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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT05193994
Registration number
NCT05193994
Ethics application status
Date submitted
6/12/2021
Date registered
18/01/2022
Titles & IDs
Public title
Triumeq in Amyotrophic Lateral Sclerosis
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Scientific title
Randomised Double-Blind Placebo-Controlled Phase 3 Trial of Triumeq in Amyotrophic Lateral Sclerosis
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Secondary ID [1]
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2020-005069-15
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Secondary ID [2]
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LIGHTHOUSE II
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Universal Trial Number (UTN)
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Trial acronym
LIGHTHOUSE II
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Amyotrophic Lateral Sclerosis
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Condition category
Condition code
Neurological
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Neurodegenerative diseases
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Human Genetics and Inherited Disorders
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Other human genetics and inherited disorders
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Treatment: Drugs - Dolutegravir, Abacavir and Lamivudine
Treatment: Drugs - Placebo
Experimental: Dolutegravir/Abacavir/Lamivudine - Combination of Dolutegravir, Abacavir and Lamivudine in a single product/capsule.
4 capsules to be taken orally once daily (all 4 at the same time, each capsule is Dolutegravir 12.5mg, Abacavir 150mg and Lamivudine 75mg). Maximum duration is 24months
Placebo comparator: Placebo - 4 capsules to be taken orally once daily (all 4 at the same time). Maximum duration is 24months
Treatment: Drugs: Dolutegravir, Abacavir and Lamivudine
Dolutegravir 50mg, Abacavir 600mg and Lamivudine 300mg.
Treatment: Drugs: Placebo
Matching placebo.
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Intervention code [1]
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Treatment: Drugs
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Comparator / control treatment
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Control group
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Outcomes
Primary outcome [1]
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Measure overall survival at 24 months or after a minimum of 212 events
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Assessment method [1]
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Overall survival is measured as death from any cause, in participants with ALS at 24 months, or after a minimum of 212 events.
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Timepoint [1]
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24 months
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Secondary outcome [1]
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Measure scoring in the ALS-Functional Rating Scale Revised (ALSFRS-R) at 3 monthly intervals.
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Assessment method [1]
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The ALSFRS-R is a 12 item participant self-report measure that monitors ALS disease progression, where a higher score reflects a better outcome.
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Timepoint [1]
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24 months
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Secondary outcome [2]
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Number of participants with abnormal Slow Vital Capacity measured by hand spirometry at 3 monthly intervals
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Assessment method [2]
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Slow vital capacity is measured in litres, and as a % of predicted.
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Timepoint [2]
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24 months
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Secondary outcome [3]
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Measure plasma creatinine at 3 monthly intervals
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Assessment method [3]
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Plasma creatinine is assessed to monitor kidney function
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Timepoint [3]
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24 months
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Secondary outcome [4]
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Assign a value using the King's Staging Scale to describe degree of disease advancement over time
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Assessment method [4]
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The King's Staging Scale is a clinical staging system defining four stages of ALS assessed by way of a semi-structured interview with the participant.
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Timepoint [4]
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24 months
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Secondary outcome [5]
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Evaluate the incidence of treatment-emergent adverse events
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Assessment method [5]
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based on physical examinations and patient reported symptoms.
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Timepoint [5]
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24 months
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Secondary outcome [6]
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Measure study medication discontinuation
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Assessment method [6]
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the number of participants who discontinue study medication will be assessed to assess tolerability
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Timepoint [6]
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24 months
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Secondary outcome [7]
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Measure the score obtained with the Edinburgh Cognitive and Behavioural Assessment Screen (ECAS)
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Assessment method [7]
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ECAS is a multidomain assessment questionnaire used in ALS to assess cognitive and behavioural changes where a higher score relates to a better outcome.
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Timepoint [7]
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24 months
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Secondary outcome [8]
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Measure the responses in the EQ-5D-5L quality of life health questionnaire.
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Assessment method [8]
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The EQ-5D-5L questionnaire is a standardised measure of health-related Quality of Life, also incorporating a Visual Analogue Scale. A higher score relates to a better outcome.
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Timepoint [8]
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24 months
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Secondary outcome [9]
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Measurement of several biomarkers from blood and urine samples
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Assessment method [9]
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Urinary P75ECD, plasma neurofilament light and heavy chain, HERV-K expression and genotyping (UNC13a / C9orf72) will be measured for post-trial exploratory analyses.
