Clinical Trials Register

Summary
EudraCT Number:	2015-001431-20
Sponsor's Protocol Code Number:	CHDR1417
National Competent Authority:	Netherlands - Competent Authority
Clinical Trial Type:	EEA CTA
Trial Status:	Completed
Date on which this record was first entered in the EudraCT database:	2015-04-21
Trial results	View results

Index
A. PROTOCOL INFORMATION
B. SPONSOR INFORMATION
C. APPLICANT IDENTIFICATION
D. IMP IDENTIFICATION
D.8 INFORMATION ON PLACEBO
E. GENERAL INFORMATION ON THE TRIAL
F. POPULATION OF TRIAL SUBJECTS
G. INVESTIGATOR NETWORKS TO BE INVOLVED IN THE TRIAL
N. REVIEW BY THE COMPETENT AUTHORITY OR ETHICS COMMITTEE IN THE COUNTRY CONCERNED
P. END OF TRIAL

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A. Protocol Information

A.1

Member State Concerned

Netherlands - Competent Authority

A.2

EudraCT number

2015-001431-20

A.3

Full title of the trial

A randomized, double blind, double-dummy placebo controlled, 3-way cross-over study to determine the test-retest reliability of, and the effect of oral retigabine and riluzole on, peripheral motor nerve excitability measurements in patients with ALS.

A.3.1

Title of the trial for lay people, in easily understood, i.e. non-technical, language

Trial to look at the nerve conductance in patients with ALS, with and without Riluzole or Retigabine.

A.3.2

Name or abbreviated title of the trial where available

Peripheral motor nerve excitability study in patients with ALS

A.4.1

Sponsor's protocol code number

CHDR1417

A.7

Trial is part of a Paediatric Investigation Plan

A.8

EMA Decision number of Paediatric Investigation Plan

B. Sponsor Information
B.Sponsor: 1
B.1.1	Name of Sponsor	Centre for Human Drug Research
B.1.3.4	Country	Netherlands
B.3.1 and B.3.2	Status of the sponsor	Non-Commercial
B.4 Source(s) of Monetary or Material Support for the clinical trial:
B.4.1	Name of organisation providing support	CHDR
B.4.2	Country	Netherlands
B.4.1	Name of organisation providing support	Biogen Idec Ltd
B.4.2	Country	United States
B.5 Contact point designated by the sponsor for further information on the trial
B.5.1	Name of organisation	CHDR
B.5.2	Functional name of contact point	Research Director
B.5.3	Address:
B.5.3.1	Street Address	Zernikedreef 8
B.5.3.2	Town/ city	Leiden
B.5.3.3	Post code	2333 CL
B.5.3.4	Country	Netherlands
B.5.6	E-mail	GGroeneveld@chdr.nl

