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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/ct2/show/NCT05218668
Registration number
NCT05218668
Ethics application status
Date submitted
23/11/2021
Date registered
1/02/2022
Date last updated
2/03/2023
Titles & IDs
Public title
Rho Kinase Inhibitor in Amyotrophic Lateral Sclerosis (REAL)
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Scientific title
A Phase 2a Open-Label Preliminary Safety, Efficacy, and Biomarker Study of WP-0512 in Patients With Amyotrophic Lateral Sclerosis (ALS)
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Secondary ID [1]
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WP-0512-003
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Universal Trial Number (UTN)
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Trial acronym
REAL
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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 - Fasudil (WP-0512)
Experimental: Fasudil - Oral fasudil up to 240 mg/day
Treatment: Drugs: Fasudil (WP-0512)
Oral fasudil up to 240 mg/day
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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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Incidence of Adverse Events (AEs) and Serious Adverse Events (SAEs)
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Assessment method [1]
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Incidence of Adverse Events (AEs] and Serious Adverse Events (SAEs) as assessed by clinically significant abnormal physical examination findings; changes in vital signs; 12-lead electrocardiogram (ECG); magnetic resonance imaging (MRI); and hematology, blood chemistry, liver function, and urine tests.
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Timepoint [1]
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Through study completion, up to 25 weeks
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Secondary outcome [1]
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Change in the slope of the decline in percent predicted Slow Vital Capacity (SVC) during treatment vs pre-treatment
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Assessment method [1]
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The SVC will be measured using the study-approved portable spirometer, and assessments will be performed using a face mask. Three SVC trials are required for each testing session, however up to 5 trials may be performed if the variability between the highest and second highest SVC is 10% or greater for the first 3 trials.
The highest SVC recorded is utilized for eligibility. At least 3 measurable SVC trials must be completed to score SVC for all visits after screening. Predicted SVC values and percent predicted SVC values will be calculated using the Quanjer Global Lung Initiative equations.
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Timepoint [1]
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Monthly from Screening to Week 12; Every six weeks to Week 24
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Secondary outcome [2]
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Change in the slope of the decline in muscle strength during treatment vs pre-treatment
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Assessment method [2]
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A spring-loaded device that "breaks" at pre-set forces will be used to assess readings obtained by HHD throughout the study. Grip strength dynamometry for both hands will be acquired, and the mean force in kilograms will be calculated. Measures will be obtained from each hand in triplicate.
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Timepoint [2]
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Monthly from Screening to Week 12; Every six weeks to Week 24
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Secondary outcome [3]
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Change in the slope of the decline Revised ALS Functional Rating Scale (ALSFRS-R) during treatment vs pre-treatment
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Assessment method [3]
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The ALSFRS-R is a validated rating instrument for monitoring the progression of disability inpatients with ALS and is utilized for monitoring functional change in ALS patients. The score assesses various 4 domains including: (i) bulbar function (speech, salivation, swallowing); (ii)fine motor task (handwriting, cutting food and handling utensils, with or without gastrostomy, dressing and hygiene); (iii) gross motor task (turning in bed, walking, climbing stairs); and (iv)respiratory function (dyspnea, orthopnea and respiratory insufficiency).
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Timepoint [3]
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Monthly from Screening to Week 12; Every six weeks toWeek 24]
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Eligibility
Key inclusion criteria
1. Between 18 and 75 years of age (inclusive) at Screening 1.
2. Subject has had a diagnosis of probable laboratory-supported, probable, or definite
ALS (as defined by El Escorial Revised ALS diagnostic criteria) by Screening 1, and no
other cause of the neurological impairment has been identified by Screening 2.
3. Average decrease in ALSFRS-R of 0.5 to 3 (inclusive) points per month, calculated
using the most recent historical ALSFRS-R score from at least 3 months prior to
Screening 1. If there is no qualifying previous score, an estimated rate will be
calculated using the historical date of ALS symptom onset (weakness and/or dysarthria
and/or dysphagia).
4. Percent predicted SVC = 50% at Screening 1.
5. ALS symptom onset (weakness and/or dysarthria, and/or dysphagia) within 48 months of
Screening 1.
6. Subjects taking riluzole, edaravone, or phenylbutyrate (PB) and/or
tauroursodeoxycholic acid (TUDCA) may be included if the following criteria are met at
Screening 1, and there is no change in treatment between Screening 1 and Enrollment:
- Stable dose of riluzole for at least 30 days;
- Stable dose of edaravone for at least 3 cycles; and/or
- Stable dose of PB and/or TUDCA for at least 90 days
Subjects taking any of these drugs prior to screening who intend to discontinue them
before starting the study must have discontinued the drug(s) at least 28 days before
Screening 1.
7. Women of childbearing potential (WCBP) must agree to abstain from sex or use an
adequate method of contraception for the duration of the screening period, the study
drug treatment period, and for 28 days after the last dose of study drug.
