Quralis has announced the completion of dosing for the first cohort of healthy volunteers participating in its Phase 1 multiple ascending dose (MAD) clinical trial of QRL-101, an investigational oral small molecule intended for the treatment of amyotrophic lateral sclerosis (ALS). This Phase 1 trial marks a significant step in evaluating the safety and potential of QRL-101 as a novel therapy for ALS, a progressive neurodegenerative disease affecting motor neurons.
The QRL-101-03 trial (NCT06532396) plans to enroll approximately 60 healthy volunteers, divided into five groups, who will be randomly assigned to receive either QRL-101 or a placebo. Each group will receive escalating doses of QRL-101 over several days. The primary objective is to assess the safety, tolerability, and pharmacokinetic profile of multiple doses of QRL-101 in healthy individuals.
The dose range for this MAD trial was determined based on the findings of the completed Phase 1 single ascending dose (SAD) trial, QRL-101-01 (NCT05667779), which involved 88 healthy participants. The SAD trial reported no significant safety concerns with single doses of QRL-101.
Mechanism of Action
ALS is characterized by the degeneration of motor neurons, leading to muscle weakness, paralysis, and ultimately, respiratory failure. In approximately half of ALS patients, motor neurons exhibit hyperexcitability, making them more prone to firing electrical signals, which contributes to their eventual death. QRL-101 is designed to address this hyperexcitability by selectively opening Kv7.2/7.3 voltage-gated potassium channels, which are crucial in regulating neuronal excitability. By activating these channels, QRL-101 aims to reduce hyperexcitability, thereby slowing down motor neuron damage and the progression of ALS symptoms.
Preclinical Evidence
Preclinical studies using patient-derived motor neurons and animal models have demonstrated that QRL-101 can effectively activate Kv7.2/7.3 ion channels. Furthermore, QRL-101 exhibits greater selectivity compared to previous Kv7.2/7.3 activators, potentially leading to a more favorable safety profile.
Expert Commentary
Doug Williamson, MD, Chief Medical Officer at Quralis, stated, "We are excited to complete dosing of our first participant cohort in our Phase 1 MAD clinical trial of QRL-101... In the SAD study, QRL-101 was shown to be well tolerated, with no significant safety concerns or serious adverse events."
Leonard H. van den Berg, MD, PhD, chair of the Treatment Research Initiative to Cure ALS (TRICALS), commented, "QRL-101, is a highly selective Kv7.2/7.3 ion channel opener, which in preclinical models shows a strong potential to control motor neuron hyperexcitability-induced neurodegeneration with an attractive side effect profile."
Anticipated Outcomes
The company anticipates results from the Phase 1 MAD trial in early 2025. These results will be crucial in guiding the design of larger, global clinical trials to evaluate the efficacy of QRL-101 in individuals with ALS. Quralis aims to develop QRL-101 into a first-in-class therapy for ALS patients experiencing hyperexcitability-induced motor neuron degeneration.
