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    Clinical Trial Results:
    A Phase IIIb, Open Label Extension Study Evaluating The Safety And Tolerability of AMX0035 Up To 108 Weeks In Adult Participants with Amyotrophic Lateral Sclerosis (ALS) Previously Enrolled In Study A35-004 (PHOENIX)

    Summary
    EudraCT number
    2022-002348-33
    Trial protocol
    ES   NL   IT   FR   SE   IE   PL   DE   BE   PT  
    Global end of trial date
    30 Oct 2024

    Results information
    Results version number
    v1(current)
    This version publication date
    16 Apr 2026
    First version publication date
    16 Apr 2026
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    A35-011
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT05619783
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    Amylyx Pharmaceuticals, Inc.
    Sponsor organisation address
    55 Cambridge Parkway Suite 6W, Cambridge, United States, MA 02142
    Public contact
    Medical Information, Amylyx Pharmaceuticals EMEA B.V., +1 8773741208, clinicaltrials@amylyx.com
    Scientific contact
    Tammy Sarnelli, Amylyx Pharmaceuticals EMEA B.V., +1 857-320-6154, tammy_sarnelli@amylyx.com
    Paediatric regulatory details
    Is trial part of an agreed paediatric investigation plan (PIP)
    No
    Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Results analysis stage
    Analysis stage
    Final
    Date of interim/final analysis
    05 Nov 2025
    Is this the analysis of the primary completion data?
    Yes
    Primary completion date
    30 Oct 2024
    Global end of trial reached?
    Yes
    Global end of trial date
    30 Oct 2024
    Was the trial ended prematurely?
    Yes
    General information about the trial
    Main objective of the trial
    To assess the long-term safety and tolerability of treatment with AMX0035
    Protection of trial subjects
    The Phase 3b A35-011 (PHOENIX Open-Label Extension [OLE]) study was initiated with the prior written approval of properly constituted Independent Ethics Committees (IECs). PHOENIX-OLE was conducted in compliance with the International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use (ICH) E6 (R2) GCP guideline; the ethical principles of the Declaration of Helsinki; and applicable local regulations. The study was also performed in accordance with applicable local data privacy and security regulations.
    Background therapy
    Not applicable.
    Evidence for comparator
    Not applicable.
    Actual start date of recruitment
    02 Jan 2023
    Long term follow-up planned
    No
    Independent data monitoring committee (IDMC) involvement?
    No
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    United Kingdom: 10
    Country: Number of subjects enrolled
    Netherlands: 21
    Country: Number of subjects enrolled
    Poland: 49
    Country: Number of subjects enrolled
    Portugal: 5
    Country: Number of subjects enrolled
    Spain: 64
    Country: Number of subjects enrolled
    Sweden: 14
    Country: Number of subjects enrolled
    Belgium: 6
    Country: Number of subjects enrolled
    France: 68
    Country: Number of subjects enrolled
    Germany: 26
    Country: Number of subjects enrolled
    Ireland: 8
    Country: Number of subjects enrolled
    Italy: 82
    Worldwide total number of subjects
    353
    EEA total number of subjects
    343
    Number of subjects enrolled per age group
    In utero
    0
    Preterm newborn - gestational age < 37 wk
    0
    Newborns (0-27 days)
    0
    Infants and toddlers (28 days-23 months)
    0
    Children (2-11 years)
    0
    Adolescents (12-17 years)
    0
    Adults (18-64 years)
    240
    From 65 to 84 years
    113
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    Up to 600 participants were planned to be enrolled in PHOENIX-OLE. A total of 352 participants were ultimately enrolled and treated before the early termination of the study by the Sponsor as described above.

    Pre-assignment
    Screening details
    A total of 354 prospective participants were screened for the PHOENIX-OLE study, of whom 352 were ultimately both enrolled and treated. One participant was randomized, enrolled, and assigned to, but did not actually receive study treatment.

    Period 1
    Period 1 title
    Treatment period (overall period)
    Is this the baseline period?
    Yes
    Allocation method
    Not applicable
    Blinding used
    Not blinded

    Arms
    Arm title
    AMX0035
    Arm description
    AMX0035, supplied as a powder-filled sachet containing 3 g sodium phenylbutyrate (PB), 1 g taurursodiol/ursodoxicoltaurine (TURSO), and excipients, administered orally.
    Arm type
    Experimental

    Investigational medicinal product name
    AMX0035
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Powder for oral suspension in sachet, Powder for oral solution in sachet
    Routes of administration
    Oral use
    Dosage and administration details
    Two (2) AMX0035 sachets daily (one morning dose and one evening dose), starting on Day 1 and continuing for the duration of the study. If twice-daily dosing was poorly tolerated, dosing interruptions and dose reductions (i.e., to one sachet per day) were permitted per protocol.

