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Amyotrophic Lateral SclerosisPhase 2NCT05039099

A Study to Evaluate, Safety, Tolerability, and PK of AP-101 in Participants With ALS

A Phase 2 study testing AP-101 in people with Amyotrophic Lateral Sclerosis, run by AL-S Pharma at 13 sites in 6 countries.

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 purpose of this study is to evaluate the safety, tolerability, PK, and PD of AP-101 in participants with fALS and sALS. 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?
AP-101
Type of treatment
Injection or infusion
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
73 participants
Where
13 sitesin 6 countries
Study dates
2 Sep 2021to 13 Aug 2025
Phase
Phase 2
Are there results?
Yes, posted in the registrySummary in the doctors' view

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

  • All participants must adhere to contraception restrictions
  • Female participants of childbearing potential must adhere to contraception restrictions
  • Have possible, clinically probable, clinically probable-laboratory supported or definite familial or sporadic ALS in accordance with the El-Escorial criteria or who have a diagnosis of ALS as defined by the Gold Coast Criteria; progressive motor impairment documented by history or repeated clinical examination, preceded by normal motor development, and presence of upper and lower motor neuron dysfunction in at least 1 body region or lower motor neuron dysfunction in at least 2 body regions and investigations excluding other conditions
  • In familial ALS participants, a confirmed pathogenic superoxide dismutase 1 (SOD1) mutation
  • Onset of symptoms (i.e, weakness) within past 24 months prior to screening, at the time of obtaining informed consent
  • Have slow vital capacity (SVC) of greater than or equal to (> or =) 50 percentage (%) of predicted values. Participants with SVC of <50% of predicted values may be permitted to enter the open-label extension, based on the opinion of the investigator
Show all 12Show fewer
  • Absence of bilevel positive airway pressure (BiPAP)/proportional assist ventilation (PAV) > 4 hours for symptoms attributable to ALS. Use of a CPAP for pre-existing conditions will be allowed
  • If on riluzole, must be on a stable dose.
  • If on edaravone, must have completed 2 cycles and are expected to remain on the same dose throughout the study
  • Able to provide informed consent which includes compliance with the requirements and restrictions
  • Have venous access sufficient to allow for blood sampling
  • Have clinical laboratory test results within the normal reference range for the population or study site, or results with acceptable deviations that are judged to be not clinically significant by the investigator

Who cannot join

  • Have participated or currently participating in another clinical trial within 5 half-lives of baseline (Day 1)
  • Have undergone a tracheostomy for ALS symptoms
  • Are on nasal intermittent positive pressure ventilation (NIPPV) >4 hours per day for the treatment of ALS related symptoms
  • Have other causes of neuromuscular weakness
  • Have cognitive impairment, severe disease in the cardiovascular, hematological, renal system, neurodegenerative disease, pulmonary disorder, or psychiatric illness
  • Pregnant or nursing women
  • Have been exposed to any antisense treatment targeting SOD1 within 6 months of the baseline visit
  • Have undergone stem cell therapy

Trial locations and contacts

13 sites in 6 countries.

13 sites in 6 countries

Canada4 sites
  • ALS clinic at the Kaye Edmonton Clinic, University of Alberta

    Edmonton, Alberta, AB T6G 1Z1

  • London Health Sciences Centre - Victoria Hospital

    London, Ontario, ON N6A 5W9

  • Montreal Neurological Institute and Hospital / Dr Genge

    Montreal, Quebec, H3A 2B4

  • ALS Research Sunnybrook Health Sciences Centre

    Toronto, Ontario, M4N 3M5

Other trials in Canada

Germany4 sites
  • Charité

    Berlin, 13353

  • Deutsches Zentrum für Neurodegenerative Erkrankungen e.V. (DZNE)

    Bonn, 53127

  • Hannover Medical School

    Hanover, 30625

  • Ulm University Hospital

    Ulm, 89081

Other trials in Germany

Sweden2 sites
  • Studieenheten Akademiskt specialistcentrum, SLSO

    Stockholm, 113 61

  • Norrlands universitetssjukhus/ University Hospital of Northern Sweden (NUS)

    Umeå, SE- 901 85

Other trials in Sweden

United States1 site
  • UC San Diego, ACTRI

    La Jolla, California, 92037

Other trials in United States

Belgium1 site
  • Department of Neurology, University Hospitals

    Leuven, 3000

Other trials in Belgium

South Korea1 site
  • Hanyang University Medical Center

    Seoul, 04763

Other trials in South Korea

About this study

Official title: A Phase 2a, Multicenter, Randomized, Double-Blind, Placebo-Controlled Study of the Safety, Tolerability, Pharmacodynamics, and Pharmacokinetics of AP-101 in Participants With Sporadic or SOD1-Associated ALS

The purpose of this study is to evaluate the safety, tolerability, PK, and PD of AP-101 in participants with fALS and sALS.

