-OP1a (cromolyn) 34.2 mg/bid (total of 68.4 mg/day)
Intervention: ALZT-OP1a (cromolyn)
Outcomes
Primary Outcomes
Plasma Biomarkers
Time Frame: up to 12 weeks
To measure the effect of ALZT-OP1a treatment on selected plasma biomarkers in ALS patients. Candidate biomarkers in ng/mL include: Beta-tryptase, Beta-Hexosaminidase Candidate biomarkers in pg/mL include: CXCL1, interferon-y, interleukin (IL)-1a, IL-1b, IL-2, IL-5, IL-6, IL-8, IL-10, IL-15, IL-17, macrophage inflammatory protein (MIP)-1a, MIP-1b, monocyte chemoattractant protein (MCP)-1, neurofilament light protein (NfL), tumor necrosis factor (TNF)-a, and vascular endothelial growth factor (VEGF)
Secondary Outcomes
- Time to Event Requiring Respiratory Support(up to 12 weeks)
- Changes from baseline in pulmonary function (forced vital capacity)(up to 12 weeks)
- Changes from baseline in pulmonary function (peak inspiratory flow rate)(up to 12 weeks)
- Number of participants with treatment emergent clinically significant laboratory assessments(up to 12 weeks)
- Changes from baseline in ALS disease progression(up to 12 weeks)
- Incidence of adverse event (tolerability) related to ALZT-OP1a(up to 12 weeks)
- Number of participants with abnormal vital signs(up to 12 weeks)
- Number of participants with abnormal physical or neurological examinations(up to 12 weeks)
- Number of participants with abnormal electrocardiograms (ECGs)(up to 12 weeks)
- The number of study dropouts due to serious, unanticipated treatment emergent adverse events(up to 12 weeks)
- Changes from baseline in suicidal ideation and behavior(up to 12 weeks)