Clinical trials

Phase 1: Complete
Phase 1b: Underway, currently recruiting
Location: Wesley Hospital, Brisbane

A Phase 1 study has been completed to evaluate the safety, tolerability, pharmacokinetics and pharmacodynamics of single and multiple ascending doses of ALS-205 in healthy volunteers.

The follow-up Phase 1b trial will primarily evaluate the safety and tolerability of a single dose of PMX205 in individuals with ALS. The secondary objectives are: to determine the plasma pharmacokinetics (PK) of PMX205, evaluate PMX205 levels in the cerebrospinal fluid (CSF) after dosing at a single level, and to evaluate PMX205 pharmacodynamic (PD) activity by measuring cytokine levels following C5a challenge in peripheral immune cells. It is important to determine the extent to which PMX205 crosses the blood-brain barrier and enters brain tissue in individuals with ALS.

Eligibility criteria:

• possible, probable, probable laboratory-supported, definite, or definite familial laboratory-supported amyotrophic lateral sclerosis (ALS) in accordance with the El-Escorial criteria
• SVC of greater than or equal to 50%

MNDRA have supported the early development of this potential treatment.

Learn more about this trial

Official clinical trial information is available at the Australia New Zealand Clinical Trials Registry

Phase 2: Active, currently recruiting patients. 
Location: Concord Hospital, Sydney

A phase 2 clinical trial of Ambroxol, a cough medicine, as an investigational treatment for MND.
 
Eligibility criteria:

• ALS as diagnosed according to the recently proposed Gold Coast diagnostic criteria.
• First symptom of ALS less than or equal to 18 months prior to screening.
• Forced vital capacity (FVC) greater than or equal to 60%

Exclusion criteria:

• Use of non-invasive ventilation (NIV) support for ALS only or gastrostomy tube

Learn more about this trial 

Official clinical trial information is available on Australian New Zealand Clinical Trials Registry (ANZCTR)

Phase 3: Active, currently recruiting patients.
Location: Gold Coast University Hospital, Queensland.

A randomised, double-blind, single-centre Phase 3 study on the safety, tolerability and efficacy of Cannabis Based Medicine Extract (CannTrust CBD Oil) in slowing the disease progression in Amyotrophic Lateral Sclerosis or Motor Neurone Disease patients (EMERALD). Participants will be assigned by chance to receive either medicinal cannabis or placebo. Treatment will continue for 180 days and participants will be seen every 3 months in the research clinic, with a monthly telephone call in between.

Eligibility criteria:

• Probable or definite amyotrophic lateral sclerosis (ALS) in accordance with the El-Escorial criteria
• Onset of first symptom within the last 2 years
• Forced Vital Capacity (FVC) of at least 60% on baseline

Learn more about this trial

Official clinical trial information is available at the Australia New Zealand Clinical Trials Registry

Active, currently recruiting patients. 
Location: Melbourne, Sydney, Adelaide, Brisbane, Perth

This study will test whether specific and individualised titration of NIV in combination with a sleep study (polysomnography) leads to better outcomes in people with MND in a large, multi-centre randomised controlled trial (RCT) across multiple sites.

Eligibility criteria:

• Age >18 years
• Clinical indication to commence long term NIV
• Confirmed clinical diagnosis of underlying condition

Learn more about this trial 

Official clinical trial information is available on ClincialTrials.gov
 

Phase 3: Currently recruiting patients
Location: Australian sites: Brisbane, Adelaide, Launceston, Melbourne, Sydney and Perth.

Safety and tolerability of antiretroviral (Triumeq) in patients with amyotrophic lateral sclerosis (ALS) (The Lighthouse Project).

The Lighthouse Project was a trial to test an antiretroviral therapy called Triumeq, following research suggesting that a virus may be a cause or trigger for ALS. The phase 2 trial showed positive results and a Phase 3 trial has now commenced. The phase 3 trial will be conducted in Europe, the U.K. and at five sites in Australia  (Brisbane, Adelaide, Launceston, Melbourne, Sydney and Perth). 

Eligibility criteria:

• Sporadic ALS diagnosed as probable, laboratory-supported probable or definite according to the World Federation of Neurology El Escorial revised criteria
• Diagnosis <24 months from date of enrolment
• Forced Vital Capacity (FVC) of at least 60% on baseline

Exclusion criteria:

• Dependence on mechanical ventilation at the time of screening
• Gastrostomy at the time of screening
• Absence of Upper Motor Neuron Signs
   

Both the Phase 2 and 3 trials have been partly supported by MNDRA.

