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Amyotrophic Lateral SclerosisPhase 2ROCK-ALSNCT03792490

Inhibition of Rho Kinase (ROCK) With Fasudil as Disease-modifying Treatment for ALS

A Phase 2 study testing Fasudil in people with Amyotrophic Lateral Sclerosis, run by University Medical Center Goettingen at 15 sites in 3 countries.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disorder and therapeutic options are limited. The rho kinase (ROCK) inhibitor Fasudil was shown to be neuroprotective, induced axonal regeneration and improved survival and behavioral outcome in models of ALS and other neurodegenerative diseases. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Amyotrophic Lateral Sclerosis
What is being tested?
Fasudil
Type of treatment
Injection or infusion
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
120 participants
Where
15 sitesin 3 countries
Study dates
20 Feb 2019to 1 Nov 2023
Phase
Phase 2
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Probable (clinically or laboratory) or definite ALS according to the revised version of the El Escorial World Federation of Neurology criteria
  • Disease duration more than 6 months and less than 24 months (inclusive). Disease onset defined as date of first muscle weakness, excluding fasciculations and cramps
  • Vital capacity more than 65% of normal (slow vital capacity; best of three measurements)
  • Age: ≥ 18 years
  • Patients have to be treated with Riluzole (2 x 50mg/d), must be stable for at least four weeks before randomization
  • Patients who have started on Edaravone therapy shall continue Edaravone treatment. Edaravone treatment must not be discontinued for reasons of trial participation.
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  • Women of childbearing age must be non-lactating and surgically sterile or using a highly effective method of birth control and have a negative pregnancy test. Acceptable methods of birth control with a low failure rate i.e. less than 1% per year) when used consistently and correct are such as implants, injectables, combined oral contraceptives, hormonal intrauterine devices (IUDs), sexual abstinence or vasectomized partner
  • Capable of thoroughly understanding all information given and giving full informed consent according to good clinical practice (GCP)
  • Patients have to have a valid health insurance, when recruited in a center in France

Who cannot join

  • Previous participation in another clinical study involving trial medication within the preceding 12 weeks or five terminal half times of the longest to be eliminated trial medications (whichever is longer) or previous participation in this trial
  • Tracheostomy or continuous assisted ventilation of any type during the preceding three months before randomization or a significant pulmonary disorder not attributed to ALS, which may complicate the evaluation of respiratory function, intermittent non-invasive ventilation is permitted,
  • Patients with a history of intracranial bleeding, known intracerebral aneurysms or Moyamoya disease, or positive family history for the above. If only family history positive, magnetic resonance (MR)- or x-ray-based cranial imaging not older than 24 months must confirm absence of bleeding, aneurysms or Moyamoya.
  • Gastrostomy
  • Any medical condition known to have an association with motor neuron dysfunction or involving neuromuscular weakness or another neurodegenerative disease, e.g. Parkinson's disease (PD) or Alzheimer's disease (AD), which might confound or obscure the diagnosis of ALS
  • Presence of any concomitant life-threatening disease or impairment likely to interfere with functional assessment
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  • Patients with known arterial hypotension (resting blood pressure <90/60 mmHg) or previous hypotensive episodes or requiring treatment for increasing of blood pressure, such as fludrocortisone, midodrine, etilefrine, cafedrine or theodrenaline
  • Patients with an uncontrollable or unstable arterial hypertensive disease (resting blood pressure >180 mmHg systolic and/or >120 mmHg diastolic under current antihypertensive medication)
  • Known pulmonary hypertension and any medication prescribed for treatment of pulmonary hypertension
  • Confirmed hepatic insufficiency or abnormal liver function (stable aspartate transaminase (ASAT) and/or alanine aminotransferase (ALAT) greater than 3 times the upper limit of the normal range) and determined to be non-transient through repeat testing
  • Renal insufficiency with a glomerular filtration rate (GFR) <60 ml/min/1,73m² (calculated by Modification of Diet in Renal Disease (MDRD) equation) and determined to be non-transient through repeat testing
  • Major psychiatric disorder, significant cognitive impairment or clinically evident dementia precluding evaluation of symptoms
  • Hypersensitivity to any component of the study drug
  • Liable to be not cooperative or comply with the trial requirements (as assessed by the investigator), or unable to be reached in the case of emergency
  • Pregnant or breast-feeding females or females with childbearing potential, if no adequate contraceptive measures are used
  • Prisoners or subjects who are involuntary incarcerated
  • Patients subject to legal protection measures

Trial locations and contacts

15 sites in 3 countries.

