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Amyotrophic Lateral SclerosisPhase 2NCT01089010

A Study of CK-2017357 in Patients With Amyotrophic Lateral Sclerosis (ALS)

A Phase 2 study testing 250 mg CK-2017357 and 500 mg CK-2017357 in people with Amyotrophic Lateral Sclerosis, run by Cytokinetics at 15 sites in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The primary objective of this study is to demonstrate a pharmacodynamic effect of CK 2017357 on measures of skeletal muscle function or fatigability in patients with ALS. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Amyotrophic Lateral Sclerosis
What is being tested?
250 mg CK-2017357 and 500 mg CK-2017357
Type of treatment
Pill or oral medicine
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
67 participants
Where
15 sitesUnited States
Study dates
Mar 2010to Nov 2010
Phase
Phase 2
Are there results?
None posted in the registry

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

  • For enrollment, patients were required to satisfy all of the following criteria at baseline:
  • 1. Able to comprehend and willing to sign an Informed Consent Form (ICF)
  • A diagnosis of familial or sporadic ALS (defined as meeting the possible, laboratory-supported probable, probable, or definite criteria for a diagnosis of ALS according to the World Federation of Neurology El Escorial criteria) (Brooks, Miller et al. 2000)
  • Males or females 18 years of age or older
  • Body Mass Index (BMI) of 18.0 to 30.0 kg/m2, inclusive
  • Maximum voluntary grip strength in at least one hand between 10 and 40 pounds (females) or 10 and 60 pounds (males)
Show all 12Show fewer
  • Able to swallow capsules with water
  • Upright Slow Vital Capacity (SVC) > 40% of predicted for age, height, and sex [See Appendix 16.6.1]
  • Able to perform pulmonary function tests
  • Pre-study clinical laboratory findings (including troponin I [TnI] and creatine phosphokinase [CPK]) within normal range, or, if outside of the normal range, deemed not clinically significant by the Investigator
  • For female patients only: The patient is post-menopausal (≥ 1 year) or sterilized, or if she is of childbearing potential, she is not breastfeeding, her pregnancy test is negative, she has no intention to become pregnant during the course of the study, and she is using contraceptive drugs or devices for the duration of the study and for 10 weeks after the end of the study.
  • For male patients only: Male patients agree for the duration of the study and 10 weeks after the end of the study to use a condom during sexual intercourse with female partners who are of reproductive potential and to have female partners use an additional effective means of contraception (e.g., diaphragm plus spermicide or oral contraceptives) or the male patient must agree to abstain from sexual intercourse for 10 weeks after the end of the study.

Who cannot join

  • Patients satisfying any of the following criteria at baseline were excluded from enrollment:
  • Alanine aminotransferase (ALT) or aspartate aminotransferase (AST) > 3 times the upper limit of normal (ULN)
  • Life expectancy < 3 months
  • Participation in any trial in which receipt of investigational study drug occurred within 30 days prior to dosing
  • Any prior treatment with CK-2017357
  • In the opinion of the Investigator, the patient is not suitable to participate in the study

Trial locations and contacts

15 sites in 1 country.

15 sites in 1 country

United States15 sites
  • Johns Hopkins Hospital

    Baltimore, Maryland, 21287

  • Massachusetts General Hospital

    Boston, Massachusetts, 02114

  • University of Vermont

    Burlington, Vermont, 05401

  • Duke University

    Durham, North Carolina, 27705

  • University Neurology Associates

    Fresno, California, 93701

  • Mayo Clinic Florida

    Jacksonville, Florida, 32224

  • University of Kentucky

    Lexington, Kentucky, 40536

  • Drexel University College of Medicine, Dept of Neurology

    Philadelphia, Pennsylvania, 19102

  • Phoenix Neurological Associates, Ltd.

    Phoenix, Arizona, 85018

  • Providence ALS Center

    Portland, Oregon, 97213

  • The University of Texas Health Science Center at San Antonio

    San Antonio, Texas, 78229

  • California Pacific Medical Center

    San Francisco, California, 94115

  • Washington University

    St Louis, Missouri, 63110

  • SUNY Upstate Medical Center

    Syracuse, New York, 13210

  • Penn State

    University Park, Pennsylvania, 17033

Other trials in United States

About this study

Official title: A Phase II, Double-Blind, Randomized, Placebo-Controlled, Three-Way Crossover, Pharmacokinetic and Pharmacodynamic Study of CK-2017357 in Patients With Amyotrophic Lateral Sclerosis (ALS)

The primary objective of this study is to demonstrate a pharmacodynamic effect of CK 2017357 on measures of skeletal muscle function or fatigability in patients with ALS.

