Amyotrophic Lateral Sclerosis Clinical Trial
Official title:
A Randomized, Double-Blind, Placebo-Controlled Sequential Clinical Trial of Sodium Valproate in ALS
The purpose of this study is to determine whether the use of sodium valproate is effective in slowing the disease progression in Amyotrophic Lateral Sclerosis.
Amyotrophic lateral sclerosis (ALS) is a devastating disease characterized by progressive
degeneration of motor neurons leading to muscle weakness.
The pathogenesis of ALS is unknown, but there is convincing evidence that several molecular
mechanisms play a role. Previous studies investigated the role of the Survival Motor Neuron
(SMN) gene in ALS. Recent data suggest that SMN genotypes producing less SMN protein
increase susceptibility and severity of ALS. This leads to the hypothesis that the clinical
expression of ALS is influenced by the total SMN protein level in affected patients. In a
population of ALS patients in the Netherlands we found that SMN genotypes producing less SMN
protein appear to increase susceptibility and severity of ALS. It was shown that the HDAC
inhibitor sodium valproate (SVP) increases levels of SMN protein in vitro. From these
results and from data suggesting neuroprotective properties of SVP, it is hypothesised that
SVP could extend survival of patients with ALS. In addition, sodium valproate significantly
prolonged the disease duration in the animal model for ALS, the SOD1 transgenic mouse. Given
that SVP is a FDA-approved compound with well-known pharmacokinetic and toxicity profiles,
it is an attractive candidate for a clinical trial in ALS patients.
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Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double-Blind, Primary Purpose: Treatment
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