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Timepoint [9]
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24 months
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Eligibility
Key inclusion criteria
1. Age = 18 years at the time of screening
2. Diagnosis of ALS according to the Gold Coast Criteria
3. Capable of providing informed consent and complying with trial procedures
4. TRICALS risk profile > -6.0 and < -2.0
5. Those taking Riluzole must be on a stable dose for at least 30 days prior to the baseline visit or must have stopped taking Riluzole at least 30 days prior to the baseline visit
6. Women must not become pregnant (e.g., post-menopausal, surgically sterile, using highly effective birth control methods or not having potentially reproductive sex) for the duration of the study plus five days. Highly effective methods of birth control are those with a failure rate of < 1% per year when employed consistently and correctly, e.g. Combined (oestrogen and progestogen containing) hormonal contraception or progestogen-only hormonal contraception. For more information, please refer to the HMA CTFG Guidelines: https://www.hma.eu/fileadmin/dateien/Human_Medicines/01-About_HMA/Working_Groups/CTFG/2014_09_HMA_CTFG_Contraception.pdf?fbclid=IwAR3AY5Ha0ESDyqIBeUaYI9VTFWmx9bbt8NZ-80N-5ME6pkBb1UHvFsTwqlQ
7. Women of childbearing potential must have a negative serum pregnancy test at screening and be non-lactating. Patients will be advised regarding appropriate contraception. A menstruation history will be taken at each visit. Women of childbearing potential are defined as females who are fertile, following menarche and until becoming post-menopausal unless permanently sterile. Permanent sterilisation methods include hysterectomy, bilateral salpingectomy and bilateral oophorectomy (https://www.hma.eu/fileadmin/dateien/Human_Medicines/01-About_HMA/Working_Groups/CTFG/2014_09_HMA_CTFG_Contraception.pdf?fbclid=IwAR3AY5Ha0ESDyqIBeUaYI9VTFWmx9bbt8NZ-80N-5ME6pkBb1UHvFsTwqlQ)
8. For participants taking antacids (regularly or as required), participant is willing and able to avoid taking antacids for at least 6 hours before and 2 hours after Triumeq
9. Participant taking taurursodiol supplements (TUDCA) can participate in this trial if the supplement does not contain sodium phenylbutyrate.
10. Participants taking taurursodiol supplements (TUDCA) that also contain sodium phenylbutyrate must be willing to stop supplementation 30 days prior randomisation.
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
1. People who are HLA-B*5701 positive
2. Known hypersensitivity to Dolutegravir, Abacavir or Lamivudine, or to any of the excipients
3. Safety Laboratory Criteria at screening:
* ALT = 5 times upper limit of normal (ULN)
* AST = 3 times ULN
* Bilirubin = 1.5 times ULN with clinical indicators of liver disease
* Creatinine clearance < 30 mL / min
* Platelet concentration of < 100 x109 per L
* Absolute neutrophil count of < 1x109 per L
* Haemoglobin < 100 g/L
* Amylase = 2 times ULN
* Lactate = 2 times ULN
4. Moderate to severe hepatic impairment, as defined by local clinical guidelines
5. Presence of HIV antibodies at screening
6. Presence of Hepatitis C antibodies at screening unless participants have had effective treatment for Hepatitis C
7. Presence of Hepatitis B core or surface antigen at screening
8. Participation in any other investigational drug trial or using investigational drug within 30 days prior to screening
9. Use of NIV =22 h per day or having a tracheostomy
10. Edaravone dose within 30 days prior to screening. Edaravone is approved by the FDA and in Japan, but remains an investigational product in Europe and Australia
11. Clinically significant history of unstable or severe cardiac, oncological, psychiatric, hepatic, or renal disease or other medically significant illness
12. Taking medication contraindicated with Triumeq: Dofetilideor Fampridine (dalfampridine)
13. Taking Tofersen within 3 months prior to screening.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people receiving the treatment/s
The people analysing the results/data
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Intervention assignment
Parallel
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Other design features
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Phase
Phase 3
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Recruiting
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Data analysis
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Reason for early stopping/withdrawal
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Other reasons
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Date of first participant enrolment
Anticipated
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Actual
24/02/2022
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
1/07/2026
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Actual
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Sample size
Target
390
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
NSW,QLD,SA,TAS,VIC,WA
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Recruitment hospital [1]
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The University of Sydney - Brain and Mind Centre - Camperdown
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Recruitment hospital [2]
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MQ Health Neurology - North Ryde
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Recruitment hospital [3]
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Sunshine Coast University Hospital - Birtinya
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Recruitment hospital [4]
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Royal Brisbane and Women's Hospital - Herston
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Recruitment hospital [5]
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Flinders Medical Centre - Bedford Park
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Recruitment hospital [6]
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Launceston General Hospital - Launceston
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Recruitment hospital [7]
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Calvary Health Care Bethlehem - Parkdale
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Recruitment hospital [8]
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The Perron Institute - Nedlands
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Recruitment postcode(s) [1]
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2050 - Camperdown
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Recruitment postcode(s) [2]
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2109 - North Ryde
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Recruitment postcode(s) [3]
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4575 - Birtinya
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Recruitment postcode(s) [4]
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4029 - Herston
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Recruitment postcode(s) [5]
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5042 - Bedford Park
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Recruitment postcode(s) [6]
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7250 - Launceston
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Recruitment postcode(s) [7]
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3195 - Parkdale
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Recruitment postcode(s) [8]
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6009 - Nedlands
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Recruitment outside Australia
Country [1]
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Ireland
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State/province [1]
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Dublin
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Country [2]