Read the detailed description

This Phase 2a, multicenter, randomized, double-blind, placebo-controlled study evaluated the safety, tolerability, pharmacokinetics, and pharmacodynamic markers of AP-101 in adults with sporadic ALS or SOD1-associated ALS. A total of 73 participants were randomized within each ALS cohort in a 2:1 ratio to receive AP-101 or placebo during a 24-week double-blind treatment period.

Participants assigned to AP-101 received a 500 mg intravenous loading dose on Day 1, a 2500 mg intravenous dose on Day 2, and 2500 mg intravenously every 3 weeks beginning on Day 22 through Week 24. Participants assigned to placebo received matching intravenous infusions on the same schedule. Stable use of locally approved ALS treatments was permitted.

Participants who completed the double-blind period could enter an optional 24-week open-label extension in which all participants received AP-101. To maintain the integrity of the double-blind period, the initial dose in the open-label extension remained blinded. Participants were followed for safety and pharmacokinetic assessments for up to 16 weeks after their final study dose.

The primary assessments evaluated adverse events, serious adverse events, immunogenicity, vital signs, clinical laboratory assessments, physical and neurological examinations, electrocardiograms, and changes in weight. Secondary assessments included serum pharmacokinetics, AP-101 concentrations in cerebrospinal fluid, and the neurofilament biomarkers phosphorylated neurofilament heavy chain (pNfH) and neurofilament light chain (NfL). Exploratory assessments included the ALS Functional Rating Scale-Revised, slow vital capacity, muscle strength, King's staging, survival and ventilation outcomes, quality of life, and cerebrospinal fluid total and misfolded SOD1.

Being tested
AP-101, Placebo
Keywords
Familial Amyotrophic Lateral Sclerosis, Sporadic Amyotrophic Lateral Sclerosis
Medical subject headings
Amyotrophic Lateral Sclerosis, Amyotrophic lateral sclerosis 1

What participants receive

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

  • AP-101Drug

    Participants receive AP-101 by intravenous infusion (IV).

  • PlaceboDrug

    Participants receive placebo by intravenous infusion (IV).

Study groups in NCT05039099
Study groupRoleWhat they receive
AP-101ExperimentalAP-101 is administered by intravenous infusion (IV).
Receives: Drug: AP-101
PlaceboPlacebo comparatorPlacebo is administered by intravenous infusion (IV).
Receives: Drug: Placebo

What is being measured

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

  1. Participants With Treatment-Emergent Adverse Events (TEAE) and Treatment-Emergent Serious Adverse Events (TESAE) During the Double-Blind Period

    Treatment-emergent adverse events were adverse events that began or worsened after the first dose of randomized study treatment during the double-blind period. Treatment-emergent serious adverse events met the protocol-defined criteria for seriousness. Participants experiencing more than one event within a category were counted once in that category. Results are presented separately for the sporadic ALS and SOD1-associated ALS cohorts.

    Measured: From the first dose through the 21-day follow-up after Week 24, approximately 27 weeks

  2. Number of Participants With Abnormalities in Vital Signs, Clinical Laboratory Assessments, Physical and Neurological Examinations, and Electrocardiograms

    Number of participants with at least one abnormality in vital signs, clinical laboratory assessments, physical examinations, neurological examinations, or electrocardiograms during the double-blind period. Participants could be included in more than one category; therefore, categories were not mutually exclusive. Results are presented separately for the sporadic ALS and SOD1-associated ALS cohorts.

    Measured: From the first dose through the 21-day follow-up after Week 24, approximately 27 weeks

  3. Participants With Treatment-Emergent Anti-Drug Antibodies (ADAs) During the Double-Blind Period

    Serum samples were assessed for anti-drug antibodies to AP-101. Participants were evaluable for treatment-emergent anti-drug antibodies if they had at least one non-missing baseline result and at least one non-missing post-baseline result. One participant was anti-drug-antibody positive at baseline and subsequently tested negative; baseline positivity was not classified as treatment-emergent. Results are presented separately for the sporadic ALS and SOD1-associated ALS cohorts. ADA testing was not assessed in placebo participants.

