Clinical trial
Targeting Metabolic Flexibility in ALS (MetFlex); Safety and Tolerability of Trimetazidine for the Treatment of ALS
Name
MetFlex
Description
MetFlex is an investigator led, open-label, single-arm, Phase 2a trial to determine the safety and tolerability of trimetazidine for the treatment of amyotrophic lateral sclerosis/motor neuron disease (ALS/MND).
Trial arms
Trial start
2021-06-29
Estimated PCD
2023-05-24
Trial end
2023-05-24
Status
Completed
Phase
Early phase I
Treatment
Trimetazidine Dihydrochloride
Oral tablet, twice-daily
Arms:
Experimental
Size
21
Primary endpoint
Incidence of Treatment-Emergent Adverse Events; Safety and Tolerability
16 weeks
Level of expression of oxidative stress markers in the plasma and/or serum of trial participants
16 weeks
Eligibility criteria
Inclusion Criteria:
* Age between 18 and 75 years
* Signed informed consent prior to the initiation of any study-specific procedures
* Familial or sporadic ALS/MND, defined as clinically possible, probable, or definite as per the El Escorial criteria
* Relative TRICALS risk score between -6.0 to -2.0 (75% of patients with ALS/MND)
* Metabolic index ≥110%, at the screening visit.
* The use of riluzole will be permitted during the study. Individuals taking riluzole must be on a stable dose for at least 30 days prior to the baseline visit, or stopped taking riluzole at least 30 days prior to the baseline visit.
* Ability to swallow tablets
* Able to lie with torso elevated at a 35° angle for 30 minutes without respiratory support
* Able to give informed consent (as judged by the investigator) and able to comply with all study visits and all study procedures
* Females must not be able to become pregnant (e.g. post-menopausal, surgically sterile or using highly effective birth control methods) for the duration of the study. Highly effective methods of birth control are those with a failure rate of \< 1% per year when employed consistently and correctly, e.g. Combined (oestrogen and progestogen containing) hormonal contraception associated with inhibition of ovulation:
* oral
* intravaginal
* transdermal
* Progestogen-only hormonal contraception associated with inhibition of ovulation:
* oral
* injectable
* implantable
* intrauterine device (IUD)
* intrauterine hormone-releasing system ( IUS)
* vasectomised partner
* Females of child-bearing potential must have a negative serum pregnancy test at screening and baseline and be non-lactating
Exclusion Criteria:
* Unable to provide informed consent
* History of, or current diagnosis of diabetes or medical condition that impacts whole body energy expenditure (e.g. Hashimoto's, heart disease)
* Parkinson's disease or parkinsonism, tremor, restless-leg syndrome
* Safety Laboratory Criteria at screening related to significant kidney disease:
* Creatinine clearance \< 50 mL / min (Cockcroft-Gault) based on Cystatin C
* Tracheostomy or non-invasive ventilation (NIV) use \> 22 hours per day
* Inability to swallow tablets
* Contraindication therapy:
* Allergy for one of the product's active pharmaceutical ingredients (APIs) or excipients.
* Antihypertensive treatment \[Trimetazidine may cause hypotension\]
* Evidence of malignant disease
* Significant neuromuscular disease other than ALS/MND
* Ongoing disease that may cause neuropathy
* Pregnancy or breastfeeding
* Females actively seeking to become pregnant who are not using an adequate form of contraceptive as detailed in the Inclusion criteria.
* Deprivation of freedom by administrative or court order
Protocol
{'studyType': 'INTERVENTIONAL', 'phases': ['PHASE2'], 'designInfo': {'allocation': 'NA', 'interventionModel': 'SINGLE_GROUP', 'interventionModelDescription': 'Open-label, single-arm study without placebo', 'primaryPurpose': 'TREATMENT', 'maskingInfo': {'masking': 'NONE'}}, 'enrollmentInfo': {'count': 21, 'type': 'ACTUAL'}}
Updated at
2023-07-20
1 organization
1 product
2 indications
Organization
The University of QueenslandProduct
TrimetazidineIndication
Amyotrophic lateral sclerosisIndication
Motor Neuron Disease