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Amyotrophic Lateral SclerosisPhase 2NCT04066244

Study of Safety and Proof of the Mechanism of BLZ945 in ALS Patients

A Phase 2 study testing BLZ945 in people with Amyotrophic Lateral Sclerosis, run by Novartis Pharmaceuticals at 4 sites in 3 countries.

Terminated

Stopped early. The study ended before it was planned to and will not resume.

Official record
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Trial summary

It was an open label study to evaluate safety, tolerability and brain microglia response in participants with Amyotrophic Lateral Sclerosis (ALS) following multiple doses of BLZ945. Read more about this study

Who is it for?
Ages 18 to 100 years
Conditions the study is for
Amyotrophic Lateral Sclerosis
What is being tested?
BLZ945
Could I receive a placebo?
No, everyone receives an active treatment
How many people
28 participants
Where
4 sitesin 3 countries
Study dates
30 Dec 2019to 1 Feb 2024
Phase
Phase 2
Are there results?
Yes, posted in the registrySummary in the doctors' view

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 to 100 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Able to communicate well with the investigator, to understand and comply with the study visits and procedures of the study
  • Written informed consent must be obtained before any assessment is performed.
  • Male and female participants who are 18 years old or older at screening, and who are diagnosed with familial or sporadic ALS according to the World Federation of Neurology Revised El Escorial criteria of either bulbar or limb onset.
  • Disease duration from symptoms onset no longer than 48 months at the screening visit.
  • Females of childbearing potential must have a negative pregnancy test at screening and/or baseline.
  • Treatment with approved ALS therapies is allowed, but participants need to be on a stable dose and regimen for at least 30 days prior to baseline.
  • Having completed the Core Treatment Period to be able to continue in the Extended Treatment Period.

Who cannot join

  • A history of clinically significant ECG abnormalities
  • Active medical or neurologic diseases other than ALS, that in the opinion of the investigator would limit their participation in the current study.
  • Use of other investigational drugs within 5 half-lives of screening, or until the expected PD effect has returned to baseline, whichever is longer; or longer if required by local regulations.
  • History of hypersensitivity to any of the study treatments or excipients or to drugs of similar chemical classes.
  • Presence of human immunodeficiency virus (HIV) infection based on screening lab results.
  • Evidence of active or latent tuberculosis as assessed by Quantiferon testing at the screening visit.
Show all 23Show fewer
  • Positive serology for hepatitis B surface antigen, or hepatitis C antibodies confirmed by an appropriate licensed test at screening.
  • Signs or symptoms, in the judgement of the investigator, of a clinically significant systemic viral, bacterial or fungal infection within 30 days prior to the screening visit.
  • Cardiac disorders, such as recent cardiac history (within 6 months of screening) of acute coronary syndrome, acute heart failure, or significant ventricular arrhythmia at the screening visit or participants with a history of severe pulmonary hypertension. Participants with cardiac failure class 3 or 4 of the NYHA classification, or history of reduced LVEF or individuals with implanted cardiac pacemaker, or defibrillator.
  • Significant hematological laboratory abnormalities.
  • Clinical evidence of liver disease or liver injury or any of the following hepatic conditions at the screening visit:
  • Women of child-bearing potential, defined as all women physiologically capable of becoming pregnant, unless they are using highly effective methods of contraception during dosing and for 14 days after last dose of BLZ945.
  • Pregnant or nursing female participants
  • Sexually active males unless they use a condom during intercourse while taking the drug during treatment, for 14 days after stopping BLZ945 and should not father a child in this period.
  • History or presence of impaired renal function at the screening visit.
  • Active suicidal ideation.
  • History of drug abuse or harmful alcohol use within the 12 months prior to dosing within the judgement of the investigator, or evidence of such abuse as indicated by the laboratory assays conducted during screening.
  • Active GI conditions such as Barrett's esophagus, achalasia, esophageal varices and active or history of esophageal cancer, pre-existing pancreatic disease at screening visit.
  • History of active vasculitis or history of autoimmune disease autoimmune disease associated with vasculitis (eg., RA, SLE, Sjögrens disease, scleroderma).
  • History or active cardiac valve disorder, congenital valve disease, or other clinical condition that might affect cardiac valve function
  • Use of systemic anticoagulation that cannot be temporarily paused before study procedures
  • Abnormal values on CT scan or echocardiography, signs of vasculitis, or evidence of a significant medical condition meeting treatment discontinuation criteria will be exclusionary for continuation in the extended treatment period.
  • Participants who are planning to initiate treatment with an additional approved ALS therapy in the next 24 weeks are not allowed to continue in the extended treatment period.

Trial locations and contacts

4 sites in 3 countries.

