HEALEY ALS Platform Trial - Regimen A Zilucoplan

Study Overview
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Brief Summary
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The HEALEY ALS Platform Trial is a perpetual multi-center, multi-regimen clinical trial evaluating the safety and efficacy of investigational products for the treatment of ALS. Regimen A will evaluate the safety and efficacy of a single study drug, zilucoplan, in participants with ALS.

Detailed Description
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The HEALEY ALS Platform Trial is a perpetual multi-center, multi-regimen clinical trial evaluating the safety and efficacy of investigational products for the treatment of ALS. This trial is designed as a perpetual platform trial. This means that there is a single Master Protocol dictating the conduct of the trial. The HEALEY ALS Platform Trial Master Protocol is registered as NCT04297683. Once a participant enrolls into the Master Protocol and meets all eligibility criteria, the participant will be eligible to be randomized into any currently enrolling regimen. All participants will have an equal chance of being randomized to any currently enrolling regimen. If a participant is randomized to Regimen A - Zilucoplan, the participant will complete a screening visit to assess additional Regimen A eligibility criteria. Once Regimen A eligibility criteria are confirmed, participants will complete a baseline assessment and be randomized in a 3:1 ratio to either active zilucoplan or matching placebo. Regimen A will enroll by invitation, as participants may not choose to enroll in Regimen A. Participants must first enroll into the Master Protocol and be eligible to participate in the Master Protocol before being able to be randomly assigned to Regimen A. For a list of enrolling sites, please see the HEALEY ALS Platform Trial Master Protocol under NCT04297683.

Official Title
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HEALEY ALS Platform Trial - Regimen A Zilucoplan

Conditions
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Amyotrophic Lateral Sclerosis

Intervention / Treatment
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* Drug: Zilucoplan
* Drug: Matching Placebo


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: The following inclusion criterion is in addition to the inclusion criteria specified in the Master Protocol (NCT NCT04297683). Vaccination with a quadrivalent meningococcal vaccine and meningococcal serotype B vaccine at least 14 days prior to the first dose of study drug at the Baseline (Day 0) visit. Meningococcal vaccines (including boosters) should be administered in accordance with the study's vaccination worksheet. Exclusion Criteria: The following exclusion criteria are in addition to the exclusion criteria specified in the Master Protocol (NCT NCT04297683). History of meningococcal disease. Prior treatment with a complement inhibitor.

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Quadruple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Zilucoplan<br>Drug: Zilucoplan Administration: Subcutaneous injection Dosage: 0.3mg/kg administered daily | Drug: Zilucoplan<br>* Drug: Zilucoplan Administration: Subcutaneous injection Dosage: 0.3mg/kg administered daily<br>|
| Placebo Comparator: Matching Placebo<br>Administration: Subcutaneous injection Dosage: Daily subcutaneous injection | Drug: Matching Placebo<br>* Drug: Matching Placebo Administration: Subcutaneous injection Dosage: Daily subcutaneous injection<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Disease Progression as Assessed by the ALSFRS-R Total Score | Change in disease severity as measured by the ALS Functional Rating Scale-Revised (ALSFRS-R) total score using a Bayesian repeated measures model that accounts for loss to follow-up due to mortality. Each of 12 questions assessing distinct functional ability is scored from 4 (normal) to 0 (no ability), with a maximum total score of 48 and a minimum total score of 0. Patients with higher scores have more physical function. | Baseline through 24 Weeks | 
| Mortality Event Rate | Mortality is defined as death or death equivalent. A participant is determined to meet the criteria of death equivalent if permanent assisted ventilation (PAV) is used for more than 22 hours per day for more than seven days in a row. The rate of mortality was estimated from a Bayesian shared-parametric model that assumed exponentially distributed survival times. | Baseline through 24 Weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Respiratory Function | Change in respiratory function as assessed by slow vital capacity (SVC). | Baseline and 24 Weeks | 
| Muscle Strength | Change in muscle strength as measured isometrically using hand-held dynamometry (HHD). | Baseline and 24 Weeks | 
| Number of Participants That Experienced Death or Death Equivalent | The number of participants who died or met the criterion for a death equivalent from the date of their baseline visit to the end of the Week 24 visit window (generally 175 days after baseline). The death equivalent criterion is use of permanent assisted ventilation (PAV) for more than 22 hours per day for more than 7 days in a row. | Baseline through 24 Weeks | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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ALS, Placebo-Controlled, Double-Blind, Regimen-Specific Appendix, Lou Gehrig's Disease, Zilucoplan, Ra Pharmaceuticals