15 sites in 3 countries

Germany10 sites
  • Charité Universitätsmedizin Berlin

    Berlin

  • Universitätsklinikum Carl Gustav Carus Dresden

    Dresden

  • University Medical Center Göttingen

    Göttingen, 37075

  • Universitätsklinikum Halle (Saale)

    Halle

  • Medizinische Hochschule Hannover

    Hanover

  • Universitätsklinikum Jena

    Jena

  • Universitätsklinikum Leipzig

    Leipzig

  • Klinikum rechts der Isar der Technischen Universität München

    München

  • Universitätsklinikum Ulm

    Ulm

  • University of Würzburg

    Würzburg

Other trials in Germany

France4 sites
  • Centre Hospitalier Universitaire Marseille

    Marseille

  • Centre Hospitalier Universitaire Montpellier

    Montpellier

  • Centre Hospitalier Universitaire Nice

    Nice

  • Centre Hospitalier Universitaire Tours

    Tours

Other trials in France

Switzerland1 site
  • Kantonsspital St. Gallen

    Sankt Gallen

Other trials in Switzerland

About this study

Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disorder and therapeutic options are limited. The rho kinase (ROCK) inhibitor Fasudil was shown to be neuroprotective, induced axonal regeneration and improved survival and behavioral outcome in models of ALS and other neurodegenerative diseases. The aim of this phase IIa, multi-center and double-blind study is to analyze the safety, tolerability and efficacy of fasudil in two different doses compared to placebo in approximately 16 trial sites in Germany, France and Switzerland. Intravenous application of fasudil will be performed in 80 patients and placebo in 40 patients two times daily for 20 treatment days. The hypothesis is that fasudil is safe and well-tolerated and its application will significantly improve the clinical outcome in patients with ALS.

Being tested
Fasudil, Placebo
Keywords
Motor neuron disease, Neurodegenerative disease
Medical subject headings
Amyotrophic Lateral Sclerosis, Motor Neuron Disease, Neurodegenerative Diseases

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • FasudilDrug

    Fasudil hydrochloride hydrate IV solution

  • PlaceboDrug

    Placebo to Fasudil hydrochloride hydrate, NaCl 0,9%

Study groups in NCT03792490
Study groupRoleWhat they receive
Fasudil 30 mgExperimentalFasudil (Fasudil hydrochloride hydrate IV solution) Dosage form: intravenous, application over 45 minutes Dosage: 30 mg/ day Frequency: 2 x 15 mg Duration of treatment: 20 days
Receives: Drug: Fasudil
Fasudil 60 mgExperimentalFasudil (Fasudil hydrochloride hydrate IV solution) Dosage form: intravenous, application over 45 minutes Dosage: 60 mg/ day Frequency: 2 x 30 mg Duration of treatment: 20 days
Receives: Drug: Fasudil
PlaceboPlacebo comparatorSodium chloride (NaCl) 0.9% Dosage form: intravenous, application over 45 minutes Dosage: 100 ml Frequency: 2 x Duration of treatment: 20 days Do2 x 1 ml, NaCl 0.9%
Receives: Drug: Placebo

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Safety (proportion of patients without treatment-related serious adverse events (SAE) up to day 180) and tolerability (proportion of patients without significant drug intolerance during the treatment period)

    Primary endpoint is the proportion of patients without significant drug intolerance during the treatment period (tolerability) and the proportion of patients without treatment-related serious adverse events (SAE) up to day 180 (safety).

    Measured: From baseline (day 1) to last follow-up (day 180 ± 5)

Secondary outcomes (7)
  1. Survival time

    Measured: From baseline (day 1) to end of treatment (day 26 to 30), second follow-up (day 90 ± 4), last follow-up (day 180 ± 5)

  2. ALS Functional Rating Scale (ALSFRS-R)

    Amyotrophic lateral sclerosis functional rating scale - revised (ALSFRS-R):

    a scale to determine different aspects of functionality in patients with ALS, minimum 0 points, maximum 48 points, derived from a questionnaire with 12 questions, each of which can yield up to 4 points, higher score indicates better functionality

    Measured: From baseline (day 1) to end of treatment (day 26 to 30), second follow-up (day 90 ± 4), last follow-up (day 180 ± 5)

  3. ALS Assessment Questionnaire (ALSAQ-5)

    Amyotrophic lateral sclerosis assessment questionnaire (ALSAQ-5):

    a patient self-report five-item scale to determine the health status and quality of life in patients with ALS, higher scores show worse quality of life

    Measured: From baseline (day 1) to end of treatment (day 26 to 30), second follow-up (day 90 ± 4), last follow-up (day 180 ± 5)

  4. Edinburgh Cognitive and Behavioral ALS Screen (ECAS)

    Edinburgh Cognitive and Behavioral Amyotrophic Lateral Sclerosis Screen (ECAS):

    a scale to determine the cognitive function of patients with ALS, minimum 0 points, maximum 136 points, higher scores show better cognitive performance