    Number of subjects in period 1
    AMX0035
    Started
    353
    Completed
    0
    Not completed
    353
         Withdrawal of Consent
    55
         Death
    88
         Study Terminated by Sponsor
    206
         Lost to follow-up
    4

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    AMX0035
    Reporting group description
    AMX0035, supplied as a powder-filled sachet containing 3 g sodium phenylbutyrate (PB), 1 g taurursodiol/ursodoxicoltaurine (TURSO), and excipients, administered orally.

    Reporting group values
    AMX0035 Total
    Number of subjects
    353 353
    Age categorical
    Units: Subjects
        Adults (18-64 years)
    240 240
        From 65-84 years
    113 113
    Age continuous
    Units: years
        median (full range (min-max))
    60.0 (21 to 84) -
    Gender categorical
    Units: Subjects
        Female
    131 131
        Male
    222 222

    End points

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    End points reporting groups
    Reporting group title
    AMX0035
    Reporting group description
    AMX0035, supplied as a powder-filled sachet containing 3 g sodium phenylbutyrate (PB), 1 g taurursodiol/ursodoxicoltaurine (TURSO), and excipients, administered orally.

    Primary: Incidence of all AEs, AEs leading to treatment discontinuation or study withdrawal, and all serious adverse events (SAEs) in participants treated with AMX0035

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    End point title
    Incidence of all AEs, AEs leading to treatment discontinuation or study withdrawal, and all serious adverse events (SAEs) in participants treated with AMX0035 [1]
    End point description
    Incidence of all AEs, AEs leading to treatment discontinuation or study withdrawal, and all serious adverse events (SAEs) in participants treated with AMX0035.
    End point type
    Primary
    End point timeframe
    108 weeks
    Notes
    [1] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
    Justification: Only descriptive analyses were performed for the primary safety endpoint.
    End point values
    AMX0035
    Number of subjects analysed
    352
    Units: participants
        Any TEAE - Number of Participants
    266
        Any TEAE - Number of AEs
    817
        Any Drug-Related TEAE - Number of Participants
    86
        Any Drug-Related TEAE - Number of AEs
    158
        Any Serious TEAE - Number of Participants
    117
        Any Serious TEAE - Number of AEs
    181
        Any Drug-Related Serious TEAE - Number of Particip
    4
        Any Drug-Related Serious TEAE - Number of AEs
    4
        Any Severe TEAE - Number of Participants
    100
        Any Severe TEAE - Number of AEs
    139
        Any Drug-Related Severe - Number of Partic TEAE -
    3
        Any Drug-Related Severe TEAE - Number of AEs
    3
        Any Fatal TEAE - Number of Participants
    72
        Any Fatal TEAE - Number of AEs
    90
        Any Drug-Related Fatal TEAE - Number of Participan
    0
        Any Drug-Related Fatal TEAE - Number of AEs
    0
        Any TEAE Leading to Dose Change - Number of Partic
    106
        Any TEAE Leading to Dose Change - Number of AEs
    189
        Any TEAE Leading to Dose Reduction - Number of Par
    22
        Any TEAE Leading to Dose Reduction - Number of AEs
    33
        Any TEAE Leading to Dose Interruption -Num of pts
    30
        Any TEAE Leading to Dose Interruption - Num of AEs
    58
        Any TEAE Leading to Drug Withdrawal - Num of pts
    73
        Any TEAE Leading to Drug Withdrawal - Num of AEs
    97
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    PHOENIX-OLE was terminated early by the Sponsor after the parent PHOENIX trial did not show clinical benefit in its primary efficacy outcome. Data collection in PHOENIX-OLE therefore did not encompass the 108 weeks of study treatment planned per protocol.
    Adverse event reporting additional description
    A total of 266 participants experienced at least one TEAE during their PHOENIX-OLE participation, with a total of 817 TEAEs reported. A total of 117 participants experienced at least one treatment-emergent SAE, and 72 participants died due to one or more such events.
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    25.1
    Reporting groups
    Reporting group title
    AMX0035
    Reporting group description
    -