Read the detailed description

This study is a Phase II, double-blind, randomized, placebo-controlled, three-way crossover study of CK-2017357 in patients with ALS. 36 to 72 patients will be randomized to one of six different treatment sequences. Each treatment sequence consists of three dosing periods; in each dosing period¸ patients receive a single oral dose of placebo, 250 mg of CK-2017357, or 500 mg of CK-2017357. All six treatment sequences will enroll approximately the same number of patients. A washout period of at least 6 days (to a maximum of 10 days) will be employed between the doses for each patient. This study is designed to assess the effect of CK-2017357 on maximal voluntary muscle strength, on the development of fatigue at maximal and sub-maximal voluntary muscle contraction, and on selected pulmonary function parameters. The plasma concentration of CK-2017357 will be measured at selected time points after each of two single doses of CK-2017357 in men and women. The plasma concentration versus time data obtained in this study may be used to develop a population PK model and estimate inter-subject variability of PK parameters in this target patient population, in particular between male and female study patients.

Being tested
Placebo, 250 mg CK-2017357, 500 mg CK-2017357
Medical subject headings
Amyotrophic Lateral Sclerosis

What participants receive

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

  • PlaceboDrug

    Matching placebo in capsules administered as a single oral dose.

  • 250 mg CK-2017357Drug

    Also called tirasemtiv

    250 mg CK-2017357 in capsules administered as a single oral dose.

  • 500 mg CK-2017357Drug

    Also called tirasemtiv

    500 mg CK-2017357 in capsules administered as a single oral dose.

Study groups in NCT01089010
Study groupRoleWhat they receive
Treatment Sequence 1ExperimentalTreatment sequence 1 consisted of three dosing periods in which patients received single oral doses of placebo, 250 mg, and 500 mg of CK-2017357, in that order, with approximately one week between each dose. Each patient acted as their own control, as all doses were represented in each treatment sequence.
Receives: Drug: Placebo; Drug: 250 mg CK-2017357; Drug: 500 mg CK-2017357
Treatment Sequence 2ExperimentalTreatment sequence 2 consisted of three dosing periods in which patients received single oral doses of placebo, 500 mg, and 250 mg of CK-2017357, in that order, with approximately one week between each dose. Each patient acted as their own control, as all doses were represented in each treatment sequence.
Receives: Drug: Placebo; Drug: 250 mg CK-2017357; Drug: 500 mg CK-2017357
Treatment Sequence 3ExperimentalTreatment sequence 3 consisted of three dosing periods in which patients received single oral doses of 250 mg, placebo and 500 mg of CK-2017357, in that order, with approximately one week between each dose. Each patient acted as their own control, as all doses were represented in each treatment sequence.
Receives: Drug: Placebo; Drug: 250 mg CK-2017357; Drug: 500 mg CK-2017357
Treatment Sequence 4ExperimentalTreatment sequence 4 consisted of three dosing periods in which patients received single oral doses of 250 mg, 500 mg and placebo of CK-2017357, in that order, with approximately one week between each dose. Each patient acted as their own control, as all doses were represented in each treatment sequence.
Receives: Drug: Placebo; Drug: 250 mg CK-2017357; Drug: 500 mg CK-2017357
Treatment Sequence 5ExperimentalTreatment sequence 5 consisted of three dosing periods in which patients received single oral doses of 500 mg, placebo, and 250 mg of CK-2017357, in that order, with approximately one week between each dose. Each patient acted as their own control, as all doses were represented in each treatment sequence.
Receives: Drug: Placebo; Drug: 250 mg CK-2017357; Drug: 500 mg CK-2017357
Treatment Sequence 6ExperimentalTreatment sequence6 consisted of three dosing periods in which patients received single oral doses of 500 mg, 250 mg, and placebo of CK-2017357, in that order, with approximately one week between each dose. Each patient acted as their own control, as all doses were represented in each treatment sequence.
Receives: Drug: Placebo; Drug: 250 mg CK-2017357; Drug: 500 mg CK-2017357

What is being measured

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

  1. ALSFRS-R

    An instrument for evaluating the functional status of patients with ALS. Minimum score is 0 and maximum score is 40. The higher the score the more function is retained.

    Measured: 2 days

  2. Maximum grip strength

    Measured using the DynEx Electronic Hand Dynamometer. Patients asked to squeeze the device with the maximum possible force to establish the maximum voluntary contraction.

    Measured: 2 days

  3. Maximum grip strength fatigability

    Handgrip fatigue is measured using the DynEx Electronic Hand Dynamometer. Patient is asked to squeeze the device until they can no longer stay above 60% of target or 120 seconds.

    Measured: 2 days

  4. Shoulder extension fatigue

    Patient is asked to hold one arm outstretched in front of them at a 90 degree angle. The time the arm falls below 90 degrees for > 2 seconds will be recorded, up to a total evaluation time of 2 minutes. This is then repeated with the other arm.

    Measured: 2 days

  5. Slow Vital Capacity (SVC)

    SVC is measured using the Puritan Bennett Renaissance II Spirometry System and accessories.

    Measured: 2 days

  6. Maximum Voluntary Ventilation (MVV)

    MVV is the volume of air that can be exhaled during 12 seconds of rapid deep breathing. The actual volume is extrapolated to one minute. the Puritan Bennett Renaissance II Spirometry System and accessories is used for this measurement.