    Measured: From baseline through the 21-day follow-up after Week 24, approximately 27 weeks

Secondary outcomes (6)
  1. Model-Derived Elimination Half-Life of AP-101 in Serum

    The individual elimination half-life of AP-101 was estimated using empirical Bayes estimates from the final two-compartment population pharmacokinetic model. The model used pooled serum AP-101 concentration data from studies AP101-01 and AP101-02. This outcome summarizes participants from AP101-02 who were included in the final population pharmacokinetic model.

    Measured: From the first AP-101 dose through 16 weeks after the final AP-101 dose, up to approximately 64 weeks

  2. Model-Derived Area Under the Serum AP-101 Concentration-Time Curve

    Individual AP-101 exposure was estimated using empirical Bayes estimates from the final two-compartment population pharmacokinetic model. Area under the concentration-time curve during the dosing interval was estimated following the second active AP-101 dose and at steady state. This outcome summarizes AP101-02 participants included in the final population pharmacokinetic model.

    Measured: AUC following the second active dose: Day 2 through Day 22; AUC at steady state: the 21-day dosing interval following the participant's final active AP-101 dose, which occurred up to approximately Week 48 of the study

  3. Model-Derived Maximum Serum AP-101 Concentration

    Individual maximum serum AP-101 concentrations were estimated using empirical Bayes estimates from the final two-compartment population pharmacokinetic model. Maximum concentration was estimated following the second active AP-101 dose and at steady state. This outcome summarizes AP101-02 participants included in the final population pharmacokinetic model.

    Measured: Cmax following the second active dose: Day 2 through Day 22; Cmax at steady state: during the 21-day dosing interval following the participant's final active AP-101 dose, which occurred up to approximately Week 48 of the study.

  4. AP-101 Concentration in Cerebrospinal Fluid During the Double-Blind Period

    AP-101 concentrations were measured in cerebrospinal fluid to assess central nervous system exposure after repeated intravenous dosing. Samples were collected at Week 12 and Week 24 of the double-blind period and summarized by ALS cohort and visit among participants with quantifiable CSF AP-101 concentrations. Actual concentrations were reported rather than change from baseline because nearly all baseline concentrations were below the limit of quantitation.

    Measured: Week 12 and Week 24 of the double-blind period

  5. Change From Baseline in Cerebrospinal Fluid Phosphorylated Neurofilament Heavy Chain (pNfH) During the Double-Blind Period

    Phosphorylated neurofilament heavy chain (pNfH) concentrations were measured in cerebrospinal fluid at baseline, Week 12, and Week 24. Results represent the mean change from baseline and are presented separately for the sporadic ALS and SOD1-ALS cohorts. Negative values indicate a decrease from baseline.

    Measured: Baseline to Week 24 of the double-blind period

  6. Change From Baseline in Serum Neurofilament Light Chain During the Double-Blind Period and 21-Day Follow-up

    Neurofilament light chain (NfL) concentrations were measured in serum at baseline, Week 12, Week 24, and the 21-day follow-up after completion of double-blind treatment. Results represent the mean change from baseline and are presented separately for the sporadic ALS and SOD1-ALS cohorts. Negative values indicate a decrease from baseline.

    Measured: Baseline through the 21-day follow-up after Week 24, approximately 27 weeks

Timeline

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

  1. First posted9 Sep 2021
  2. Study start2 Sep 2021
  3. Primary completion13 Aug 2025
  4. Study completion13 Aug 2025

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
Parallel groups
Masking
Double blind
Who is masked
Participant, Investigator
Enrolment
73 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05039099
Sponsor's protocol ID
AP101-02
Other IDs
2020-005971-11
Status last verified
Sep 2026
First submitted
1 Sep 2021
Last updated
30 Sep 2026
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing AP-101 in people with Amyotrophic Lateral Sclerosis, run by AL-S Pharma at 13 sites in 6 countries.

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 8 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 30 Sep 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 13 sites in Canada, Germany, Sweden, United States, Belgium and 1 more country. 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. Some participants in this study may receive a placebo. 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?

Yes. Results are posted in the registry (first posted 30 Sep 2026). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

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?

Participants With Treatment-Emergent Adverse Events (TEAE) and Treatment-Emergent Serious Adverse Events (TESAE) During the Double-Blind Period (time frame: From the first dose through the 21-day follow-up after Week 24, approximately 27 weeks). The study lists 3 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
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 30 Sep 2026; AzTrials last refreshed its copy on 7 Nov 2026.

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