    Serious adverse events
    AMX0035
    Total subjects affected by serious adverse events
         subjects affected / exposed
    117 / 352 (33.24%)
         number of deaths (all causes)
    72
         number of deaths resulting from adverse events
    72
    Vascular disorders
    Circulatory collapse
         subjects affected / exposed
    1 / 352 (0.28%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    Surgical and medical procedures
    Euthanasia
         subjects affected / exposed
    1 / 352 (0.28%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    Gastrostomy
         subjects affected / exposed
    1 / 352 (0.28%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    General disorders and administration site conditions
    Death
         subjects affected / exposed
    4 / 352 (1.14%)
         occurrences causally related to treatment / all
    0 / 4
         deaths causally related to treatment / all
    0 / 4
    Disease progression
         subjects affected / exposed
    3 / 352 (0.85%)
         occurrences causally related to treatment / all
    0 / 3
         deaths causally related to treatment / all
    0 / 3
    Chest pain
         subjects affected / exposed
    1 / 352 (0.28%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Complication associated with device
         subjects affected / exposed
    1 / 352 (0.28%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Pain
         subjects affected / exposed
    1 / 352 (0.28%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Pyrexia
         subjects affected / exposed
    1 / 352 (0.28%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Respiratory, thoracic and mediastinal disorders
    Respiratory failure
         subjects affected / exposed
    41 / 352 (11.65%)
         occurrences causally related to treatment / all
    1 / 41
         deaths causally related to treatment / all
    0 / 28
    Acute respiratory failure
         subjects affected / exposed
    11 / 352 (3.13%)
         occurrences causally related to treatment / all
    0 / 11
         deaths causally related to treatment / all
    0 / 9
    Dyspnoea
         subjects affected / exposed
    8 / 352 (2.27%)
         occurrences causally related to treatment / all
    0 / 8
         deaths causally related to treatment / all
    0 / 5
    Respiratory arrest
         subjects affected / exposed
    2 / 352 (0.57%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 2
    Aspiration
         subjects affected / exposed
    2 / 352 (0.57%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 1
    Atelectasis
         subjects affected / exposed
    1 / 352 (0.28%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    Choking
         subjects affected / exposed
    1 / 352 (0.28%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    Diaphragm muscle weakness
         subjects affected / exposed
    2 / 352 (0.57%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 1
    Hypoxia
         subjects affected / exposed
    1 / 352 (0.28%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    Lung disorder
         subjects affected / exposed
    3 / 352 (0.85%)
         occurrences causally related to treatment / all
    0 / 3
         deaths causally related to treatment / all
    0 / 1
    Obstructive airways disorder
         subjects affected / exposed
    1 / 352 (0.28%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    Respiratory distress
         subjects affected / exposed
    1 / 352 (0.28%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    Upper airway obstruction
         subjects affected / exposed
    1 / 352 (0.28%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    Pulmonary embolism
         subjects affected / exposed
    2 / 352 (0.57%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Hypoventilation
         subjects affected / exposed
    1 / 352 (0.28%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Upper-airway cough syndrome
         subjects affected / exposed
    1 / 352 (0.28%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Psychiatric disorders
    Completed suicide
         subjects affected / exposed
    1 / 352 (0.28%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    Anxiety
         subjects affected / exposed
    1 / 352 (0.28%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Sleep disorder
         subjects affected / exposed
    1 / 352 (0.28%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Investigations
    Oxygen saturation decreased
         subjects affected / exposed
    1 / 352 (0.28%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Injury, poisoning and procedural complications
    Femur fracture
         subjects affected / exposed
    1 / 352 (0.28%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Head injury
         subjects affected / exposed
    1 / 352 (0.28%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Jaw fracture
         subjects affected / exposed
    1 / 352 (0.28%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Ligament injury
         subjects affected / exposed
    1 / 352 (0.28%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Cardiac disorders
    Cardio-respiratory arrest
         subjects affected / exposed
    4 / 352 (1.14%)
         occurrences causally related to treatment / all
    0 / 4
         deaths causally related to treatment / all
    0 / 4
    Acute myocardial infarction
         subjects affected / exposed
    1 / 352 (0.28%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Myocardial infarction
         subjects affected / exposed
    1 / 352 (0.28%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Nervous system disorders
