| E.1 Medical condition or disease under investigation | 
| E.1.1 | Medical condition(s) being investigated  | 
| Amyotrophic Lateral Sclerosis (ALS) | 
 
 
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| E.1.1.1 | Medical condition in easily understood language  | 
| ALS (also known as Lou Gehrig's disease or motor neuron disease) is a progressive and fatal degeneration of the nervous system. | 
 
 
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| 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  | 21.1 | 
 
| 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 | 
 
 
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| E.1.3 | Condition being studied is a rare disease  |  Yes  | 
| E.2 Objective of the trial | 
| E.2.1 | Main objective of the trial  | 
 To assess the long-term safety and tolerability of reldesemtiv in patients with ALS. | 
 
 
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| E.2.2 | Secondary objectives of the trial  | 
To assess the long-term effect of reldesemtiv on ALSFRS-R functional outcomes and hospitalization by comparing early-start to delayed-start groups from CY 5031 | 
 
 
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| E.2.3 | Trial contains a sub-study  |  No  | 
| E.3 | Principal inclusion criteria  | 
• Able to comprehend and willing to sign an Informed Consent Form (ICF). If patient is able to comprehend, but non-written consent is given, an impartial witness of the patient must sign the ICF form • Completed dosing in CY 5031 | 
 
 
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| E.4 | Principal exclusion criteria | 
| • Has taken an investigational study drug (other than reldesemtiv) prior to dosing, within 30 days or five half-lives of the prior agent, whichever is greater | 
 
 
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| E.5 End points | 
| E.5.1 | Primary end point(s) | 
The incidence of adverse events (AEs) in the patient population | 
 
 
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| E.5.1.1 | Timepoint(s) of evaluation of this end point | 
 | 
| E.5.2 | Secondary end point(s) | 
• Combined assessment of change in ALSFRS-R total score, time to dependence on assisted ventilation (use non-invasive or invasive ventilation for ≥ 22 hours per day for ≥ 10 consecutive days), and survival time from baseline of CY 5031 through Week 48 of CY 5032 and from Week 24 of CY 5031 through Week 48 of CY 5032 • Time to the first occurrence of dependence on assisted ventilation or death from Day 1 in CY 5031 through CY 5032 Week 48  • Changes in ALS Functional Rating Scale – Revised (ALSFRS-R) total score from baseline of CY 5031 through Week 48 of CY 5032 and from Week 24 of CY 5031 through Week 48 of CY 5032 • Slopes of the changes in ALSFRS-R total score from baseline of CY 5031 through Week 48 of CY 5032 and from Week 24 of CY 5031 through Week 48 of CY 5032 • Time to the first hospitalization from Day 1 in CY 5031 through Week 48 of CY 5032 • Time to recurrent hospitalizations from Day 1 in CY 5031 through CY 5032 Week 48 | 
 
 
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| E.5.2.1 | Timepoint(s) of evaluation of this end point | 
 | 
| E.6 and E.7 Scope of the trial | 
| E.6 | Scope of the trial | 
| E.6.1 | Diagnosis |  No  | 
| E.6.2 | Prophylaxis |  No  | 
| E.6.3 | Therapy |  Yes  | 
| E.6.4 | Safety |  Yes  | 
| E.6.5 | Efficacy |  Yes  | 
| E.6.6 | Pharmacokinetic |  No  | 
| E.6.7 | Pharmacodynamic |  No  | 
| E.6.8 | Bioequivalence |  No  | 
| E.6.9 | Dose response |  No  | 
| E.6.10 | Pharmacogenetic |  No  | 
| E.6.11 | Pharmacogenomic |  No  | 
| E.6.12 | Pharmacoeconomic |  No  | 
| E.6.13 | Others |  No  | 
| E.7 | Trial type and phase | 
| E.7.1 | Human pharmacology (Phase I) |  No  | 
| E.7.1.1 | First administration to humans |  No  | 
| E.7.1.2 | Bioequivalence study |  No  | 
| E.7.1.3 | Other |  No  | 
| E.7.1.3.1 | Other trial type description |  | 
| E.7.2 | Therapeutic exploratory (Phase II) |  No  | 
| E.7.3 | Therapeutic confirmatory (Phase III) |  Yes  | 
| E.7.4 | Therapeutic use (Phase IV) |  No  | 
| E.8 Design of the trial | 
| E.8.1 | Controlled |  No  | 
| E.8.1.1 | Randomised |  No  | 
| E.8.1.2 | Open |  Yes  | 
| E.8.1.3 | Single blind |  No  | 
| E.8.1.4 | Double blind  |  No  | 
| E.8.1.5 | Parallel group |  No  | 
| E.8.1.6 | Cross over  |  No  | 
| E.8.1.7 | Other |  No  | 
| E.8.2 |  Comparator of controlled trial | 
| E.8.2.1 | Other medicinal product(s) |  No  | 
| E.8.2.2 | Placebo  |  No  | 
| E.8.2.3 | Other |  No  | 
| 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  |  No  | 
| E.8.5 | The trial involves multiple Member States |  Yes  | 
| E.8.5.1 | Number of sites anticipated in the EEA | 29 | 
| E.8.6 Trial involving sites outside the EEA | 
| E.8.6.1 | Trial being conducted both within and outside the EEA |  Yes  | 
| E.8.6.2 | Trial being conducted completely outside of the EEA |  No  | 
| E.8.6.3 | If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned | 
| Australia | 
 
| Canada | 
 
| United States | 
 
| Switzerland | 
 
| Belgium | 
 
| Denmark | 
 
| France | 
 
| Germany | 
 
| Ireland | 
 
| Italy | 
 
| Netherlands | 
 
| Poland | 
 
| Portugal | 
 
| Spain | 
 
| Sweden | 
 
| United Kingdom | 
 
 
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| E.8.7 | Trial has a data monitoring committee |  No  | 
| 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
                     | 
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| E.8.9 Initial estimate of the duration of the trial | 
| E.8.9.1 | In the Member State concerned years | 2 | 
| E.8.9.1 | In the Member State concerned months | 0 | 
| E.8.9.1 | In the Member State concerned days | 0 | 
| E.8.9.2 | In all countries concerned by the trial years | 2 | 
| E.8.9.2 | In all countries concerned by the trial months | 6 | 
| E.8.9.2 | In all countries concerned by the trial days | 0 |