A Phase 2, Multicenter, Randomized, Double-blind, Placebo-controlled Study to Evaluate the Efficacy and Safety of SAR443820 in Adult Participants With Amyotrophic Lateral Sclerosis, Followed by an Open-label Extension

Study Purpose:

This is a parallel treatment, Phase 2, randomized, double-blind study to assess the efficacy, safety, tolerability, PK, and PD of twice daily (BID) oral SAR443820 compared with placebo in male and female participants,18 to 80 years of age with ALS followed by an open label, longterm extension period.

Study ACT16970 consists of 2 parts (A and B) as follows:

Part A is a 24week, double blind, placebo controlled part, preceded by a screening period of up to 4 weeks before Day 1.

On Day 1 of Part A, participants will be randomized in a 2:1 ratio to the SAR443820 treatment arm or matching placebo arm as listed below:

Treatment arm: SAR443820, BID

Placebo arm: Placebo, BID

Randomization will be stratified by the geographic region of the study site, region of ALS onset (bulbar vs other areas), use of riluzole (yes vs no), use of edaravone (yes vs no) and use of the combination of sodium phenylbutyrate and taurursodiol (named Relyvrio in the United States of America [USA] and Albrioza in Canada) (yes vs no). Participants will attend in clinic study assessments at baseline (Day 1), Week 2, Week 4, Week 8, Week 16, and Week 24, and will receive a phone call at Week 12 and Week 20. All ongoing participants in Part A will rollover to part B. The Week 24 Visit is the end of Part A and the beginning of Part B.

Part B is an open label, longterm extension period that starts from the end of Part A (Week 24) and continues up to Week 106. The objectives of Part B are to further determine the safety and efficacy of longterm SAR443820 treatment. The treatment assignment of participants in Part A will remain blinded to Investigators, participants, and site personnel until the end of Part B. Every participant, except those who discontinued Investigational Medicinal Product (IMP) treatment permanently in Part A , will receive BID oral tablets of SAR443820 in Part B.

Study Status:

Active, Not Recruiting

Disease:

Amyotrophic Lateral Sclerosis

Study Type:

Interventional

Type of Intervention:

Drug

Intervention Name:

SAR443820, Placebo

Placebo:

Yes

Phase:

Phase 2

Study Chair(s)/Principal Investigator(s):

Clinical Sciences & Operations, Sanofi

Clinicaltrials.gov ID:

NCT05237284

Neals Affiliated?

Yes

Coordinating Center Contact Information

Sanofi

Trial Transparency email recommended (Toll free for US & Canada) / email hidden; JavaScript is required / 800-633-1610

Full Study Summary:

Part A of the study will last for 24 weeks, and participants will receive BID oral SAR443820 or placebo in a double-blind fashion for 24 weeks. All ongoing participants in Part A will rollover to Part B.

Part B begins at the end of Week 24 and continues up to Week 106. All participants except those who discontinued Investigational Medicinal Product (IMP) treatment permanently in Part A will receive BID oral tablets of SAR443820 in Part B.

The study duration includes an up to 4-week screening period, 24-week double blind treatment period in Part A, 80-week open label treatment period in Part B, and 2-week post treatment follow up period, with a maximum total study duration of 110 weeks.

Study Sponsor:

Sanofi

Estimated Enrollment:

261

Estimated Study Start Date:

04 / 13 / 2022

Estimated Study Completion Date:

08 / 12 / 2025

Posting Last Modified Date:

05 / 03 / 2023

Date Study Added to neals.org:

02 / 14 / 2022

For more information, visit the Himalaya study website: www.sanofistudies.com/ALS

Minimum Age:

18 Years

Maximum Age:

80 Years

Can participants use Riluzole?

Yes

Inclusion Criteria:

- Diagnosis of possible, clinically probable ALS, clinically probable laboratory supported ALS, or clinically definite ALS according to the revised version of the El Escorial World Federation of Neurology criteria

- Time since onset of first symptom of ALS ≤2 years.

- Slow Vital Capacity (SVC) ≥60% of the predicted value.

- Be able to swallow the study tablets at the screening visit.

- Either not currently receiving riluzole or on a stable dose of riluzole for at least 4 weeks before the screening visit. Participants receiving riluzole are expected to remain on the same dose throughout the duration of the study.

- Either not currently receiving edaravone or on the approved standard schedule of edaravone treatment. Participants receiving edaravone must have completed at least 1 cycle of treatment before the screening visit and are expected to continue edaravone treatment throughout the duration of the study.

- Either not currently receiving the combination of sodium phenylbutyrate and taurursodiol or on the approved standard schedule of the combination of sodium phenylbutyrate and taurursodiol treatment for at least 4 weeks before the screening visit. Participants receiving the combination of sodium phenylbutyrate and taurursodiol are expected to remain on the approved standard schedule throughout the duration of the study.