D. IMP Identification
D.IMP: 1
D.1.2 and D.1.3	IMP Role	Test
D.2	Status of the IMP to be used in the clinical trial
D.2.1	IMP to be used in the trial has a marketing authorisation	Yes
D.2.1.1.1	Trade name	Rilutek 50 mg film-coated tablets
D.2.1.1.2	Name of the Marketing Authorisation holder	Aventis Pharma S.A.
D.2.1.2	Country which granted the Marketing Authorisation	European Union
D.2.5	The IMP has been designated in this indication as an orphan drug in the Community	No
D.2.5.1	Orphan drug designation number
D.3 Description of the IMP
D.3.1	Product name	Rilutek
D.3.4	Pharmaceutical form	Film-coated tablet
D.3.4.1	Specific paediatric formulation	No
D.3.7	Routes of administration for this IMP	Oral use
D.3.8 to D.3.10 IMP Identification Details (Active Substances)
D.3.8	INN - Proposed INN	RILUZOLE
D.3.9.1	CAS number	1744-22-5
D.3.9.4	EV Substance Code	SUB10319MIG
D.3.10	Strength
D.3.10.1	Concentration unit	mg milligram(s)
D.3.10.2	Concentration type	equal
D.3.10.3	Concentration number	100
D.3.11 The IMP contains an:
D.3.11.1	Active substance of chemical origin	Yes
D.3.11.2	Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP)	No
	The IMP is a:
D.3.11.3	Advanced Therapy IMP (ATIMP)	No
D.3.11.3.1	Somatic cell therapy medicinal product	No
D.3.11.3.2	Gene therapy medical product	No
D.3.11.3.3	Tissue Engineered Product	No
D.3.11.3.4	Combination ATIMP (i.e. one involving a medical device)	No
D.3.11.3.5	Committee on Advanced therapies (CAT) has issued a classification for this product	No
D.3.11.4	Combination product that includes a device, but does not involve an Advanced Therapy	No
D.3.11.5	Radiopharmaceutical medicinal product	No
D.3.11.6	Immunological medicinal product (such as vaccine, allergen, immune serum)	No
D.3.11.7	Plasma derived medicinal product	No
D.3.11.8	Extractive medicinal product	No
D.3.11.9	Recombinant medicinal product	No
D.3.11.10	Medicinal product containing genetically modified organisms	No
D.3.11.11	Herbal medicinal product	No
D.3.11.12	Homeopathic medicinal product	No
D.3.11.13	Another type of medicinal product	No
D.IMP: 2
D.1.2 and D.1.3	IMP Role	Test
D.2	Status of the IMP to be used in the clinical trial
D.2.1	IMP to be used in the trial has a marketing authorisation	Yes
D.2.1.1.1	Trade name	Trobalt
D.2.1.1.2	Name of the Marketing Authorisation holder	Glaxo Group Limited
D.2.1.2	Country which granted the Marketing Authorisation	European Union
D.2.5	The IMP has been designated in this indication as an orphan drug in the Community	No
D.2.5.1	Orphan drug designation number
D.3 Description of the IMP
D.3.1	Product name	Trobalt
D.3.4	Pharmaceutical form	Film-coated tablet
D.3.4.1	Specific paediatric formulation	No
D.3.7	Routes of administration for this IMP	Oral use
D.3.8 to D.3.10 IMP Identification Details (Active Substances)
D.3.8	INN - Proposed INN	RETIGABINE
D.3.9.1	CAS number	150812-12-7
D.3.9.4	EV Substance Code	SUB10291MIG
D.3.10	Strength
D.3.10.1	Concentration unit	mg milligram(s)
D.3.10.2	Concentration type	equal
D.3.10.3	Concentration number	300
D.3.11 The IMP contains an:
D.3.11.1	Active substance of chemical origin	Yes
D.3.11.2	Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP)	No
	The IMP is a:
D.3.11.3	Advanced Therapy IMP (ATIMP)	No
D.3.11.3.1	Somatic cell therapy medicinal product	No
D.3.11.3.2	Gene therapy medical product	No
D.3.11.3.3	Tissue Engineered Product	No
D.3.11.3.4	Combination ATIMP (i.e. one involving a medical device)	No
D.3.11.3.5	Committee on Advanced therapies (CAT) has issued a classification for this product	No
D.3.11.4	Combination product that includes a device, but does not involve an Advanced Therapy	No
D.3.11.5	Radiopharmaceutical medicinal product	No
D.3.11.6	Immunological medicinal product (such as vaccine, allergen, immune serum)	No
D.3.11.7	Plasma derived medicinal product	No
D.3.11.8	Extractive medicinal product	No
D.3.11.9	Recombinant medicinal product	No
D.3.11.10	Medicinal product containing genetically modified organisms	No
D.3.11.11	Herbal medicinal product	No
D.3.11.12	Homeopathic medicinal product	No
D.3.11.13	Another type of medicinal product	No

D.8 Information on Placebo
D.8 Placebo: 1
D.8.1	Is a Placebo used in this Trial?	Yes
D.8.3	Pharmaceutical form of the placebo	Capsule
D.8.4	Route of administration of the placebo	Oral use

E. General Information on the Trial

E.1 Medical condition or disease under investigation

E.1.1

Medical condition(s) being investigated

Amytrophic Lateral Sclerosis

E.1.1.1

Medical condition in easily understood language

Neuromuscular disorder that involves death of neurons, leading to muscle weakness due to muscle wasting.

E.1.1.2

Therapeutic area

Diseases [C] - Nervous System Diseases [C10]

MedDRA Classification

E.1.2 Medical condition or disease under investigation

E.1.2	Version	18.1
E.1.2	Level	PT
E.1.2	Classification code	10002026
E.1.2	Term	Amyotrophic lateral sclerosis
E.1.2	System Organ Class	10029205 - Nervous system disorders

E.1.3

Condition being studied is a rare disease

E.2 Objective of the trial

E.2.1

Main objective of the trial

To evaluate the test-retest reliability of nerve excitability threshold tracking in patients with ALS.