4 sites in 3 countries

United States2 sites
  • Massachusetts General Hospital

    Boston, Massachusetts, 02114

  • Yale University School of Medicine

    New Haven, Connecticut, 06520-8048

Other trials in United States

Finland1 site
  • Novartis Investigative Site

    Turku, 20520

Other trials in Finland

Sweden1 site
  • Novartis Investigative Site

    Stockholm, 14186

Other trials in Sweden

About this study

Official title: An Open-label, Adaptive Design Study in Patients With Amyotrophic Lateral Sclerosis (ALS) to Characterize Safety, Tolerability and Brain Microglia Response, as Measured by TSPO Binding, Following Multiple Doses of BLZ945 Using Positron Emission Tomography (PET) With the Radioligand [11C]-PBR28

It was an open label study to evaluate safety, tolerability and brain microglia response in participants with Amyotrophic Lateral Sclerosis (ALS) following multiple doses of BLZ945.

Read the detailed description

The purpose of the study was to identify a dose (or doses) of BLZ945, that measurably decrease(s) 18 KDa Translocator Protein (TSPO) binding in the brain of participants with ALS. The study also aimed to evaluate the safety and tolerability of BLZ945 in participants with ALS at different doses and dosing regimens, and safety related effects on extracellular matrix (ECM) accumulation.

This was an exploratory, adaptive , open label study of approximately 16 participants in cohorts of 4 participants per cohort at increasing doses of BLZ945 with the last dose determined after the completion of cohorts 1 to 3.

Each cohort received treatment for 4 days and continued with a 32 day follow up period with an end of study visit at day 36.

After completion of the 4 initial cohorts a fifth cohort was initiated with two parallel arms receiving BLZ945 for up to 12 weeks at two different treatment regimens, either once weekly or 4 days of treatment followed by 10 days off drug.

Being tested
BLZ945
Keywords
PET, ALS, Microglia, CSF
Medical subject headings
Amyotrophic Lateral Sclerosis

What participants receive

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

  • BLZ945Drug

    Investigational drug capsules taken orally or via enteral infusion

Study groups in NCT04066244
Study groupRoleWhat they receive
Cohort 1OtherBLZ945 300mg
Receives: Drug: BLZ945
Cohort 2OtherBLZ945 600mg
Receives: Drug: BLZ945
Cohort 3OtherBLZ945 1200mg
Receives: Drug: BLZ945
Cohort 4OtherBLZ945 800mg
Receives: Drug: BLZ945
Cohort 5 Arm #1OtherBLZ945 800mg (4 days treatment + 10 days off)
Receives: Drug: BLZ945
Cohort 5 Arm #2OtherBLZ945 800mg (once weekly)
Receives: Drug: BLZ945

What is being measured

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

  1. Cohorts 1-4 : Change From Baseline in Volume of Distribution (Vt) in Different Brain Regions for [11C]-PBR28 PET Scan

    [11C]-PBR28 is a positron emission tomography (PET) radiotracer for the 18 kDa translocator protein (TSPO) that is used to image neuroinflammation in vivo. [11C]PBR28 imaging was used to measure microglial volume at baseline and after BLZ945 treatment in ALS participants.

    Relative % change from baseline in volume of distribution (Vt) of [11C]-PBR28 in different brain regions after BLZ945 treatment

    Measured: Baseline, day 5

  2. Cohort 5 (PET Sub-study): Change From Baseline in Volume of Distribution (Vt) in Different Brain Regions for [11C]-PBR28 PET Scan

    [11C]-PBR28 is a positron emission tomography (PET) radiotracer for the 18 kDa translocator protein (TSPO) that is used to image neuroinflammation in vivo. [11C]PBR28 imaging was used to measure microglial volume at baseline and after BLZ945 treatment in ALS participants.

    Relative % change from baseline in volume of distribution (Vt) of [11C]-PBR28 in different brain regions after BLZ945 treatment

    Measured: Baseline, day 84

  3. Cohort 5: Change From Baseline in Esophageal Wall Thickness

    Mean change from baseline in esophageal wall thickness measured in mm

    Measured: Baseline, Day 84

  4. Cohort 5: Cardiac Valve Thickness at Day 84 Compared to Baseline

    Cardiac valve thickness on a three point ordinal scale. Categorized by imaging vendor into three semiquantitative (normal, mild-moderate and severe) categories

    Measured: Baseline, Day 84

  5. Cohort 5: Cardiac Valve Stenosis at Day 84 Compared to Baseline

    Cardiac valve stenosis on a four point ordinal scale. Categorized by imaging vendor into four semiquantitative (normal, mild, moderate and severe) categories

    Measured: Baseline, Day 84

  6. Cohort 5: Cardiac Valve Regurgitation Severity at Day 84 Compared to Baseline

    Cardiac valve regurgitation severity on a four point ordinal scale. Categorized by imaging vendor into four semiquantitative (normal, mild, moderate and severe) categories

    Measured: Baseline, Day 84

  7. Cohort 5: Change From Baseline in Left Ventricular Ejection Fraction (LVEF)

    Mean change from baseline in Left Ventricular Ejection Fraction.

    LVEF is defined as the percentage of blood volume ejected from the left ventricle during systole (contraction phase) relative to the total volume of blood present in the ventricle at the end of diastole (relaxation phase).

