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Amyotrophic Lateral SclerosisPhase 3NCT04248465

An Efficacy and Safety Study of Ravulizumab in ALS Participants

A Phase 3 study testing Ravulizumab in people with Amyotrophic Lateral Sclerosis and ALS, run by Alexion Pharmaceuticals, Inc. at 95 sites in 17 countries.

Terminated

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

Official record
Search all trials

Trial summary

The purpose of the study is to assess the efficacy and safety of ravulizumab for the treatment of adult participants with ALS. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Amyotrophic Lateral Sclerosis, ALS
What is being tested?
Ravulizumab
Type of treatment
Injection or infusion
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
382 participants
Where
95 sitesin 17 countries
Study dates
30 Mar 2020to 17 Oct 2021
Phase
Phase 3
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 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • A diagnosis of sporadic or familial ALS, defined by the El Escorial criteria (possible, laboratory-supported probable, probable, or definite ALS).
  • ALS onset ≤ 36 months from Screening.
  • Documented meningococcal vaccination not more than 3 years prior to, or at the time of, initiating study treatment.
  • Upright slow vital capacity ≥ 65% predicted at Screening.
  • If on riluzole, participant must be on a stable dose for 30 days; if on edaravone, participant must be on a stable dose for 60 days (2 cycles).
  • Body weight ≥ 40 kilograms at Screening.
  • Contraceptive use by men or women should be consistent with local regulations regarding the methods of contraception for those participating in clinical studies.

Who cannot join

  • History of Neisseria meningitidis infection.
  • Human immunodeficiency virus (HIV) infection (evidenced by HIV 1 or HIV 2 antibody titer).
  • Dependence on invasive or non-invasive mechanical ventilation.
  • Previously or currently treated with a complement inhibitor.
  • Exposure to an investigational drug or device within 30 days of Screening or 5 half lives of the study drug, whichever is greater.

Trial locations and contacts

95 sites in 17 countries.

95 sites in 17 countries

United States34 sites
  • University of Colorado Anschutz Medical Campus School of Medicine

    Aurora, Colorado, 80045

  • Austin Neuromuscular Center

    Austin, Texas, 78756

  • Johns Hopkins University School Of Medicine

    Baltimore, Maryland, 21205

  • Massachusetts General Hospital

    Boston, Massachusetts, 02114

  • University of Vermont Medical Center

    Burlington, Vermont, 05401

  • Atrium Health Neuroscience Institute

    Charlotte, North Carolina, 28207

  • University of Chicago Medical Center

    Chicago, Illinois, 60637

  • The Cleveland Clinic Foundation

    Cleveland, Ohio, 44195

  • The Ohio State University

    Columbus, Ohio, 43221

  • Houston Methodist Neurological Institute-Movement Disorders Clinic

    Houston, Texas, 77030

  • Nerve & Muscle Center of Texas

    Houston, Texas, 77030

  • Indiana University Medical Center

    Indianapolis, Indiana, 46202

  • University of Florida at Shands Jacksonville

    Jacksonville, Florida, 32209

  • University of Kansas Medical Center Research Institute, Inc.

    Kansas City, Kansas, 66160

  • Las Vegas Clinic

    Las Vegas, Nevada, 89145

  • University of Kentucky

    Lexington, Kentucky, 40536

  • Loma Linda University Medical Center

    Loma Linda, California, 92354

  • University of Southern California

    Los Angeles, California, 90033

  • Vanderbilt University Medical Center

    Nashville, Tennessee, 37232

  • Beth Israel Medical Center - PRIME

    New York, New York, 10003

  • Hospital for Special Surgery

    New York, New York, 10021

  • University of California-Irvine

    Orange, California, 92868

  • Stanford University Medical Center

    Palo Alto, California, 94304

  • Barrow Neurological Institute

    Phoenix, Arizona, 85013

  • Neuromuscular Research Center and Clinic

    Phoenix, Arizona, 85028

  • Allegheny Neurological Associates

    Pittsburgh, Pennsylvania, 15212

  • Virginia Commonwealth University, Neurology Clinical and Translational Research Office

