Amyotrophic Lateral Sclerosis Clinical Trial
Official title:
Phase 2a Open Label Study, Safety and Tolerability of Combination Antiretroviral Therapy (Triumeq) in Participants With Amyotrophic Lateral Sclerosis (ALS) - The Lighthouse Project.
This is a phase 2a open label, multicentre design study to investigate the safety of Triumeq in patients with ALS at 24 weeks post treatment. In this phase 2a study the investigators aim to determine whether a combination of anti-retroviral therapy, Triumeq (dolutegravir 50mg, abacavir 600mg, lamivudine 300mg) is tolerated and safe in patients with ALS. As secondary outcomes, ALSFRS-R, ALSQOL, physical examination, neurophysical parameters and respiratory and muscle function will be evaluated. Blood and urine samples will be stored for possible future analysis for viral activity. Subjects will be screened for the study after signing an approved Informed consent document.
This study will be a multi-centre, open-label longitudinal study to investigate the safety
and tolerability of combination antiretroviral therapy (Triumeq) in Motor Neuron Disease
(MND)/Amyotrophic Lateral Sclerosis (ALS) for 24 weeks in 40 HIV negative ALS patients.
The overall study duration will be 34 weeks, with up to 14 days for screening, followed by an
8-week lead-in phase and 24-week treatment phase. Outcomes will be measured at 4, 8, 12, 20
and 24 weeks. Participants will be followed at 4-weekly intervals for safety and clinical
measures.
Subjects will be screened for the study after signing an approved Informed consent form. As
part of the 14 day screening phase, subjects will undertake an extensive medical and
neurological assessments.
Following the screening phase subjects will enter the 8 week lead-in-phase. During this
phase, they will undertake two ALSFRS-R at 4 week intervals. The ALSFRS-R will be undertaken
with the subject by telephone.
At the baseline visit, following the lead-in-period, blood and urine will be taken for safety
monitoring and also bio-banked for possible future measurement of Human Endogenous
Retroviruses (HERVs). Baseline signs and symptoms will be collected.
All subjects will have their inclusion and exclusion criteria checked at the Baseline visit
(Week 0) and eligible subjects will start the Triumeq.
Subjects will return to the centre on Weeks 4, 8, 16, 24 and at 7 days after the last dose of
investigational product (or early termination) to undertake a neurological examination as
well as an assessment of the ALS Functional Rating Scale-Revised (ALSFRS-R), neurophysical
index (NPI), forced vital capacity (FVC) as measured by handheld spirometer, SNIP test and
quantitative hand muscle testing by dynamometry. All subjects will undertake an evaluation of
hematological and biochemical parameters and collection of blood and urine samples for
bio-banking. A voice recording will be undertaken.
At early termination visit, subjects will undergo an ECG Test. At baseline, weeks 8, 16 and
24 or early termination visit subjects will be asked to complete the Columbia Suicide
Severity Rating Scale. At screening week 8 and end of treatment/early termination visit,
subjects will also be asked to complete an ALSFRS-R.
SAE's, AE's and changes to concomitant medications will be observed and evaluated throughout
the study. Each study visit will have a 7 day window after the due date to account for
scheduling conflicts/holidays/weekends.
Subjects will be given additional study product to account for the 7- day window.
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