    Measured: Baseline, day 84

  8. Cohort 5: Adverse Events Related to Extracellular Matrix (ECM) Accumulation

    Number of patients with adverse events related to ECM accumulation

    Measured: Up to Day 84

Secondary outcomes (6)
  1. Cohorts 1-5: Plasma Pharmacokinetics (PK) of BLZ945 - Cmax

    Measured by Cmax - The maximum plasma concentration of BLZ945

    Measured: Cohort 1-4: Pre-dose, 0.5, 1, 2, 4, 6, 8, 12 and 24 hours after BLZ945 dosing on Day 1 and Day 4. Cohort 5: pre-dose, 1, 2 and 4 hours after BLZ945 dosing on Day 1 (Arm#2 only) and Day 4 (Arm#1 only)

  2. Cohorts 1-5: Plasma Pharmacokinetics (PK) of BLZ945 - Tmax

    Measured by Tmax - Time to Reach the Maximum Concentration After Drug Administration of BLZ945.

    Actual recorded sampling times were taken into consideration for the calculation of PK parameters.

    Measured: Cohort 1-4: Pre-dose, 0.5, 1, 2, 4, 6, 8, 12 and 24 hours after BLZ945 dosing on Day 1 and Day 4. Cohort 5: pre-dose, 1, 2 and 4 hours after BLZ945 dosing on Day 1 (Arm#2 only) and Day 4 (Arm#1 only)

  3. Cohorts 1-5: Plasma Pharmacokinetics (PK) of BLZ945 - AUC

    Measured by AUC - Area under the curve of BLZ945

    AUC0-24h is the AUC calculated from time zero to 24 hours after dosing (end of a dosing interval).

    AUClast is the AUC from time zero to the last measurable concentration sampling time.

    Measured: Cohort 1-4: Pre-dose, 0.5, 1, 2, 4, 6, 8, 12 and 24 hours after BLZ945 dosing on Day 1 and Day 4. Cohort 5: pre-dose, 1, 2 and 4 hours after BLZ945 dosing on Day 1 (Arm#2 only) and Day 4 (Arm#1 only)

  4. Cohorts 1-4: Plasma Pharmacokinetics (PK) of BLZ945 - T1/2

    Measured by T1/2 - The elimination half-life of BLZ945

    Measured: Cohort 1-4: Pre-dose, 0.5, 1, 2, 4, 6, 8, 12 and 24 hours after BLZ945 dosing on Day 1 and Day 4.

  5. Cohorts 1-4: Renal Clearance (CLR) of BLZ945

    Urine renal clearance (CLR) of BLZ945

    Measured: pre-dose, 0-4, 4-8, 8-12 and 12-24 hours after BLZ945 dosing on Day 1 and Day 4

  6. Cohorts 1-5: Number of Patients With Adverse Events (AEs) and Serious Adverse Events (SAEs)

    Incidence and severity of AEs and SAEs by treatment group.

    AE grades to characterize the severity of the AEs were based on the Common Terminology Criteria for Adverse Events (CTCAE) version 5. For CTCAE, Grade 1 = mild; Grade 2 = moderate; Grade 3 = severe; Grade 4 = life-threatening; Grade 5 = death related to AE

    Measured: From first dose of study treatment up to 32 days after last dose (Day 36) for Cohorts 1-4 and up to 4 weeks after last dose (Day 330) for Cohort 5. *Maximum duration of exposure in Cohort 5 was 302 days. 302 + 28 days of FU=330 days

Timeline

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

  1. First posted26 Aug 2019
  2. Study start30 Dec 2019
  3. Primary completion1 Feb 2024
  4. Study completion1 Feb 2024

Why it stopped: Study terminated after assessment of potential benefit-risk from available data

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
Sequential
Model description
This study is an exploratory, adaptive, open-label study of single or multiple cycles of BLZ945 in participants with ALS. Cohorts 1-4 are not randomized, while Cohort 5 is randomized in open label two treatment arms. Cohorts 1-4 have single group design and Cohort 5 has parallel design.
Masking
None (open label)
Enrolment
28 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04066244
Sponsor's protocol ID
CBLZ945C12201
Other IDs
2019-000826-22, 2019
Status last verified
Oct 2025
First submitted
21 Aug 2019
Last updated
16 Oct 2025
Data monitoring committee
No
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
Yes: Novartis is committed to sharing access to patient-level data and supporting clinical documents from eligible studies with qualified external researchers. Requests are reviewed and approved by an independent review panel on the basis of scientific merit. All data provided is anonymized to protect the privacy of patients who have participated in the trial in line with applicable laws and regulations. This trial data availability is according to the criteria and process described on www.clinicalstudydatarequest.com

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing BLZ945 in people with Amyotrophic Lateral Sclerosis, run by Novartis Pharmaceuticals at 4 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 7 inclusion and 23 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: stopped early, as of the sponsor's last update on 16 Oct 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 4 sites in United States, Finland, Sweden. 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. 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?

Yes. Results are posted in the registry (first posted 19 Mar 2025). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

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?

Cohorts 1-4 : Change From Baseline in Volume of Distribution (Vt) in Different Brain Regions for [11C]-PBR28 PET Scan (time frame: Baseline, day 5). The study lists 8 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
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 16 Oct 2025.

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