    Richmond, Virginia, 23298

  • University of California San Diego Medical Center

    San Diego, California, 92093-0949

  • Norris MDA/ALS Center

    San Francisco, California, 94115

  • University of California San Francisco Medical Center

    San Francisco, California, 94143

  • HonorHealth Research Institute

    Scottsdale, Arizona, 85251

  • Swedish Neuroscience Institute

    Seattle, Washington, 98122-4470

  • University of South Florida

    Tampa, Florida, 33612

  • Sentara Neurology Specialists

    Virginia Beach, Virginia, 23456

Other trials in United States

Japan10 sites
  • Medical Hospital, Tokyo Medical and Dental University

    Bunkyō City, Tokyo-To, 113-8519

  • Chiba University Hospital

    Chiba, Chiba, 260-8677

  • Yoshino Neurology Clinic

    Ichikawa-shi, Chiba, 272-0827

  • Nagoya University Hospital

    Nagoya, Aichi-ken, 466-8560

  • Niigata University Medical & Dental Hospital

    Niigata, Niigata, 951-8520

  • Toho University Omori Medical Center

    Ōta-ku, Tokyo-To, 143-8541

  • Shiga University of Medical Science Hospital

    Ōtsu, Shiga, 520-2192

  • Tohoku University Hospital

    Sendai, Miyagi, 980-8574

  • Keio University Hospital

    Shinjuku-Ku, Tokyo-To, 160-8582

  • Tokushima University Hospital

    Tokushima, Tokushima, 770-8503

Other trials in Japan

France8 sites
  • Hopital Neurologique Pierre Wertheimer

    Bron, Rhone, 69677

  • Hopital Roger Salengro - CHU Lille

    Lille, 59037

  • CHU de Limoges - Hôpital Dupuytren

    Limoges, Haute Vienne, 87042

  • Hôpital de la Timone

    Marseille, 13385

  • Hopital Gui de Chauliac

    Montpellier, Herault, 34295

  • CHU de Nice Hôpital Pasteur 2

    Nice, Alpes Maritimes, 06001

  • Groupe Hospitalier Pitie-Salpetriere

    Paris, 75651

  • CHU Tours - Hôpital Bretonneau

    Tours, Indre Et Loire, 37044

Other trials in France

Canada7 sites
  • Heritage Medical Research Centre (HMRC)

