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Open Label Extension Study of AMX0035 in Patients With ALS

Phase 2
Completed
Conditions
Amyotrophic Lateral Sclerosis
ALS
Interventions
Registration Number
NCT03488524
Lead Sponsor
Amylyx Pharmaceuticals Inc.
Brief Summary

This extension study, in which all participants received active treatment (AMX0035), was designed to assess the longer-term safety and therapeutic potential of AMX0035 for participants who have completed the Main Study (AMX3500, also known as CENTAUR).

Detailed Description

The Centaur Open Label Extension Study (CENTAUR-OLE) is an extension study for patients with ALS who participated in the CENTAUR study (Study AMX3500). During the OLE, all participants received active treatment (AMX0035), and the investigators, evaluators, and participants remained blinded to the randomized treatment assigned at the beginning of the double-blind main study. The study was designed to assess the longer term safety and therapeutic potential of AMX0035.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
90
Inclusion Criteria
  1. Completion of all visits in the randomized, double blind AMX3500 study. Participants who received tracheostomy or permanent assisted ventilation (PAV) during the course of the main study could enroll in the OLE if they completed all visits in the main study.
  2. Must enroll in the OLE within 28 days of the Week 24 visit of the main study.
  3. Signed informed consent to enter the OLE phase.
Exclusion Criteria
  1. Discontinued study drug prematurely in the double-blind phase of the study for reasons other than tracheostomy or PAV.
  2. Exposure to or anticipated requirement for any disallowed medication listed in the protocol.
  3. Any ongoing adverse events that in the opinion of the Site Investigator are clear contraindications to the study drug.
  4. Unstable cardiac or other life-threatening disease emergent during the randomized, double blind study
  5. Any major medical condition that in the opinion of the Site Investigator would interfere with the study and place the subject at increased risk.

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
AMX0035AMX0035AMX0035 twice daily--a combination of Sodium Phenylbutyrate (3g) and Taurursodiol (1g)
Primary Outcome Measures
NameTimeMethod
Number of Participants With Treatment-Emergent Adverse Events (TEAEs)From the Baseline Visit in the OLE study through Week 132 or the Early Discontinuation (Final Safety) Visit for each participant (for up to approximately 132 weeks)

Number of participants with TEAEs from baseline in the OLE study through the last participant's last visit in the OLE

Secondary Outcome Measures
NameTimeMethod
Amyotrophic Lateral Sclerosis Rating Scale Revised Total Score (ALSFRS-R) Change in SlopeFrom baseline in the Main Study through Week 24 of the OLE (48 weeks overall)

Comparison of the difference in change in slope of Amyotrophic Lateral Sclerosis Rating Scale Revised (ALSFRS-R) total score from the Main Study baseline through Week 48 of the open-label extension (OLE) between the 2 treatment groups: those randomized to AMX0035 in the Main Study and those randomized to Placebo in the main study (all participants in the OLE received AMX0035). The slope is measured as a change in score divided by a change in time. ALSFRS-R consists of 12 items across 4 subdomains of function (bulbar, fine motor, gross motor, and breathing) with each item scored on a scale from 0 (total loss of function) to 4 (no loss of function). Total scores range from 0 to 48, with higher scores indicating better function.

Survival - Time to DeathFrom date of first dose in the Main Study (each participant's Baseline Visit) through up to approximately 42 months (approximately 182 weeks)

Median survival in months

Composite of Time to Hospitalization, Death or Death EquivalentFrom date of first dose in the Main Study (each participant's Baseline Visit) through up to approximately 42 months (approximately 182 weeks)

The composite endpoint of time to hospitalization, death or death equivalent was defined as hospitalization, death, tracheostomy or PAV. PAV is defined as more than 22 hours daily of non-invasive mechanical ventilation for more than 1 week (7 days).

Slow Vital Capacity Change in SlopeFrom baseline in the Main Study through Week 24 of the OLE (48 weeks overall)

Comparison of the difference in change in slope of Slow Vital Capacity (SVC) from the Main Study baseline through Week 48 of the open-label extension (OLE) between the 2 treatment groups: those randomized to AMX0035 in the Main Study and those randomized to Placebo in the main study (all participants in the OLE received AMX0035). SVC volumes were standardized to predicted percent normalized values for respiratory muscle function based on age, sex, and height.

Accurate Testing of Limb Isometric Strength (ATLIS) Change in Slope - Upper ExtremitiesFrom baseline in the Main Study through Week 24 of the OLE (48 weeks overall)

Comparison of the difference in change in slope of Accurate Testing of Limb Isometric Strength (ATLIS) upper extremity score from the Main Study baseline through Week 48 of the open-label extension (OLE) between the 2 treatment groups: those randomized to AMX0035 in the Main Study and those randomized to Placebo in the main study (all participants in the OLE received AMX0035). The ATLIS device measures isometric strength in 6 upper extremity muscle groups. Raw values were standardized to percent predicted normal values for strength based on sex, age, weight, and height.

Accurate Testing of Limb Isometric Strength (ATLIS) Change in Slope - Lower ExtremitiesFrom baseline in the Main Study through Week 24 of the OLE (48 weeks overall)

Comparison of the difference in change in slope of Accurate Testing of Limb Isometric Strength (ATLIS) lower extremity score from the Main Study baseline through Week 48 of the open-label extension (OLE) between the 2 treatment groups: those randomized to AMX0035 in the Main Study and those randomized to Placebo in the main study (all participants in the OLE received AMX0035). The ATLIS device measures isometric strength in 6 lower extremity muscle groups. Raw values were standardized to percent predicted normal values for strength based on sex, age, weight, and height.

Accurate Testing of Limb Isometric Strength (ATLIS) Total Score Change in SlopeFrom Baseline in the Main Study through Week 24 in the OLE (48 weeks overall)

Comparison of the difference in change in slope of Accurate Testing of Limb Isometric Strength (ATLIS) total score from the Main Study baseline through Week 48 of the open-label extension (OLE) between the 2 treatment groups: those randomized to AMX0035 in the Main Study and those randomized to Placebo in the main study (all participants in the OLE received AMX0035). The ATLIS device measures isometric strength in 6 upper and 6 lower extremity muscle groups. Raw values were standardized to percent predicted normal values for strength based on sex, age, weight, and height.

Trial Locations

Locations (24)

Barrow Neurological Institute-Dignity Health, St Joseph's Hospital and Medical Center

🇺🇸

Phoenix, Arizona, United States

University of California, Irvine

🇺🇸

Orange, California, United States

California Pacific Medical Center

🇺🇸

San Francisco, California, United States

University of Florida College of Medicine

🇺🇸

Gainesville, Florida, United States

University of South Florida College of Medicine

🇺🇸

Tampa, Florida, United States

Emory University Hospital

🇺🇸

Atlanta, Georgia, United States

University of Iowa, Carver College of Medicine

🇺🇸

Iowa City, Iowa, United States

University of Kentucky Medical Center

🇺🇸

Lexington, Kentucky, United States

Ochsner Neuroscience Institute

🇺🇸

New Orleans, Louisiana, United States

Johns Hopkins Hospital

🇺🇸

Baltimore, Maryland, United States

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Barrow Neurological Institute-Dignity Health, St Joseph's Hospital and Medical Center
🇺🇸Phoenix, Arizona, United States

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