A Study to Evaluate the Efficacy and Safety of Reldesemtiv in Patients With Amyotrophic Lateral Sclerosis (ALS) (COURAGE-ALS)

  • STATUS
    Recruiting
  • End date
    Mar 15, 2024
  • participants needed
    555
  • sponsor
    Cytokinetics
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Updated on 15 June 2022
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weakness
primary lateral sclerosis
riluzole
edaravone

Summary

The purpose of this study is to assess the effect of reldesemtiv versus placebo on functional outcomes in ALS.

Description

COURAGE-ALS is a Phase 3, double-blind, randomized, placebo-controlled trial of reldesemtiv in patients aged 18 to 80 with ALS.

The screening and qualification period for the trial will be no more than 14 days in duration. Approximately 555 eligible ALS patients will be randomized (2:1) to receive the following dose of reldesemtiv or placebo (stratified by riluzole use/non-use and edaravone use/non-use) for the first 24 weeks (double-blind, placebo-controlled period):

  • 300 mg reldesemtiv twice a day for a 600 mg total daily dose (TDD)
  • Placebo twice daily

At the end of the 24-week double-blind, placebo-controlled period, patients will transition to the active drug period, where all patients will receive the following dose of reldesemtiv for the next 24 weeks:

  • 300 mg reldesemtiv twice a day for a 600 mg TDD for patients who were not down titrated during the 24 weeks of blinded dosing
  • 150 mg reldesemtiv twice a day for a 300 mg TDD for patients who were down titrated during the 24 weeks of blinded dosing

Details
Condition Amyotrophic Lateral Sclerosis
Treatment Placebo, Reldesemtiv, Reldesemtiv
Clinical Study IdentifierNCT04944784
SponsorCytokinetics
Last Modified on15 June 2022

Eligibility

 Yes No Not Sure

Inclusion Criteria

Males or Females between the ages of 18 and 80 years of age, inclusive
Diagnosis of familial or sporadic ALS (defined as meeting the laboratory-supported probable, probable, or definite criteria for ALS according to the World Federation of Neurology El Escorial criteria). Patients who meet the possible criteria are eligible if they have lower motor neuron findings; those who have purely upper motor neuron findings are ineligible
First symptom of ALS ≤ 24 months prior to screening. The qualifying first symptoms of ALS are limited to manifestations of weakness in extremity, bulbar, or respiratory muscles
ALSFRS-R total score ≤ 44 at screening. Patients with a total score of 45 or higher may be rescreened 60±7 days following the original screening date
Upright FVC ≥ 65.0% of predicted for age, height, sex and ethnicity at screening according to Global Lung Initiative equation
Must be either on riluzole for ≥ 30 days prior to screening or have not taken it for at least 30 days prior to screening
Must have completed at least 2 cycles of edaravone at the time of screening or have not received it for at least 30 days prior to screening
Able to swallow whole tablets

Exclusion Criteria

eGFRCysC < 45.0 mL/min/1.73 m2 at screening
Urine protein/creatinine ratio > 1 mg/mg (113 mg/mmol) at screening
Alanine aminotransferase (ALT) or aspartate aminotransferase (AST) ≥ 3-times the upper limit of normal (ULN)
Total bilirubin (TBL), direct or indirect bilirubin above the ULN
Cognitive impairment, related to ALS or otherwise that impairs the patient's ability to understand and/or comply with study procedures and provide informed consent
Other medically significant neurological conditions that could interfere with the assessment of ALS symptoms, signs or progression
Has a tracheostomy
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Additional screening procedures may be conducted by the study team before you can be confirmed eligible to participate.

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If you are confirmed eligible after full screening, you will be required to understand and sign the informed consent if you decide to enroll in the study. Once enrolled you may be asked to make scheduled visits over a period of time.

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Complete your scheduled study participation activities and then you are done. You may receive summary of study results if provided by the sponsor.

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