    Edmonton, Alberta, T6G2S2

  • Stan Cassidy Center for Rehabilitation

    Fredericton, New Brunswick, E3B 0C7

  • LHSC - University Hospital

    London, Ontario, N6A 5A5

  • Montreal Neurological Institute and Hospital

    Montreal, Quebec, H3A 2B4

  • University Hospital of Quebec-Universite Laval

    Québec, Quebec, G1J 1Z4

  • Royal University Hospital

    Saskatoon, Saskatchewan, S7K 0M7

  • Toronto Sunnybrook Hospital

    Toronto, Ontario, M4N 3M5

Other trials in Canada

Italy7 sites
  • Ospedale San Raffaele

    Milan, 20132

  • ICS Maugeri IRCCS

    Milan, 20138

  • Istituto Auxologico Italiano

    Milan, 20149

  • Azienda Ospedaliero-Universitaria di Modena - Ospedale Civile di Baggiovara

    Modena, 1355 - 41126

  • Azienda Ospedaliero Universitaria Policlinico Paolo Giaccone

    Palermo, 90127

  • Azienda Ospedaliero Universitaria Pisana

    Pisa, 56126

  • University of Turin

    Torino, 10126

Other trials in Italy

Germany5 sites
  • Universitaetsmedizin Goettingen

    Goettigen, Lower Saxony, 37099

  • Medizinische Hochschule Hannover

    Hanover, Lower Saxony, 30625

  • Universitaetsklinikum Jena

    Jena, Thuringia, 07749

  • Klinikum rechts der Isar der TU Muenchen

    Munich, Bavaria, 81675

  • Universitaetsklinikum Ulm

    Ulm, Baden-Wurttemberg, 89081

Other trials in Germany

Spain5 sites
  • Hospital de la Santa Creu i Sant Pau

    Barcelona, 08025

  • Hospital Universitari Vall d'Hebron

    Barcelona, 08035

  • Hospital Universitari de Bellvitge

    L'Hospitalet de Llobregat, Barcelona, 08907

  • Hospital San Rafael

    Madrid, 28016

  • Hospital Universitari i Politecnic La Fe

    Valencia, 46026

Other trials in Spain

Australia4 sites
  • Brain and Mind Centre

    Camperdown, New South Wales, 2050

  • Royal Brisbane and Women's Hospital

    Herston, Queensland, 4029

  • Perron Institute for Neurological and Translational Science

    Nedlands, Western Australia, 6009

  • Westmead Hospital

    Westmead, New South Wales, 2145

Other trials in Australia

Denmark3 sites
  • Ålborg Universitets Hospital

    Aalborg, 9100

  • Aarhus University Hospital Department of Neurology

    Aarhus, 8200

  • Bispebjerg Hospital

    Copenhagen, 2400

Other trials in Denmark

Israel3 sites
  • Rambam Health Care Center

    Haifa, 91096

  • Hadassah University Hospital - Ein Kerem

    Jerusalem, 91120

  • Tel Aviv Sourasky Medical Center

    Tel Aviv, 6423906

Other trials in Israel

Sweden2 sites
  • Karolinska Trial Alliance (KTA)

    Huddinge, 141 86

  • Norrlands universitetssjukhus

    Umeå, 90185

Other trials in Sweden

United Kingdom2 sites
  • The National Hospital for Neurology & Neurosurgery

    London, Greater London, WC1N 3BG

  • Royal Hallamshire Hospital

    Sheffield, West Midlands, S10 2JF

Other trials in United Kingdom

Belgium1 site
  • UZ Leuven

    Leuven, 3000

Other trials in Belgium

Ireland1 site
  • Beaumont Hospital

    Dublin, DUBLIN 9

Other trials in Ireland

Netherlands1 site
  • University Medical Centre Utrecht

    Utrecht, 3508 GA

Other trials in Netherlands

Poland1 site
  • CityClinic

    Warsaw, 02-473

Other trials in Poland

Switzerland1 site
  • Kantonsspital St. Gallen

    Sankt Gallen, 9007

Other trials in Switzerland

About this study

Official title: A Phase 3, Double-Blind, Randomized, Placebo-Controlled, Parallel Group, Multicenter Study With an Open-Label Extension to Evaluate the Efficacy and Safety of Ravulizumab in Patients With Amyotrophic Lateral Sclerosis (ALS)

The purpose of the study is to assess the efficacy and safety of ravulizumab for the treatment of adult participants with ALS.

Being tested
Placebo, Ravulizumab
Keywords
Ravulizumab, ALXN1210, Ultomiris, Motor Neuron Disease, Amyotrophic Lateral Sclerosis, ALS
Medical subject headings
Amyotrophic Lateral Sclerosis, Motor Neuron Disease

What participants receive

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

  • PlaceboDrug

    Single loading dose via intravenous infusion, followed by regular maintenance dosing, based on weight.

  • RavulizumabBiological

    Also called ALXN1210, Ultomiris

    Single loading dose via intravenous infusion, followed by regular maintenance dosing, based on weight.

Study groups in NCT04248465
Study groupRoleWhat they receive
RavulizumabExperimentalParticipants will receive ravulizumab for the duration of the study.
Receives: Biological: Ravulizumab
PlaceboPlacebo comparatorParticipants will receive placebo during the 50-week Randomized Controlled Period of the study, after which they will enter the Open-label Extension Period of the study and switch to receive ravulizumab.
Receives: Drug: Placebo; Biological: Ravulizumab

What is being measured

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

  1. Change From Baseline In Amyotrophic Lateral Sclerosis Functional Rating Scale-Revised (ALSFRS-R) Total Score

    The ALSFRS-Revised is a validated instrument for evaluating the levels of the functional status of participants with amyotrophic lateral sclerosis (ALS) in 4 areas, including bulbar, gross motor activity, fine motor activity, and respiratory functions. The scale included 12 functional items and each item is rated on a 0 to 4 scale, with a maximum total score of 48. A higher score indicated greater retention of function. Baseline was defined as last non-missing value on or before first study drug administration.