Learn more about this trial

Official clinical trial information is available at clinicaltrials.gov 

Phase 2a: Active, currently recruiting patients
Location: Brisbane

A Phase 2a trial to determine the safety and tolerability of (Metflex) trimetazidine in ALS.

The MetFlex trial will be conducted in a controlled setting across three hospitals globally. The primary goal is to assess the safety and tolerability of Trimetazidine in patients with ALS. Second to this, the trial will explore if Trimetazidine can reduce hypermetabolism in patients with ALS. This open-label trial (no placebo) is open to patients with familial or sporadic ALS. Enrolment into the trial is dependent on participants meeting inclusion criteria.

Eligibility criteria:

• Familial or sporadic ALS/MND, defined as clinically possible, probable, or definite as per the El Escorial criteria
• Relative TRICALS risk score between -6.0 to -2.0 (75% of patients with ALS/MND)
• Metabolic index ≥110%, at the screening visit. 

This trial is being conducted by a number of MNDRA funded researchers.

Learn more about this trial

Official clinical trial information is available on clinicaltrials.gov

Phase 2: Active, currently recruiting patients.
Location: Brisbane, Melbourne, Sydney 

REAL is a phase 2a open-label study to assess preliminary safety, tolerability, and effect on clinical outcomes as well as neurodegeneration biomarkers, of an oral Rho kinase inhibitor, BRAVYL, in patients with ALS.  The study has been sponsored by Woolsey Pharma. Inhibition of the serine/threonine kinase Rho kinase was shown to counteract neurodegenerative processes and to foster neuronal regeneration in different animal models of neurodegenerative disease.

The study will enrol approximately 20 patients, all of whom will be treated with BRAVYL for 24 weeks. 

Eligibility criteria:

• Diagnosis of probable laboratory-supported, probable, or definite ALS (as defined by El Escorial Revised ALS diagnostic criteria)
• Average decrease in ALSFRS-R of 0.5 to 3 (inclusive) points per month
• Percent predicted SVC ≥ 50%
• ALS symptom onset (weakness and/or dysarthria, and/or dysphagia) within 48 months

Exclusion criteria:

• ALSFRS-R < 24

Learn more about this trial 

Official clinical trial information is available at clinical trails.gov

Phase 3 (equivalent): Open - see information below
Location: Sydney

Biogen initiated the ATLAS study in 2021 to determine if pre-symptomatic treatment of SOD1 mutation carriers may represent more optimal timing of intervention. Given that individuals with SOD1 mutations can be recognised as at-risk of developing ALS through genetic testing prior to onset of symptoms, tofersen represents a tremendous opportunity to determine if treatment in pre-symptomatic individuals could provide a more robust effect on disease progression.

The primary objective of this study is to evaluate the efficacy of BIIB067 when initiated in presymptomatic adult carriers of a superoxide dismutase 1 (SOD1) mutation with elevated neurofilament (NF). The secondary objectives of this study are to evaluate the safety and tolerability of BIIB067 and to evaluate the effect of BIIB067 on pharmacodynamics (PD)/treatment response biomarkers when initiated prior to versus at the time of emergence of clinically manifest amyotrophic lateral sclerosis (ALS).

Eligibility criteria:

• Participants should have a protocol-defined rapidly progressive SOD1 mutation, confirmed by a central reader, or a SOD1 mutation that is approved for inclusion by an external mutation adjudication committee.
• Participants with plasma neurofilament light chain (NfL) level less than the protocol-defined threshold.
• Participants who are clinically presymptomatic for ALS (i.e., must not have clinically manifest ALS).

Learn more about this trial

Official clinical trial information is available at clinicaltrials.gov

Phase 2/3: Complete, results not yet available. The community is keenly waiting to hear about the outcome of this trial but the company (Collaborative Medicinal Development Pty Limited) running the trial have not yet announced the outcome despite repeated requests.
Location: This study was coordinated by Macquarie University, Sydney. 
 
A phase 2/3 clinical trial to evaluate the use of copper-ATSM (CuATSM) for the treatment of MND progression. This trial was administered through Macquarie University in Sydney. This trial followed from the successful completion of a phase 1 clinical trial, which identified a safe dosage.

MNDRA has provided more than $1.2 million to support three projects that helped develop copper-ATSM as a potential therapeutic.

Learn more about this trial

Official clinical trial information is available on clinicaltrials.gov