Amyotrophic Lateral Sclerosis Clinical Trial
Official title:
A Phase II Randomized, Placebo-Controlled, Double Blinded, Multi-Centre Clinical Trial of Pimozide in Patients With Amyotrophic Lateral Sclerosis
This study will look at whether Pimozide may help to slow the progression of Amyotrophic
Lateral Sclerosis.
100 people from several Canadian centres with ALS who have provided their consent will be
randomly assigned into one of 2 groups. The first group will receive a dose of up to 2mg of
Pimozide per day and the second group will receive placebo (lactose tablets). Subjects will
be assigned randomly (like by a flip of a coin) to receive either Pimozide 2 mg per day or
placebo tablets. There will be a fifty-fifty chance of receiving Pimozide or placebo.
Participants will be on study medication up to 22 weeks, and on study up to 26 weeks. There
are 8 clinic visits and 1 phone visit over the course of the Treatment Phase of the study.
The second phase which is Observational, is optional with follow-up for up to 5 years from
the end of the Treatment Phase.
Amyotrophic lateral sclerosis (ALS) or Lou Gehrig's disease is a neuromuscular disease that
results in rapid decline in normal muscle function and tone leading to difficulties with
mobility, eating, drinking, breathing, sleeping, and communicating. The disease is
progressive and no cure currently exists. Most people diagnosed with ALS succumb within 3 to
5 years. Rilutek® (riluzole) has been approved as a treatment to slow progression of ALS, but
is minimally effective with mean increase in survival of only a few months. Radicava® or
Radicut® (edaravone) has recently been approved in Canada, USA, Japan and South Korea.
Muscular dysfunction present in people with ALS is caused by nerve breakdown and a
dysfunction in the communication between the muscles and the nerves. The area where these
communications occur is called the neuromuscular junction. Some recent studies have focused
on using different medications to enhance communication at the neuromuscular junction with
the goal of improving muscle function as a result. This approach is unproven but may help to
slow the progression of the disease.
Pimozide is a medication that has been demonstrated to enhance communication at the
neuromuscular junction in fish and mice. This study will look at whether Pimozide may help to
slow the progression of ALS.
There are two parts to this study.
Treatment Phase: In the first part of this study, 100 people from several Canadian centres
with ALS who have provided their consent will be randomly assigned into one of 2 groups. The
first group will receive a dose of up to 2mg of Pimozide per day and the second group will
receive placebo (lactose tablets). Subjects will be assigned randomly (like by a flip of a
coin) to receive either Pimozide 2 mg per day or placebo tablets. There will be a fifty-fifty
chance of receiving Pimozide or placebo.
Each Pimozide tablet contains 2 mg of Pimozide. The matching placebo tablets for this study
will look exactly like the Pimozide tablets. Placebos are used in clinical trials to find out
if the results observed in the study are due the drug being tested, or for other reasons.
Neither the subject nor their doctor will know which group a patient belongs to. However, if
an emergency should arise, information about a treatment group will be shared with their
doctor to ensure appropriate medical care. Participants will take their treatment once a day,
every day for about 22 weeks. The total time in the study from the screen visit up until the
last phone call communication is about 26 weeks.
Observational Phase: The second part of this study is optional. It is each subject's decision
whether to participate only in the first part of this study, or in both parts of the study,
or not at all. In the second part of this study, the Canadian Neuromuscular Disease Registry
(CNDR) will collect data on overall ALS progression using the Revised ALS Functional Rating
Scale (ALSFRS-R) and breathing using Vital Capacity data collected during breathing tests.
This information will be collected from a subject medical record following each routine
clinical appointment. Data will be collected at each routine clinic visit for up to 5 years
from the end of the first part of the study. There will be no extra visits for this part of
the study beyond routine ALS clinic visits.
The information collected during this part of the study will be used to compare the
progression of ALS, after the clinical trial is completed, among the two treatment types
(Placebo or 2 mg per day). By analyzing this information, the researchers conducting this
study hope to determine if Pimozide may help to slow the progression of ALS. To participate
in this part of the study consent must be provided to join the CNDR. A subject who hasn't
already provided their CNDR consent, and wishes to participate in this part of the study will
be given a CNDR consent form to review and sign in addition to this consent form. A subject
already participating in the CNDR will just need to sign the main study consent form.
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