8. Males must agree to abstain from sex with WCBP or use an adequate method of
contraception for the duration of the study drug treatment period and for 75 days
after.
9. Capable of providing informed consent and following trial procedures (where subject
consents but is unable to sign the informed consent a legally authorized
representative (LAR)/surrogate must sign on their behalf).
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Minimum age
18
Years
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Maximum age
75
Years
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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
1. ALSFRS-R < 24 at Screening 1.
2. Expected change in dosing of riluzole, edaravone, or PB and/or TUDCA between Screening
1 and the end of the study.
3. Presence of other causes of neuromuscular weakness or other neurodegenerative diseases
that could interfere with the objectives of the study or the safety of the subject, in
the opinion of the Investigator.
4. Mechanical ventilation via tracheostomy. (Use of non-invasive ventilation e.g.,
continuous positive airway pressure, non-invasive bi-level positive airway pressure or
non-invasive volume ventilation is not an exclusion).
5. Any medical condition (including cardiovascular, hematologic, renal, hepatic, or
psychiatric diseases) that in the opinion of the Investigator would disallow safe
participation in the trial or interpretation of the study results.
6. Suicidal ideation per the Columbia-Suicide Severity Rating Scale (C-SSRS) that in the
opinion of the Investigator would pose a safety risk.
7. ALT = 3 x upper limit of normal (ULN) or aspartate aminotransferase (AST) = 3 x ULN at
Screening 2.
8. Estimated glomerular filtration rate (eGFR) < 45 mL/min/1.73m2 at Screening 2.
9. Participants who, in the opinion of the Investigator, are unable or unlikely to comply
with the dosing schedule or study evaluations.
10. Treatment in a clinical trial with another investigational drug within 28 days or 5
half-lives of drug before Screening 1, whichever is longer.
11. Exposure at any time to any gene therapies under investigation for the treatment of
ALS.
12. Treatment with clenbuterol within 28 days of Screening 1, or any time between
Screening 1 and enrollment.
13. On more than one of the following drug classes: long-acting nitrates, beta-blockers,
or calcium channel blockers. (Note: subjects may be on one of the drug classes.)
14. Systolic blood pressure < 90 mmHg and/or diastolic blood pressure < 60 mmHg at
Screening 2. (Note: in the case of a systolic blood pressure < 90 and/or diastolic
blood pressure < 60, BP measurements should be repeated after 10 minutes, and the
higher reading used for Inclusion/Exclusion.)
15. Known hypersensitivity to the active (fasudil) or inactive ingredients in the study
drug.
16. Known to be pregnant or lactating; or positive pregnancy test for WCBP.
17. At Screening 2, neutrophil count < 1,500/mm3, platelets < 100,000/mm3, international
normalized ratio (INR) > 1.5 or any contraindication to or unable to tolerate lumbar
puncture, including use of anticoagulant medications that cannot be withheld. For
example, if a subject is taking warfarin and it cannot be withheld for lumbar
puncture, this would exclude the subject from study entry.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
N/A
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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
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Single group
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Other design features
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Phase
Phase 2
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Active, not recruiting
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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
22/12/2021
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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
1/07/2024
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Actual
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Sample size
Target
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Accrual to date
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Final
30
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Recruitment in Australia
Recruitment state(s)
NSW,QLD,VIC
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Recruitment hospital [1]
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Macquarie University Hospital - Sydney
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Recruitment hospital [2]
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Royal Brisbane and Women's Hospital - Brisbane
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Recruitment hospital [3]
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Calvary Health Bethlehem Hospital - Melbourne
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Recruitment postcode(s) [1]
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NSW 2109 - Sydney
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Recruitment postcode(s) [2]
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QLD 4029 - Brisbane
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Recruitment postcode(s) [3]
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VIC 3195 - Melbourne
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Recruitment outside Australia
Country [1]
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United States of America
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State/province [1]
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Arizona
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Country [2]
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United States of America
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State/province [2]
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Colorado
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Country [3]
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United States of America
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State/province [3]
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Florida
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Country [4]
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United States of America
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State/province [4]
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Illinois
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Country [5]
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United States of America
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State/province [5]
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Kentucky
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Country [6]
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United States of America
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State/province [6]
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Missouri
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Country [7]
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United States of America
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State/province [7]
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New York
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Funding & Sponsors
Primary sponsor type
Commercial sector/Industry
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Name
Woolsey Pharmaceuticals
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Address
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Country
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Ethics approval
Ethics application status
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Summary
Brief summary
A Phase 2a Open-Label Preliminary Safety, Efficacy, and Biomarker Study of WP-0512 in
Patients with Amyotrophic Lateral Sclerosis (ALS)
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Trial website
https://clinicaltrials.gov/ct2/show/NCT05218668
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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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Address
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Phone
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Fax
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Email
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Contact person for public queries
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Address
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Phone
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Fax
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Email
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Contact person for scientific queries
Summary Results
For IPD and results data, please see
https://clinicaltrials.gov/ct2/show/NCT05218668
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