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Trial registered on ANZCTR
Registration number
ACTRN12624001204538
Ethics application status
Approved
Date submitted
18/09/2024
Date registered
1/10/2024
Date last updated
1/10/2024
Date data sharing statement initially provided
1/10/2024
Type of registration
Retrospectively registered
Titles & IDs
Public title
An Open Label Extension of the double-blind randomised, placebo-controlled clinical trial to test the treatment of amyotrophic lateral sclerosis with ambroxol.
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Scientific title
Ambroxol therapy for ALS trial: An Open Label Extension of the double-blind, randomised, placebo-controlled Phase 2 clinical trial of ambroxol for ALS
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Secondary ID [1]
313002
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FLO-AMB-01 OLE
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Universal Trial Number (UTN)
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Trial acronym
AMBALS - OLE
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Linked study record
ACTRN12622001380785 is the double blinded randomised placebo-controlled phase of this trial. This registration documents the Open Label Extension phase of the trial, where all participants receive ambroxol for an additional 48 week period.
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Health condition
Health condition(s) or problem(s) studied:
Amyotrophic Lateral Sclerosis
335196
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Condition category
Condition code
Neurological
331684
331684
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0
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Neurodegenerative diseases
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Participants who have successfully completed the randomised phase of the parent AMBALS study, will be invited to participate in the Open Label Extension (OLE). The OLE will involve participants taking 420mg capsules of ambroxol, orally, three times a day (total dose 1260mg per day).
Participants will complete an OLE baseline visit, for consenting and OLE eligibility assessments. They will then start their OLE dosing. This will then be followed 48 weeks of follow-up (4x in clinic follow-up visits - one every 12 weeks). These 48 weeks will be the drug administration period, meaning that the total duration of drug administration is 48 weeks. Following this drug administration and follow-up period, there will be an End of Study safety-follow up visit that will occur 4 weeks after the final follow-up visit (52 weeks from OLE baseline).
Participants will return IP bottles at each of the 4 in-clinic follow-up visits, to monitor IP compliance.
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Intervention code [1]
329545
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Treatment: Drugs
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Comparator / control treatment
No control group - Open Label Extension
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
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Time to event (death, need for tracheostomy, the need for gastrostomy feeding or non-invasive ventilation (NIV) support (greater than or equal to 12 hours a day in a 24-hour period), or greater than or equal to 6-point progression on the Amyotrophic Lateral Sclerosis Functional Rating Scale (ALSFRS))
This will be assessed as a composite outcome
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Assessment method [1]
339408
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This will be measured by patient medical records, and the completion of the ALSFRS by investigators.
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Timepoint [1]
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12 weeks, 24 weeks, 36 weeks, and 48 weeks from OLE baseline
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Secondary outcome [1]
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ALS functional rating score-revised (ALSFRS-R)
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Assessment method [1]
439810
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ALSFRS-R
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Timepoint [1]
439810
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48 weeks from OLE baseline
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Secondary outcome [2]
439813
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Split Hand Index (SI) Score for progression of ALS
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Assessment method [2]
439813
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Split Hand Index (SI) test
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Timepoint [2]
439813
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48 weeks from OLE baseline
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Secondary outcome [3]
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Neurophysiology Index (NPI) score for progression of ALS
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Assessment method [3]
439814
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Neurophysiology Index (NPI) test
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Timepoint [3]
439814
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48 weeks from OLE baseline
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Secondary outcome [4]
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Kings staging system score for progression of ALS
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Assessment method [4]
439815
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Kings staging system assessment
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Timepoint [4]
439815
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48 weeks from OLE baseline
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Secondary outcome [5]
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Muscle strength assessment score
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Assessment method [5]
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Muscle strength assessment as measured by the Medical Research Council (MRC) Scale for Muscle Strength
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Timepoint [5]
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48 weeks from OLE baseline
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Secondary outcome [6]
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Respiratory function (FVC)
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Assessment method [6]
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FVC score per Spirometer
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Timepoint [6]
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48 weeks from OLE baseline
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Secondary outcome [7]
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Survival
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Assessment method [7]
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Assessing patient survival status
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Timepoint [7]
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52 weeks from OLE baseline
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Secondary outcome [8]
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Serum NFL levels
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Assessment method [8]
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Serum NFL blood test
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Timepoint [8]
439819
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48 weeks from OLE baseline
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Secondary outcome [9]
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Assessment of Quality of Life (AQoL)
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Assessment method [9]
439820
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ALSAQ-40 Questionnaire
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Timepoint [9]
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48 weeks from OLE baseline
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Eligibility
Key inclusion criteria
Refer to ACTRN12622001380785 for the inclusion criteria of the randomized placebo-controlled Treatment Period of the AMBALS trial.