- Participants with a body weight no less than 45 kg and body mass index no less than 18 kg/m2 at the screening visit

- Female participants with childbearing potential are eligible to participate if they are not pregnant or breastfeeding and agree to use adequate contraceptive method during study intervention period and for at least 32 days after the last dose of study drug.

- Male participants must agree to use highly effective contraceptive method during the study period and for at least 92 days following their last dose of the study drug. Male participants must not donate sperms for the duration of study and 92 days after last dose of study drug.

Exclusion Criteria:

- A history of seizure (History of febrile seizure during childhood is allowed).

- Having central IV lines, such as a peripherally inserted central catheter (PICC XE ' PICC ' \f Abbreviation \t 'peripherally inserted central catheter' ) or midline or portacath lines.

- With significant cognitive impairment, psychiatric disease, other neurodegenerative disorder (eg, Parkinson disease or AD), substance abuse other causes of neuromuscular weakness, or any other condition that would make the participants unsuitable for participating in the study or could interfere with assessment or completing the study in the opinion of the Investigator.

- History of recent serious infection (eg, pneumonia, septicemia) within 4 weeks of the screening visit; infection requiring hospitalization or treatment with IV antibiotics, antivirals, or antifungals within 4 weeks of screening; or chronic bacterial infection (such as tuberculosis) deemed unacceptable as per the Investigator's judgment.

- With active herpes zoster infection within 2 months prior to the screening visit.

- A documented history of attempted suicide within 6 months prior to the screening visit, present with suicidal ideation of category 4 or 5 on the Columbia Suicide Severity Rating Scale (CSSRS) , or in the Investigator's judgment are at risk for a suicide attempt.

- History of unstable or severe cardiac, pulmonary, oncological, hepatic, or renal disease or another medically significant illness other than ALS precluding their safe participation in this study.

- Participants who are pregnant or are currently breastfeeding.

- A known history of allergy to any ingredients of SAR443820.

- Currently or previously treated with any strong or moderate CYP3A4 inhibitors or strong CYP3A4 inducers listed in Appendix 10 of the protocol within the specified washout period before the screening visit.

- Received a live vaccine within 14 days before the screening visit.

- Participants with concurrent participation in any other interventional clinical study or who have received treatment with another investigational drug (eg sodium phenylbutyrate or taurursodiol ) within 4 weeks or 5 halflives of the investigational agent before the screening visit, whichever is longer.

- Participants who have received stem cell or gene therapy for ALS at any time in the past.

- Alanine aminotransferase (ALT) or aspartate aminotransferase (AST) >3.0 × upper limit of normal (ULN)

- Bilirubin >1.5 × ULN unless the participant has documented Gilbert syndrome (isolated bilirubin >1.5 × ULN is acceptable if bilirubin is fractionated and direct bilirubin is <35%)

- Serum albumin <3.5 g/dL

- Estimated glomerular filtration rate <60 mL/min/1.73 m2 (Modification of Diet in Renal Disease [MDRD])

The above information is not intended to contain all considerations relevant to a patient's potential participation in a clinical trial.

St. Joseph's Hospital and Medical Center-Site Number:8400016 | Recruiting

Phoenix, Arizona 85013
United States

Phoenix Neurological Associates-Site Number:8400018 | Recruiting

Phoenix, Arizona 85018
United States

UC San Diego Health-Site Number:8400022 | Recruiting

La Jolla, California 92121
United States

USC-Site Number:8400008 | Recruiting

Los Angeles, California 00000
United States

University of California Irvine-Site Number:8400012 | Recruiting

Orange, California 92868
United States

California Pacific Medical Center-Site Number:8400015 | Recruiting

San Francisco, California 94115
United States

University of Colorado-Site Number:8400025 | Recruiting

Aurora, Colorado 80045
United States

Georgetown University Medical Center-Site Number:8400020 | Recruiting

Washington, District of Columbia 20007
United States

AdventHealth Medical Group - Neurology at Winter Park-Site Number:8400006 | Recruiting

Winter Park, Florida 32789
United States

Mayo Clinic-Site Number:8400029 | Recruiting

Jacksonville, Florida 32224
United States

Northwestern Medical Group, Department of Neurology-Site Number:8400003 | Recruiting