E.2.2

Secondary objectives of the trial

• To investigate the ability of Strength Duration Time Constant (SDTC) to detect effects of retigabine and riluzole in patients with ALS.
• To investigate the ability of Refractoriness at 2 ms to detect effects of retigabine and riluzole in patients with ALS.
• To investigate the ability of Superexcitability to detect effects of retigabine and riluzole in patients with ALS.
• To investigate the ability of depolarizing Threshold Electrotonus (40-60 ms)to detect effects of retigabine and riluzole in patients with ALS.
• To investigate the ability of depolarizing Threshold Electrotonus (90-100 ms) to detect effects of retigabine and riluzole in patients with ALS.
• To determine if there is a correlation between ALSFRS-R score at baseline and at 3 months and motor nerve excitability measures refractoriness at 2 ms, superexcitability, depolarizing Threshold Electrotonus (40-60 ms), depolarizing Threshold Electrotonus (90-100 ms) or Strength Duration time Constant at baseline on day 0.

E.2.3

Trial contains a sub-study

E.3

Principal inclusion criteria

1. Ability to understand the purpose and risks of the study and provide signed and dated informed consent.
2. Aged 18 to 80 years old, inclusive, at the time of informed consent.
3. Women of childbearing potential must practice effective contraception for the duration of the study.
4. Willing to limit the intake of alcohol to no more than 2 units per day from the screening visit to the the last scheduled visit and to refrain from alcohol intake 48 hours prior to each study visit until their stay in the clinical research unit. One unit of alcohol is defined as 1 pint of beer (350 mL), 1 glass of wine (150 mL) or 1 shot of liquor (30 mL).
5. Willing to refrain from marijuana use throughout the study.
6. Willing to refrain from vigorous exercise within 48 hours prior to each study visit.
7. Must have a diagnosis of “definite”, “probable”, or “probable laboratory-supported”, ALS according to the World Federation of Neurology El Escorial criteria (revised according to the Airlie House Conference 1998 [Brooks 1999]). \
8. Fasciculations in the arms observed by the treating neurologist

E.4

Principal exclusion criteria

1. History of diabetes or neuropathy.
2. History of neuromuscular disorders (other than ALS) including but not limited to ALS mimic syndromes, myopathy, myasthenia gravis, and other motor neuron diseases.
3. Median nerve CMAP less than 1 mV.
4. Unstable cardiac, pulmonary, renal, hepatic disease or active malignancy.
5. Clinically significant abnormalities in laboratory test results as judged by the investigator. In the case of uncertain or questionable results, laboratory tests performed during the screening visit may be repeated 1 time before participation in the study to confirm eligibility or may be judged to be clinically irrelevant.
6. History or symptoms of any clinically significant cardiac, endocrinologic, hematologic, hepatic, immunologic, metabolic, urologic, pulmonary, neurologic, dermatologic, psychiatric, renal, and ophthalmologic or other major disease, as determined by the investigator (with the exception of the neurological syndrome listed in the inclusion criteria section).
7. 12-lead ECG demonstrating QTcB >450 msec at Screening.
8. Concomitant disease or condition that can interfere with the conduct of the study, or that in the opinion of the investigator, would pose an unacceptable risk to the subject in this study.
9. History of trauma to the upper extremities or other orthopaedic conditions that, in the opinion of the investigator, could affect the electrophysiological measurements.
10. Use of medications including but not limited to anticholinergics and muscle relaxants that, in the opinion of the investigator, could affect the electrophysiological measurements within 2 weeks prior to first dosing or within 6 times the elimination half-life of the medication prior to first dosing (whichever is longer).
11. Current enrolment in any interventional clinical study in which treatment with an investigational drug or approved therapy for investigational use is administered within 30 days prior to the screening or participation in an interventional study for an investigational drug or device within 3 months prior to Screening.
12. Pregnant, breastfeeding, or a positive pregnancy test result at Screening.
13. A positive urine test for drugs of abuse at Screening.
14. Unwillingness or inability to comply with study requirements.
15. Unspecified reasons that, in the opinion of the Investigator, make the subject unsuitable for enrollment.

E.5 End points

E.5.1

Primary end point(s)

• ICC for nerve excitability parameters.

E.5.1.1

Timepoint(s) of evaluation of this end point

For each occasion at pre-dose and at 1 or 2 hours post-dose and 5 or 6 hours post-dose

E.5.2

Secondary end point(s)

• Axonal excitability parameters of motor axons in the median nerve.
o CMAP
o Strength Duration Time Constant (SDTC)
o Refractoriness at 2 ms
o Superexcitability
o Subexcitability
o depolarizing Threshold Electrotonus (40-60 ms)
o depolarizing Threshold Electrotonus (90-100 ms)
o hyperpolarizing Threshold Electrotonus (90-100 ms)
o Rheobase
o Hyperpolarizing I/V gradient
• Points change in ALSFRS-R scale at 3 months compared to baseline.
• Muscle strength and fatigue variables as measured with the POWERjar:
o Maximum grip strength in kilograms
o Time in seconds to reach a grip strength 10% below the maximal grip strength
o Time in seconds to reach a torque 10% (or higher, if applicable) below the predefined resistance for torque
o Time in seconds to fully release grip.