1) Participants must have completed the randomized placebo-controlled Treatment Period of the AMBALS trial without compliance issues
2) Able to understand and give written informed consent to participant in the open-label extension.
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Minimum age
18
Years
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Maximum age
85
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
Refer to ACTRN12622001380785 for the exclusion criteria of the randomized placebo-controlled Treatment Period of the AMBALS trial.
1) Lack of treatment compliance during the randomized placebo-controlled Treatment Period.
2) Positive pregnancy test at the Week 24 visit of the AMBALS study randomised phase, or, females who plan to get pregnant during the course of this extension or within 6 months of the end of this extension.
3) Based on the investigator’s judgment, participants who may have difficulty complying with the protocol and/or any study procedures.
4)Participants with any clinically significant medical conditions based on the Investigator’s judgment, which may interfere with continued participation.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Non-randomised 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
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
Recruiting
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Date of first participant enrolment
Anticipated
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Actual
16/09/2024
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Date of last participant enrolment
Anticipated
30/09/2025
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Actual
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Date of last data collection
Anticipated
30/09/2026
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Actual
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Sample size
Target
20
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Accrual to date
2
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Final
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Recruitment in Australia
Recruitment state(s)
NSW,SA,TAS,VIC
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Recruitment hospital [1]
27113
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Concord Repatriation Hospital - Concord
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Recruitment hospital [2]
27114
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Neuroscience Research Australia (NeuRA) - Randwick
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Recruitment hospital [3]
27115
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Calvary Health Care Bethlehem Ltd - Caulfield
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Recruitment hospital [4]
27116
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Flinders Medical Centre - Bedford Park
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Recruitment hospital [5]
27117
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Launceston General Hospital - Launceston
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Recruitment postcode(s) [1]
43191
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2139 - Concord
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Recruitment postcode(s) [2]
43192
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2031 - Randwick
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Recruitment postcode(s) [3]
43193
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3162 - Caulfield
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Recruitment postcode(s) [4]
43194
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5042 - Bedford Park
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Recruitment postcode(s) [5]
43195
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7250 - Launceston
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Funding & Sponsors
Funding source category [1]
317441
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Charities/Societies/Foundations
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Name [1]
317441
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FightMND
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Address [1]
317441
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Country [1]
317441
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Australia
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Primary sponsor type
Other Collaborative groups
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Name
The Florey Institute of Neuroscience and Mental Health (part of the University of Melbourne)
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Address
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Country
Australia
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Secondary sponsor category [1]
319733
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None
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Name [1]
319733
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Address [1]
319733
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Country [1]
319733
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Other collaborator category [1]
283204
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Commercial sector/Industry
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Name [1]
283204
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Mobius Medical Pty Ltd
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Address [1]
283204
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Country [1]
283204
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
316159
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Sydney Local Health District HREC – Concord Repatriation General Hospital
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Ethics committee address [1]
316159
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http://www.slhd.nsw.gov.au/concord/ethics/
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Ethics committee country [1]
316159
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Australia
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Date submitted for ethics approval [1]
316159
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07/05/2024
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Approval date [1]
316159
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31/05/2024
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Ethics approval number [1]
316159
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Summary
Brief summary
Ambroxol is a simple cough medicine that is predicted to slow ALS disease progression. This study is the open label extension (OLE) of the parent study, which aims to investigate if ambroxol in high doses is effective in treating ALS. This OLE study will be carried out across 5 research sites in Australia (2 NSW, 1 VIC, 1 SA and 1 TAS), where ALS patients whole have successfully completed the randomised phase of the parent study, will be asked to participate in the OLE phase. Participation will be over a 52-week period, where they will come in for a an OLE baseline, followed by 48-week treatment, and 4-week end of study safety follow-up period. All participants will active drug that they will take three times a day, Throughout the study their disease progression will be assessed using tests, questionnaires, and blood biomarkers.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Prof Steve Vucic
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Address
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Building 20, Level 1 Hospital Rd, Concord Hospital Concord, NSW, 2139
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Country
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Australia
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Phone
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+61 02 9767 8447
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Bradley Turner
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Address
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The Florey Institute of Neuroscience and Mental Health 30 Royal Parade, Parkville VIC 3052
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Country
136979
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Australia
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Phone
136979
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+61 3 9035 6521
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Fax
136979
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Email
136979
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[email protected]
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Contact person for scientific queries
Name
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Bradley Turner
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Address
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The Florey Institute of Neuroscience and Mental Health 30 Royal Parade, Parkville VIC 3052
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Country
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Australia
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Phone
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+61 3 9035 6521
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Fax
136980
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Email
136980
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[email protected]
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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
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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