A Multi-Center Controlled Screening Trial of Safety and Efficacy of Lithium Carbonate in Subjects With Amyotrophic Lateral Sclerosis (ALS)

Phase 2

Completed

Brief Summary: This is a Phase II screening study of lithium carbonate in ALS. The purpose of this study is to find out if lithium carbonate is safe to be used in people with ALS and if it can slow the progression of the disease. Since there is no placebo in this study, all patients will be taking lithium carbonate.

Detailed Description: This is a Phase II Screening study. There is no placebo (inactive or 'fake' drug) in this study, meaning that all participants will be taking lithium carbonate. The purpose of this study is to find out if lithium carbonate is safe to be used in people with ALS and if it can slow the progression of the disease.

A recent article was published in a highly regarded medical journal that showed a positive effect of lithium carbonate on an ALS type mouse. The researchers then studied a very small number of people with ALS, giving 16 people lithium carbonate with riluzole and giving 28 people only riluzole. The people who took lithium remained stronger for a considerably longer period of time. However, the study was very small and we cannot really tell if lithium works unless a larger study is performed. It is not well understood why lithium carbonate might be helpful but it is believed that it may play a role in protecting the motor nerves from the damage of ALS.

If you choose to participate, you will need to go to your study clinic for research study visits 7 times in one year and you will have 4 telephone interviews during that time. These visits and phone calls could take up to 17 hours in total.

Caution: Lithium is an FDA approved drug used for some psychiatric disorders. It is not FDA approved for ALS. Lithium has many potentially serious side effects and must only be taken under close supervision of your physician.

Recruitment & Eligibility

Inclusion Criteria

Clinical diagnosis of laboratory-supported probable, probable, or definite ALS
Vital capacity of at least 75% of predicted
Onset of weakness within 3 years prior to enrollment
If patients are on riluzole, they must be on a stable dose for at least 30 days prior to baseline visit
Women of childbearing potential must be surgically sterile or using an effective method of birth control and have a negative pregnancy test
Willing and able to give informed consent

Exclusion Criteria

Diagnosis of other neurodegenerative disease
Need tracheotomy ventilation or non-invasive ventilation 23 or more hours/day
Clinically significant history of any unstable medical condition in past 30 days
History of renal
History of liver disease
Current pregnancy or lactation
Use of lithium within thirty days of enrollment
Significantly limited mental capacity
History of recent drug or alcohol abuse
Use of any investigational drug within 30 days prior to enrollment

Arm && Interventions

Group	Intervention	Description
lithium carbonate	lithium carbonate	-

Primary Outcome Measures

Name	Time	Method
Change in Monthly Rate of Decline in ALSFRS-R (Amyotrophic Lateral Sclerosis Functional Rating Score - Revised)	Baseline, Month 1,3,4.5,6,7.5,9,10.5,12,13	This questionnaire has 12 questions about the patient's ability to complete certain daily activities. There are three questions each about the mouth area, arms, legs, and breathing. A normal score is 48 with each question scored at 0 (worst) to 4 (normal function). In research studies, the change in slope is measured in number of points changed per month. Maximum possible=48 (normal) Minimum=0 (severe dysfunction)

Secondary Outcome Measures

Name	Time	Method
Vital Capacity	Screen, Baseline, Month 1,3,6,9,12	Vital Capacity (VC) is a breathing test in which the patient is asked to take a deep breath and then blow out all of the breath through a tube. The volume is measured in number of liters. It is converted to a percent predicted for the patient's age, height, and gender.

Locations (10): California Pacific Medical Center
🇺🇸
San Francisco, California, United States
University of Utah Clinical Neurosciences Center
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Salt Lake City, Utah, United States
Mayo Clinic
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Scottsdale, Arizona, United States
Providence ALS Clinic
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Portland, Oregon, United States
Kansas University Medical Center
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Kansas City, Kansas, United States
Methodist Neurological Institute
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Houston, Texas, United States
University of Pennsylvania Neurological Institute
🇺🇸
Philadelphia, Pennsylvania, United States
UCLA Neuromuscular Research Center
🇺🇸
Los Angeles, California, United States
UC Irvine MDA/ALS & Neuromuscular Center
🇺🇸
Orange, California, United States
Washington University Department of Neurology
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Saint Louis, Missouri, United States