Chicago, Illinois 60611
United States

Johns Hopkins University-Site Number:8400028 | Recruiting

Baltimore, Maryland 21287
United States

Massachusetts General Hospital-Site Number:8400001 | Recruiting

Boston, Massachusetts 02114
United States

Mount Sinai Beth Israel Medical Center-Site Number:8400002 | Recruiting

New York, New York 10003
United States

Penn State Milton S. Hershey Medical Center-Site Number:8400004 | Recruiting

Hershey, Pennsylvania 17033
United States

University of Pennsylvania-Site Number:8400021 | Recruiting

Philadelphia, Pennsylvania 19104
United States

Thomas Jefferson University Hospital-Site Number:8400014 | Recruiting

Philadelphia, Pennsylvania 19107
United States

University of Utah-Site Number:8400009 | Recruiting

Salt Lake City, Utah 84132
United States

Froedtert Hospital & Medical College of Wisconsin-Site Number:8400010 | Recruiting

Milwaukee, Wisconsin 53226
United States

Investigational Site Number :0560001 | Recruiting

Leuven 3000
Belgium

Investigational Site Number :1240004 | Recruiting

Edmonton, Alberta T6G 2C8
Canada

Investigational Site Number :1240007 | Recruiting

Hamilton, Ontario L8N 3Z5
Canada

Investigational Site Number :1240006 | Recruiting

London, Ontario N6A 5A5
Canada

Investigational Site Number :1240008 | Recruiting

Toronto, Ontario M4N 3M5
Canada

Investigational Site Number :1240003 | Recruiting

Gatineau, Quebec J8Y 1W2
Canada

Investigational Site Number :1240002 | Recruiting

Montreal, Quebec H3A 2B4
Canada

Investigational Site Number :1560006 | Recruiting

Xi'An 710061
China

Investigational Site Number :1560004 | Recruiting

Wuhan 430030
China

Investigational Site Number :1560002 | Recruiting

Hangzhou 310009
China

Investigational Site Number :1560005 | Recruiting

Guangzhou 510515
China

Investigational Site Number :1560003 | Recruiting

Chengdu 610041
China

Investigational Site Number :1560001 | Recruiting

Beijing 100191
China

Investigational Site Number :2500007 | Recruiting

Caen 14033
France

Investigational Site Number :2500006 | Recruiting

Lille 59037
France

Investigational Site Number :2500002 | Recruiting

Marseille 13385
France

Investigational Site Number :2500003 | Recruiting

Montpellier 34295
France

Investigational Site Number :2500004 | Recruiting

Tours 37044
France

Investigational Site Number :2500005 | Recruiting

Vandoeuvre-les-nancy 54511
France

Investigational Site Number :2760009 | Recruiting

Würzburg 97074
Germany

Investigational Site Number :2760001 | Recruiting

Ulm 89081
Germany

Investigational Site Number :2760002 | Recruiting

Lübeck 23538
Germany

Investigational Site Number :2760005 | Recruiting

Hannover 30625
Germany

Investigational Site Number :2760003 | Recruiting

Dresden 01307
Germany

Investigational Site Number :2760004 | Recruiting

Berlin 13353
Germany

Investigational Site Number :2760008 | Recruiting

Haag In OB 83527
Germany

Investigational Site Number :3800001 | Recruiting

Milano 20132
Italy

Investigational Site Number :3800004 | Recruiting

Milano 20138
Italy

Investigational Site Number :3800002 | Recruiting

Torino 10126
Italy

Investigational Site Number :3920005 | Recruiting

Fuchu-shi, Tokyo 183-0042
Japan

Investigational Site Number :3920001 | Recruiting

Ota-ku, Tokyo 143-8541
Japan

Investigational Site Number :3920002 | Recruiting

Koshi-shi 861-1196
Japan

Investigational Site Number :3920006 | Recruiting

Tokushima-shi, Tokushima 770-8503
Japan

Investigational Site Number :3920004 | Recruiting

Ichikawa-shi, Chiba 272-0827
Japan

Investigational Site Number :3920003 | Recruiting

Nagoya-shi, Aichi 466-8560
Japan

Investigational Site Number :5280001 | Recruiting

Utrecht 3584 CX
Netherlands

Investigational Site Number :6160001 | Recruiting

Krakow 31-503
Poland

Investigational Site Number :6160002 | Recruiting

Ksawerow 95-054
Poland

Investigational Site Number :7240005 | Recruiting

Barcelona, Barcelona [Barcelona] 08035
Spain

Investigational Site Number :7240002 | Recruiting

Hospitalet de Llobregat, Catalunya [Cataluña] 08907
Spain

Investigational Site Number :7240003 | Recruiting

Madrid 28029
Spain

Investigational Site Number :7240001 | Recruiting

Valencia 46026
Spain

Investigational Site Number :7520002 | Recruiting

Stockholm 113 61
Sweden

Investigational Site Number :7520001 | Recruiting

Umea SE-901 85 Umea
Sweden

Investigational Site Number :8260002 | Recruiting

Plymouth, Devon PL6 8DH
United Kingdom

Investigational Site Number :8260003 | Recruiting

Stoke-on-Trent, Staffordshire ST46QG
United Kingdom