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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT04944784
Registration number
NCT04944784
Ethics application status
Date submitted
16/06/2021
Date registered
30/06/2021
Titles & IDs
Public title
A Study to Evaluate the Efficacy and Safety of Reldesemtiv in Patients With Amyotrophic Lateral Sclerosis (ALS)
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Scientific title
A Phase 3, Multi-Center, Double-Blind, Randomized, Placebo-Controlled Trial to Evaluate the Efficacy and Safety of Reldesemtiv in Patients With Amyotrophic Lateral Sclerosis (ALS)
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Secondary ID [1]
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2020-004040-29
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Secondary ID [2]
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CY 5031
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Universal Trial Number (UTN)
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Trial acronym
COURAGE-ALS
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Amyotrophic Lateral Sclerosis
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Condition category
Condition code
Neurological
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Neurodegenerative diseases
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Human Genetics and Inherited Disorders
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Other human genetics and inherited disorders
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Treatment: Drugs - Reldesemtiv
Treatment: Drugs - Placebo
Experimental: 300 mg reldesemtiv twice daily for a 600 mg total daily dose, from Day 1 until Week 24 - Patients in this arm take 2 reldesemtiv 150 mg oral tablets twice a day for a 600 mg total daily dose from Day 1 until Week 24.
Placebo comparator: Placebo twice daily, from Day 1 until Week 24 - Patients in this arm take 2 placebo oral tablets twice a day from Day 1 until Week 24.
Experimental: 300 mg reldesemtiv twice daily for a 600 mg total daily dose, from Week 24 until Week 48 - Patients in this arm take 2 reldesemtiv 150 mg oral tablets twice a day for a 600 mg total daily dose from Week 24 until Week 48 for patients who were not down titrated during the 24 weeks of blinded dosing.
Experimental: 150 mg reldesemtiv twice daily for a 300 mg total daily dose, from Week 24 until Week 48 - Patients in this arm take 1 reldesemtiv 150 mg oral tablet twice a day for a 300 mg total daily dose from Week 24 until Week 48 for patients who were down titrated for any reason during the 24 weeks of blinded dosing.
Treatment: Drugs: Reldesemtiv
Reldesemtiv Oral Tablet
Treatment: Drugs: Placebo
Placebo Oral Tablet
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Intervention code [1]
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Treatment: Drugs
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Comparator / control treatment
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Control group
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Outcomes
Primary outcome [1]
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Effect of reldesemtiv versus placebo on functional outcomes in ALS
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Assessment method [1]
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Change from baseline to Week 24 in ALS Functional Rating Scale-Revised (ALSFRS-R) total score; rating scale 0 to 48; higher scores indicate better functional status
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Timepoint [1]
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Baseline to Week 24
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Secondary outcome [1]
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Effect of reldesemtiv versus placebo on combined functional and survival outcomes in ALS
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Assessment method [1]
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Combined assessment of change in ALSFRS-R total score, time to onset of respiratory insufficiency, and survival time up to Week 24. In this joint rank test each individual patient is ranked compared to all other patients based on survival time, time to onset of respiratory insufficiency, and changes from baseline to Week 24 in ALSFRS-R total score. Deaths have the worst rank (with earlier deaths being ranked worse than later deaths); patients with onset of respiratory insufficiency have the next worst rank; and the more favorable changes from baseline at week 24 in ALSFRS-R total score have the best rank using this process.
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Timepoint [1]
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24 Weeks
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Secondary outcome [2]
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Effect of reldesemtiv versus placebo on ventilatory function
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Assessment method [2]
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Change from baseline to Week 24 in the percent predicted FVC
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Timepoint [2]
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Baseline to Week 24
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Secondary outcome [3]
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Effect of reldesemtiv versus placebo on quality of life
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Assessment method [3]
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Change from baseline to Week 24 in the ALS Assessment Questionnaire-40 (ALSAQ-40) total score; rating scale 0 to 100; higher scores indicate worse quality of life
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Timepoint [3]
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Baseline to Week 24
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Secondary outcome [4]
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Effect of reldesemtiv versus placebo on handgrip strength
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Assessment method [4]
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Change from baseline to Week 24 in handgrip strength (average of both hands)
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Timepoint [4]
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Baseline to Week 24
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Eligibility
Key inclusion criteria
Key
* 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
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Minimum age
18
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Maximum age
80
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key 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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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people receiving the treatment/s
The people administering the treatment/s
The people assessing the outcomes
The people analysing the results/data
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Intervention assignment
Parallel
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Other design features
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Phase
Phase 3
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Stopped early
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Data analysis
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Reason for early stopping/withdrawal
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Other reasons
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Date of first participant enrolment
Anticipated
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Actual
16/08/2021
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
18/07/2023
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Sample size
Target
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Accrual to date
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Final
486
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Recruitment in Australia
Recruitment state(s)
NSW,QLD,SA,WA
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Recruitment hospital [1]
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Brain and Mind Centre - Camperdown
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Concord Repatriation General Hospital - Concord
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Royal Brisbane and Women's Hospital - Herston
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Flinders Medical Centre - Bedford Park
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The Perron Institute - Nedlands
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2050 - Camperdown
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Recruitment postcode(s) [2]
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2139 - Concord
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Recruitment postcode(s) [3]
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4029 - Herston
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Recruitment postcode(s) [4]
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5042 - Bedford Park
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Recruitment postcode(s) [5]
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6009 - Nedlands
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Recruitment outside Australia
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Funding & Sponsors
Primary sponsor type
Commercial sector/industry
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Name
Cytokinetics
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Address
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Ethics approval
Ethics application status
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Summary
Brief summary
The purpose of this study is to assess the effect of reldesemtiv versus placebo on functional outcomes in ALS.
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Trial website
https://clinicaltrials.gov/study/NCT04944784
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
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Cytokinetics, MD
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Cytokinetics
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Contact person for scientific queries
Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
No documents have been uploaded by study researchers.
Results not provided in
https://clinicaltrials.gov/study/NCT04944784