    Measured: 2 days

  7. Sniff Inspiratory Pressure (SNIP)

    SNIP is measured at Functional Residual Capacity, the bottom of the tidal breathing cycle, through one plugged nostril while the other remains open using the Micro Medical MicroRPM Respiratory Pressure Meter

    Measured: 2 days

  8. Maximum Voluntary Muscle Contraction (MVC)

    MVC is measured using the MicroFET 2 HHD.

    Measured: 2 days

  9. Repeated Sub-Maximum Grip Strength Fatigability

    Sub-Maximum Grip Strength Fatigability is measured using the DynEx Electronic Hand. Dynamometer

    Measured: 2 days

Secondary outcomes (12)
  1. Characterize the relationship, if any, between the plasma concentration of CK-2017357 and ALSFRS-R.

    ALSFRS-R assessments will be paired with PK concentrations obtained at or near the same time as the ALSFRS-R assessments and analyzed for concentration related effects.

    Measured: 2 days

  2. Characterize the relationship, if any, between the plasma concentration of CK-2017357 and maximum grip strength

    Maximum grip strength assessments will be paired with PK concentrations obtained at or near the same time as the maximum grip strength assessments and analyzed for concentration related effects.

    Measured: 2 days

  3. Characterize the relationship, if any, between the plasma concentration of CK-2017357 and maximum grip strength fatigability

    Maximum grip strength fatigability assessments will be paired with PK concentrations obtained at or near the same time as the maximum grip strength fatigability assessments and analyzed for concentration related effects.

    Measured: 2 days

  4. Characterize the relationship, if any, between the plasma concentration of CK-2017357 and shoulder extension fatigue

    Shoulder extension fatigue assessments will be paired with PK concentrations obtained at or near the same time as the shoulder extension fatigue assessments and analyzed for concentration related effects.

    Measured: 2 days

  5. Characterize the relationship, if any, between the plasma concentration of CK-2017357 and slow vital capacity

    Slow vital capacity assessments will be paired with PK concentrations obtained at or near the same time as the slow vital capacity assessments and analyzed for concentration related effects.

    Measured: 2 days

  6. Characterize the relationship, if any, between the plasma concentration of CK-2017357 and maximum voluntary ventilation

    Maximum voluntary ventilation assessments will be paired with PK concentrations obtained at or near the same time as the maximum voluntary ventilation assessments and analyzed for concentration related effects.

    Measured: 2 days

  7. Characterize the relationship, if any, between the plasma concentration of CK-2017357 and sniff inspiratory pressure

    Sniff inspiratory pressure assessments will be paired with PK concentrations obtained at or near the same time as the sniff inspiratory pressure assessments and analyzed for concentration related effects.

    Measured: 2 days

  8. Characterize the relationship, if any, between the plasma concentration of CK-2017357 and maximum voluntary muscle contraction

    Maximum voluntary muscle contraction assessments will be paired with PK concentrations obtained at or near the same time as the maximum voluntary muscle contraction assessments and analyzed for concentration related effects.

    Measured: 2 days

  9. Characterize the relationship, if any, between the plasma concentration of CK-2017357 and repeated sub-maximum grip strength fatigability

    Repeated sub-maximum grip strength fatigability assessments will be paired with PK concentrations obtained at or near the same time as the repeated sub-maximum grip strength fatigability assessments and analyzed for concentration related effects.

    Measured: 2 days

  10. Number of patients with adverse events

    Measured: 4 weeks

  11. Effect of CK-2017357 on patient determined global functional assessment

    Patients will be asked to assess whether they feel the same, better or worse as compared to how they felt pre-dose

    Measured: 2 days

  12. Effect of CK-2017357 on investigator determined global functional assessment

    Investigator will assess whether they the patient appears the same, better or worse as compared to the patient's status at pre-dose

    Measured: 2 days

Timeline

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

  1. First posted18 Mar 2010 (estimated)
  2. Study startMar 2010
  3. Primary completionNov 2010
  4. Study completionNov 2010

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 2
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Crossover
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
67 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT01089010
Sponsor's protocol ID
CY 4021
Status last verified
May 2019
First submitted
16 Mar 2010
Last updated
10 May 2019
Results posted
No
Data monitoring committee
No

Publications

  • Shefner J, Cedarbaum JM, Cudkowicz ME, Maragakis N, Lee J, Jones D, Watson ML, Mahoney K, Chen M, Saikali K, Mao J, Russell AJ, Hansen RL, Malik F, Wolff AA; Neals/Cytokinetics Study Team. Safety, tolerability and pharmacodynamics of a skeletal muscle activator in amyotrophic lateral sclerosis. Amyotroph Lateral Scler. 2012 Sep;13(5):430-8. doi: 10.3109/17482968.2012.684214. Epub 2012 May 16.

    PubMed 22591195

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing 250 mg CK-2017357 and 500 mg CK-2017357 in people with Amyotrophic Lateral Sclerosis, run by Cytokinetics at 15 sites in United States.

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 12 inclusion and 6 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: finished, as of the sponsor's last update on 10 May 2019. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 15 sites in United States. 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. 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 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

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?

ALSFRS-R (time frame: 2 days). The study lists 9 primary outcomes in all. 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 NCT01089010, 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 May 2019.

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