E.5.2.1

Timepoint(s) of evaluation of this end point

For each occasion at pre-dose and at 1 or 2 hours post-dose and 5 or 6 hours post-dose

ALSFRS-R will be taken at day 0 and at the 90 day follow-up phone-call.

POWERjar will be measured in two occasions at 4 hours post dose.

E.6 and E.7 Scope of the trial

E.6

Scope of the trial

E.6.1

Diagnosis

E.6.2

Prophylaxis

E.6.3

Therapy

Yes

E.6.4

Safety

E.6.5

Efficacy

E.6.6

Pharmacokinetic

Yes

E.6.7

Pharmacodynamic

Yes

E.6.8

Bioequivalence

E.6.9

Dose response

E.6.10

Pharmacogenetic

E.6.11

Pharmacogenomic

E.6.12

Pharmacoeconomic

E.6.13

Others

Yes

E.6.13.1

Other scope of the trial description

Biomarker development

E.7

Trial type and phase

E.7.1

Human pharmacology (Phase I)

E.7.1.1

First administration to humans

E.7.1.2

Bioequivalence study

E.7.1.3

Other

E.7.1.3.1

Other trial type description

E.7.2

Therapeutic exploratory (Phase II)

Yes

E.7.3

Therapeutic confirmatory (Phase III)

E.7.4

Therapeutic use (Phase IV)

E.8 Design of the trial

E.8.1

Controlled

Yes

E.8.1.1

Randomised

Yes

E.8.1.2

Open

E.8.1.3

Single blind

E.8.1.4

Double blind

Yes

E.8.1.5

Parallel group

E.8.1.6

Cross over

Yes

E.8.1.7

Other

E.8.2

Comparator of controlled trial

E.8.2.1

Other medicinal product(s)

E.8.2.2

Placebo

Yes

E.8.2.3

Other

E.8.2.4

Number of treatment arms in the trial

E.8.3

The trial involves single site in the Member State concerned

Yes

E.8.4

The trial involves multiple sites in the Member State concerned

E.8.5

The trial involves multiple Member States

E.8.6 Trial involving sites outside the EEA

E.8.6.1

Trial being conducted both within and outside the EEA

E.8.6.2

Trial being conducted completely outside of the EEA

E.8.7

Trial has a data monitoring committee

E.8.8

Definition of the end of the trial and justification where it is not the last visit of the last subject undergoing the trial

Last subject Last Contact (follow-up phone call).

E.8.9 Initial estimate of the duration of the trial

E.8.9.1

In the Member State concerned years

E.8.9.1

In the Member State concerned months

E.8.9.1

In the Member State concerned days

F. Population of Trial Subjects

F.1 Age Range

F.1.1

Trial has subjects under 18

F.1.1.1

In Utero

F.1.1.2

Preterm newborn infants (up to gestational age < 37 weeks)

F.1.1.3

Newborns (0-27 days)

F.1.1.4

Infants and toddlers (28 days-23 months)

F.1.1.5

Children (2-11years)

F.1.1.6

Adolescents (12-17 years)

F.1.2

Adults (18-64 years)

Yes

F.1.2.1

Number of subjects for this age range:

F.1.3

Elderly (>=65 years)

F.2 Gender

F.2.1

Female

Yes

F.2.2

Male

Yes

F.3 Group of trial subjects

F.3.1

Healthy volunteers

F.3.2

Patients

Yes

F.3.3

Specific vulnerable populations

Yes

F.3.3.1

Women of childbearing potential not using contraception

F.3.3.2

Women of child-bearing potential using contraception

Yes

F.3.3.3

Pregnant women

F.3.3.4

Nursing women

F.3.3.5

Emergency situation

F.3.3.6

Subjects incapable of giving consent personally

F.3.3.7

Others

F.4 Planned number of subjects to be included

F.4.1

In the member state

F.5

Plans for treatment or care after the subject has ended the participation in the trial (if it is different from the expected normal treatment of that condition)

None

G. Investigator Networks to be involved in the Trial

N. Review by the Competent Authority or Ethics Committee in the country concerned

Competent Authority Decision

Authorised

Date of Competent Authority Decision

2015-04-20

Ethics Committee Opinion of the trial application

Favourable

Ethics Committee Opinion: Reason(s) for unfavourable opinion

Date of Ethics Committee Opinion

2015-08-17

P. End of Trial
P.	End of Trial Status	Completed

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