    Measured: From baseline (day 1) to end of treatment (day 26 to 30), second follow-up (day 90 ± 4), last follow-up (day 180 ± 5)

  5. Motor Unit Number Index (MUNIX)

    Motor Unit Number Index (MUNIX):

    a neurophysiological method based on surface EMG recordings to estimate the number of motor units, higher scores indicate a higher number of motor units

    Measured: From baseline (day 1) to end of treatment (day 26 to 30), second follow-up (day 90 ± 4), last follow-up (day 180 ± 5)

  6. slow Vital capacity (VC)

    Measured: From baseline (day 1) to end of treatment (day 26 to 30), second follow-up (day 90 ± 4), last follow-up (day 180 ± 5)

  7. Safety (proportion of patients without treatment-related serious adverse events (SAE) up to end of treatment (day 26 to 30)) and tolerability (proportion of patients without significant drug intolerance during the treatment period)

    Measured: From baseline (day 1) to end of treatment (day 26 to 30)

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted3 Jan 2019
  2. Study start20 Feb 2019
  3. Primary completion30 Nov 2022
  4. Study completion1 Nov 2023

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 2
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
120 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03792490
Sponsor's protocol ID
01742
Other IDs
2017-003676-31, 01GM1704A, 01GM1704B, 00013948, 2017
Acronym
ROCK-ALS
Status last verified
Nov 2023
First submitted
28 Dec 2018
Last updated
30 Nov 2023
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Undecided

Publications

  • Lingor P, Weber M, Camu W, Friede T, Hilgers R, Leha A, Neuwirth C, Gunther R, Benatar M, Kuzma-Kozakiewicz M, Bidner H, Blankenstein C, Frontini R, Ludolph A, Koch JC; ROCK-ALS Investigators. ROCK-ALS: Protocol for a Randomized, Placebo-Controlled, Double-Blind Phase IIa Trial of Safety, Tolerability and Efficacy of the Rho Kinase (ROCK) Inhibitor Fasudil in Amyotrophic Lateral Sclerosis. Front Neurol. 2019 Mar 27;10:293. doi: 10.3389/fneur.2019.00293. eCollection 2019.

    PubMed 30972018
  • Wolff AW, Leha A, Koch JC, Demleitner AF, Neuwirth C, Friede T, Weber M, Lingor P. Effects of fasudil on disease spreading in ALS - A MUNIX-based post-hoc analysis of the ROCK-ALS trial. Neurotherapeutics. 2026 Jun 3;23(4):e00936. doi: 10.1016/j.neurot.2026.e00936. Online ahead of print.

    PubMed 42235092
  • Koch JC, Leha A, Bidner H, Cordts I, Dorst J, Gunther R, Zeller D, Braun N, Metelmann M, Corcia P, De La Cruz E, Weydt P, Meyer T, Grosskreutz J, Soriani MH, Attarian S, Weishaupt JH, Weyen U, Kuttler J, Zurek G, Rogers ML, Feneberg E, Deschauer M, Neuwirth C, Wuu J, Ludolph AC, Schmidt J, Remane Y, Camu W, Friede T, Benatar M, Weber M, Lingor P; ROCK-ALS Study group. Safety, tolerability, and efficacy of fasudil in amyotrophic lateral sclerosis (ROCK-ALS): a phase 2, randomised, double-blind, placebo-controlled trial. Lancet Neurol. 2024 Nov;23(11):1133-1146. doi: 10.1016/S1474-4422(24)00373-9.

    PubMed 39424560
  • Lingor P, Koch JC, Statland JM, Hussain S, Hennecke C, Wuu J, Langbein T, Ahmed R, Gunther R, Ilse B, Kassubek J, Kollewe K, Kuttler J, Leha A, Lengenfeld T, Meyer T, Neuwirth C, Tostmann R, Benatar M. Challenges and opportunities for Multi-National Investigator-Initiated clinical trials for ALS: European and United States collaborations. Amyotroph Lateral Scler Frontotemporal Degener. 2021 Aug;22(5-6):419-425. doi: 10.1080/21678421.2021.1879866. Epub 2021 Feb 3.

    PubMed 33533663

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Fasudil in people with Amyotrophic Lateral Sclerosis, run by University Medical Center Goettingen at 15 sites in 3 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 9 inclusion and 17 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 30 Nov 2023. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 15 sites in Germany, France, Switzerland. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Safety (proportion of patients without treatment-related serious adverse events (SAE) up to day 180) and tolerability (proportion of patients without significant drug intolerance during the treatment period) (time frame: From baseline (day 1) to last follow-up (day 180 ± 5)). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT03792490, which also lists 4 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 30 Nov 2023.

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