    Measured: Baseline, Week 50

Secondary outcomes (8)
  1. Time To Ventilator Assistance-free Survival

    Ventilation Assistance-Free Survival (VAFS) is a composite endpoint of survival and severe and irreversible respiratory decline. The use of VAFS allowed for the collection of survival data that was not impacted by survival prolongation from noninvasive or permanent ventilatory interventions which could prolong life without impacting underlying disease progression.

    Measured: Up to Week 50

  2. Change From Baseline In Percent Predicted Slow Vital Capacity

    Slow vital capacity measures slow and gradual expulsion of air from the lungs using a spirometer.

    Measured: Baseline, Week 50

  3. Number of Participants With Treatment-emergent Adverse Events (TEAEs), Treatment-emergent Serious Adverse Events, and TEAEs Leading To Study Drug Discontinuation

    An adverse event (AE) was defined as any unfavorable and unintended sign (for example, including an abnormal laboratory finding), symptom, or disease temporally associated with the use of a medicinal product or procedure, whether or not considered related to the medicinal product or procedure, which occurred during the course of the clinical study. TEAEs were defined as AEs that occurred on or after the date and time of study drug administration, or those that first occurred before dosing but worsened in frequency or severity after study drug administration. A summary of all Serious Adverse Events and Other Adverse Events (nonserious) regardless of causality is located in the 'Reported Adverse Events' Section.

    Measured: Baseline up to Week 156

  4. Change From Baseline In Muscle Strength As Assessed By Handheld Dynamometry

    Handheld dynamometry (HHD) is a procedure for quantitative strength testing. Muscle strength testing was performed on prespecified muscles in the upper and lower extremities bilaterally and the force measurements were recorded. Force of measurement is reported in megascores (lower, upper, total). The total megascore is defined as the average of the non-missing ratios over baseline for all the muscles involved. The megascore at baseline is always 100. The range of a potential megascore can not be determined in advance. A megascore >100 indicates more strength compared to baseline.

    Measured: Baseline, Week 50

  5. Change From Baseline In Serum Neurofilament Light Chain

    Measured: Baseline, Week 50

  6. Change From Baseline in Serum Ravulizumab Concentration Over the Study Duration

    Measured: Baseline, Predose at Week 50

  7. Change From Baseline in Serum Free Complement Component 5 (C5) Concentration Over the Study Duration

    Measured: Baseline, Predose at Week 50

  8. Number of Participants With Positive Antidrug Antibodies (ADAs) to ALXN1210

    Blood samples were collected to evaluate antibody response through development of ADAs.

    Measured: Week 50

Timeline

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

  1. First posted30 Jan 2020
  2. Study start30 Mar 2020
  3. Primary completion17 Oct 2021
  4. Study completion17 Oct 2021

Why it stopped: The IDMC recommended the study be discontinued due to lack of efficacy with ravulizumab.

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 3
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
382 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04248465
Sponsor's protocol ID
ALXN1210-ALS-308
Other IDs
2019-004619-30, 2019
Status last verified
Dec 2022
First submitted
27 Jan 2020
Last updated
10 Jan 2023
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No

Publications

  • Genge A, van den Berg LH, Frick G, Han S, Abikoff C, Simmons A, Lin Q, Patra K, Kupperman E, Berry JD. Efficacy and Safety of Ravulizumab, a Complement C5 Inhibitor, in Adults With Amyotrophic Lateral Sclerosis: A Randomized Clinical Trial. JAMA Neurol. 2023 Oct 1;80(10):1089-1097. doi: 10.1001/jamaneurol.2023.2851.

    PubMed 37695623

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing Ravulizumab in people with Amyotrophic Lateral Sclerosis and ALS, run by Alexion Pharmaceuticals, Inc. at 95 sites in 17 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 5 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 10 Jan 2023. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 95 sites in United States, Japan, France, Canada, Italy and 12 more countries. 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 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

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 10 Jan 2023). 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?

Change From Baseline In Amyotrophic Lateral Sclerosis Functional Rating Scale-Revised (ALSFRS-R) Total Score (time frame: Baseline, Week 50). 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 NCT04248465, which also lists 1 linked publication.

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 10 Jan 2023.

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