MedPath

Methodology Study of Novel Outcome Measures to Assess Progression of ALS

Completed
Conditions
Amyotrophic Lateral Sclerosis
Registration Number
NCT02611674
Lead Sponsor
Biogen
Brief Summary

The primary objectives of the study are to estimate and rank-order the longitudinal standardized mean changes over 6 months and over 12 months, for a set of outcome measures administered to participants with amyotrophic lateral sclerosis (ALS), in order to identify measures that are more sensitive to disease progression than Amyotrophic Lateral Sclerosis Functional Rating Scale-Revised (ALSFRS-R). The secondary objectives of this study are: To evaluate the test-retest reproducibility of each outcome measure; To determine correlations between 6 and 12-month changes in all exploratory measures with 18 and 24-month changes in ALSFRS-R and survival; To assess correlations between/among the various measures; To obtain biological samples in order to identify molecular correlates to the clinical measures and to further characterize previously identified and novel molecular biomarkers of disease progression for incorporation into future clinical studies.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
138
Inclusion Criteria
  • A diagnosis of sporadic or familial ALS
  • ALS onset within ≤5 years
  • Must be 16 to 85 years of age, inclusive, for sites in the United States and 18 to 85 years of age, inclusive, for all sites outside of the United States

Key

Exclusion Criteria
  • History of or positive test result at Screening for human immunodeficiency virus (HIV)
  • History of or positive test result at Screening for hepatitis C virus (HCV) antibody or hepatitis B virus (HBV)
  • Possibility of neuromuscular weakness other than ALS
  • Unspecified reasons that, in the opinion of the site Investigator, make the subject unsuitable for enrollment or unlikely to be able to complete, at a minimum, the Month 6 Visit

NOTE: Other protocol defined Inclusion/ Exclusion criteria may apply

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Longitudinal standardized mean change in electrophysiological measures as assessed by motor unit number estimation (MUNE)Baseline to Month 6 and Baseline to Month 12

Optional, to be administered at each site's Investigator's discretion. MUNE is used to estimate the number of functioning motor units.

Longitudinal standardized mean change in electrophysiological measures as assessed by electrical impedance myography (EIM)Baseline to Month 6 and Baseline to Month 12

EIM is an electrophysiological technique in which current is applied to a muscle of interest and resultant voltage and impedance are measured. These measured parameters reflect the conductivity of underlying tissue and presumably the pathologic state of denervated muscle in an ALS participant

Longitudinal standardized mean change in electrophysiological measures as assessed by motor unit number index (MUNIX)Baseline to Month 6 and Baseline to Month 12

MUNIX estimates functioning motor units within a muscle. CMAP and surface electromyography potentials (surface interference patterns) are obtained at various levels of voluntary effort, and MUNIX is estimated using power and area of CMAP and surface interference patterns.

Longitudinal standardized mean change in functional measures as assessed by Amyotrophic Lateral Sclerosis Functional Rating Scale-Revised (ALSFRS-R)Baseline to Month 6 and Baseline to Month 12

The ALSFRS-R has been demonstrated to predict survival. The ALSFRS-R measures 4 functional domains, including respiratory, bulbar function, gross motor skills, and fine motor skills. There are a total of 12 questions, each scored from 0 to 4 for a total possible score of 48 \[Cedarbaum 1999\], with higher scores representing better function.

Longitudinal standardized mean change in electrophysiological measures as assessed by compound muscle action potential (CMAP)Baseline to Month 6 and Baseline to Month 12

CMAP is a standard electrophysiological measure generated by maximally stimulating a nerve such that all muscle fibers innervated by the respective nerve are depolarized. Reduction of CMAP amplitude reflects loss of motor axons and, therefore, is directly relevant to ALS.

Longitudinal standardized mean change in respiratory measures as assessed by slow vital capacity (SVC)Baseline to Month 6 and Baseline to Month 12

Vital capacity will be measured by means of an SVC test, administered in the upright position. Upright SVC will be determined by performing 3 to 5 measures, in accordance with criteria established by the American Thoracic Society and the European Respiratory Society.

Longitudinal standardized mean change in muscle strength measures as assessed by hand-held dynamometry (HHD)Baseline to Month 6 and Baseline to Month 12

HHD tests isometric strength of multiple muscles using standard participant positioning. Approximately 10 muscle groups will be examined (per each side) in both upper and lower extremities.

Secondary Outcome Measures
NameTimeMethod
Comparison between 6 and 12-month changes in exploratory measures with 18 and 24-month changes in ALSFRS-R and survivalBaseline to Month 24
Within-participant test-retest reliability between the 2 repeated measurements for HHDDay 1 and Day 7
Comparison between 6-month changes for muscle electrophysiological measuresBaseline to Month 12
Comparison between 6-month changes for muscle strength measuresBaseline to Month 12
Within-participant test-retest reliability between the 2 repeated measurements for MUNIXDay 1 and Day 7
Within-participant test-retest reliability between the 2 repeated measurements for MUNEDay 1 and Day 7
Within-participant test-retest reliability between the 2 repeated measurements for SVCDay 1 and Day 7
Comparison between 6-month changes for functional measuresBaseline to Month 12
Within-participant test-retest reliability between the 2 repeated measurements occurring on Day 1 and Day 7 for EIMDay 1 and Day 7
Within-participant test-retest reliability between the 2 repeated measurements for CMAPDay 1 and Day 7
Within-participant test-retest reliability between the 2 repeated measurements for ALSFRS-RDay 1 and Day 7
Comparison of molecular biomarkers with disease progressionBaseline to Month 12

Trial Locations

Locations (21)

University of California San Diego Medical Center

🇺🇸

San Diego, California, United States

University of South Florida

🇺🇸

Tampa, Florida, United States

Johns Hopkins Hospital

🇺🇸

Baltimore, Maryland, United States

The Emory Clinic

🇺🇸

Atlanta, Georgia, United States

UZ Leuven

🇧🇪

Leuven, Belgium

Massachusetts General Hospital, MA

🇺🇸

Charlestown, Massachusetts, United States

Penn State Milton S. Hershey Medical Center

🇺🇸

Hershey, Pennsylvania, United States

Hopital Gui de Chauliac, Service de Neurologie

🇫🇷

Montpellier, Hérault, France

Sunnybrook Health Sciences Centre

🇨🇦

Toronto, Ontario, Canada

Montreal Neurological Institute Clinical Research Unit

🇨🇦

Montréal, Quebec, Canada

Groupe Hospitalier Pitie-Salpetriere

🇫🇷

Paris cedex 13, Paris, France

Charite - Campus Virchow-Klinikum

🇩🇪

Berlin, Germany

Universitaetsklinikum Jena

🇩🇪

Jena, Germany

Beaumont Hospital

🇮🇪

Dublin, Ireland

UMC Utrecht

🇳🇱

Utrecht, CX, Netherlands

Universitaetsklinikum Ulm

🇩🇪

Ulm, Germany

Kantonsspital St. Gallen

🇨🇭

St. Gallen, Switzerland

Medizinische Hochschule Hannover

🇩🇪

Hannover, Germany

Washington University School of Medicine

🇺🇸

Saint Louis, Missouri, United States

California Pacific Medical Center

🇺🇸

San Francisco, California, United States

Royal Hallamshire Hospital

🇬🇧

Sheffield, West Midlands, United Kingdom

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