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Netherlands
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State/province [2]
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Utrecht
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Country [3]
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New Zealand
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State/province [3]
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Christchurch
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Country [4]
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New Zealand
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State/province [4]
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Tauranga
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Country [5]
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New Zealand
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State/province [5]
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Wellington
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Country [6]
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Slovenia
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State/province [6]
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Ljubljana
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Country [7]
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Spain
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State/province [7]
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Barcelona
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Country [8]
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Spain
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State/province [8]
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València
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Country [9]
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Sweden
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State/province [9]
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Stockholm
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Country [10]
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United Kingdom
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State/province [10]
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Edinburgh
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Country [11]
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United Kingdom
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State/province [11]
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Liverpool
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Country [12]
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United Kingdom
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State/province [12]
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London
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Country [13]
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United Kingdom
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State/province [13]
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Oxford
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Country [14]
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United Kingdom
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State/province [14]
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Plymouth
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Country [15]
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United Kingdom
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State/province [15]
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Preston
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Country [16]
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United Kingdom
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State/province [16]
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Sheffield
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Country [17]
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United Kingdom
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State/province [17]
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Stoke
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Funding & Sponsors
Primary sponsor type
Other
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Name
Macquarie University, Australia
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Address
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Other collaborator category [1]
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Other
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Name [1]
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King's College London
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Address [1]
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Country [1]
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Other collaborator category [2]
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Other
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Name [2]
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Stichting TRICALS Foundation
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Address [2]
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Country [2]
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Ethics approval
Ethics application status
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Summary
Brief summary
To determine if Triumeq improves survival in Amyotrophic Lateral Sclerosis (ALS) compared with placebo
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Trial website
https://clinicaltrials.gov/study/NCT05193994
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Trial related presentations / publications
Gold J, Rowe DB, Kiernan MC, Vucic S, Mathers S, van Eijk RPA, Nath A, Garcia Montojo M, Norato G, Santamaria UA, Rogers ML, Malaspina A, Lombardi V, Mehta PR, Westeneng HJ, van den Berg LH, Al-Chalabi A. Safety and tolerability of Triumeq in amyotrophic lateral sclerosis: the Lighthouse trial. Amyotroph Lateral Scler Frontotemporal Degener. 2019 Nov;20(7-8):595-604. doi: 10.1080/21678421.2019.1632899. Epub 2019 Jul 8.
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Public notes
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Contacts
Principal investigator
Name
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Julian Gold, MD, FFPHM
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Address
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Macquarie University
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Country
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Phone
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Fax
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Email
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Contact person for public queries
Name
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Ammar Al-Chalabi, PhD, FRCP
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Address
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Country
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Phone
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+44 20 7848 5174
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
Yes
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What data in particular will be shared?
It is anticipated participant level data will be available as open access.
Supporting document/s available: Study protocol
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When will data be available (start and end dates)?
Contact the Chief Investigators for access information.
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Available to whom?
Contact the Chief Investigators for access information.
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Available for what types of analyses?
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How or where can data be obtained?
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
No documents have been uploaded by study researchers.
Results not provided in
https://clinicaltrials.gov/study/NCT05193994