    Haemorrhagic stroke
         subjects affected / exposed
    1 / 352 (0.28%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    Muscle spasticity
         subjects affected / exposed
    1 / 352 (0.28%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Seizure
         subjects affected / exposed
    1 / 352 (0.28%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Subarachnoid haemorrhage
         subjects affected / exposed
    1 / 352 (0.28%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Transient ischaemic attack
         subjects affected / exposed
    1 / 352 (0.28%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Blood and lymphatic system disorders
    Agranulocytosis
         subjects affected / exposed
    1 / 352 (0.28%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Gastrointestinal disorders
    Constipation
         subjects affected / exposed
    1 / 352 (0.28%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    Diarrhoea
         subjects affected / exposed
    1 / 352 (0.28%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Pancreatitis
         subjects affected / exposed
    1 / 352 (0.28%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Dysphagia
         subjects affected / exposed
    2 / 352 (0.57%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Faecaloma
         subjects affected / exposed
    1 / 352 (0.28%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Gastric prolapse
         subjects affected / exposed
    1 / 352 (0.28%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Gastric ulcer
         subjects affected / exposed
    1 / 352 (0.28%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Salivary hypersecretion
         subjects affected / exposed
    1 / 352 (0.28%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Hepatobiliary disorders
    Hepatic cirrhosis
         subjects affected / exposed
    1 / 352 (0.28%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    Renal and urinary disorders
    Urinary retention
         subjects affected / exposed
    1 / 352 (0.28%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Infections and infestations
    Pneumonia
         subjects affected / exposed
    19 / 352 (5.40%)
         occurrences causally related to treatment / all
    0 / 19
         deaths causally related to treatment / all
    0 / 5
    Pneumonia aspiration
         subjects affected / exposed
    7 / 352 (1.99%)
         occurrences causally related to treatment / all
    0 / 7
         deaths causally related to treatment / all
    0 / 4
    Respiratory tract infection
         subjects affected / exposed
    5 / 352 (1.42%)
         occurrences causally related to treatment / all
    0 / 5
         deaths causally related to treatment / all
    0 / 3
    Bronchitis
         subjects affected / exposed
    4 / 352 (1.14%)
         occurrences causally related to treatment / all
    0 / 4
         deaths causally related to treatment / all
    0 / 1
    COVID-19
         subjects affected / exposed
    3 / 352 (0.85%)
         occurrences causally related to treatment / all
    0 / 3
         deaths causally related to treatment / all
    0 / 1
    Cardiac arrest
         subjects affected / exposed
    1 / 352 (0.28%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    Cardiac failure
         subjects affected / exposed
    1 / 352 (0.28%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    Cardiopulmonary failure
         subjects affected / exposed
    1 / 352 (0.28%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    Cellulitis
         subjects affected / exposed
    1 / 352 (0.28%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Clostridium difficile infection
         subjects affected / exposed
    1 / 352 (0.28%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Infection
         subjects affected / exposed
    1 / 352 (0.28%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Upper respiratory tract infection
         subjects affected / exposed
    1 / 352 (0.28%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Urinary tract infection
         subjects affected / exposed
    1 / 352 (0.28%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 2%
    Non-serious adverse events
    AMX0035
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    64 / 352 (18.18%)
    Nervous system disorders
    Dizziness
         subjects affected / exposed
    7 / 352 (1.99%)
         occurrences all number
    7
    Gastrointestinal disorders
    Diarrhoea
         subjects affected / exposed
    37 / 352 (10.51%)
         occurrences all number
    37
    Nausea
         subjects affected / exposed
    14 / 352 (3.98%)
         occurrences all number
    14
    Abdominal pain
         subjects affected / exposed
    6 / 352 (1.70%)
         occurrences all number
    6

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? No

    Interruptions (globally)

    Were there any global interruptions to the trial? No

    Limitations and caveats

    Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data.
    None
    For support, Contact us.
    The status and protocol content of GB trials is no longer updated since 1 January 2021. For the UK, as of 31 January 2021, EU Law applies only to the territory of Northern Ireland (NI) to the extent foreseen in the Protocol on Ireland/NI. Legal notice
    As of 31 January 2023, all EU/EEA initial clinical trial applications must be submitted through CTIS . Updated EudraCT trials information and information on PIP/Art 46 trials conducted exclusively in third countries continues to be submitted through EudraCT and published on this website.

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