G-CSF Treatment for Amyotrophic Lateral Sclerosis: A RCT Study Assessing Clinical Response

NCT ID: NCT00397423

Last Updated: 2007-11-28

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: PHASE2
• Total Enrollment: 40 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2006-12-31
• Study Completion Date: 2007-08-31

Brief Summary

This study will examine the effectiveness of G-CSF in treating patients with amyotrophic lateral sclerosis (ALS) - a fatal neurological degenerative disease that causes adult-onset, progressive motor neurons loss in the spinal cord, brain stem and motor cortex. Patients develop progressive wasting and weakness of both upper and lower limbs, bulbar and respiratory muscles. Usually death from respiratory failure typically is within 3-5 years of diagnosis. Although there are various treatments for ALS, riluzole is the only approved treatment to delay the disease progression. G-CSF is an approved drug that is used to increase white blood cell counts. Moreover, G-CSF and its receptor are expressed by neurons. It acts anti-apoptosis by activating several protective pathways, stimulates neuronal differentiation of adult neural stem cells in the brain, and improves long-term recovery. G-CSF is a novel neurotrophic factor, and a highly attractive candidate for the treatment of neurodegenerative conditions such as ALS.

Patients 18 to 65 years of age who have had mild to moderately severe ALS for 0.5 to 2 years of duration may be eligible for this study. Candidates will be screened with a medical history and possible review of medical records, physical examination, blood test, urine and stool analyses, electrocardiogram, electrophysiological examination, neurological imaging and, for women, a pregnancy test.

Participants will have drug therapy according to randomized number. One group receives G-CSF while other group receives placebo. All of the participants receive riluzole treatment. For the procedure, patients are given a medication to lessen anxiety and any discomfort. Patients receive drug injections every 3 months for 5 days. The G-CSF dosage is 5μg/kg/day. Physical examination and interview, Appel ALS scale and ALS-Functional Rating Scale will be done in 14, 28 days and 3, 6, 9, 12 months. Electrophysiological examination will be tested per 3 months. Blood samples will be collected on treat 5, 14, 28 days and 3, 6, 9, 12 months.

Conditions

Amyotrophic Lateral Sclerosis

Keywords

Amyotrophic Lateral Sclerosis; Granulocyte Colony Stimulating Factor; Randomized Control Trial Study

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: TRIPLE

Study Groups

1

1,G-CSF,intervention

Group Type: ACTIVE_COMPARATOR

Granulocyte Colony Stimulating Factor

Intervention Type: DRUG

Granulocyte Colony Stimulating Factor,5ug/kg/day iH Qd\*5 days,3 months interval for 4 times

2

2,NS,intervention

Group Type: PLACEBO_COMPARATOR

NS

Intervention Type: DRUG

NS 1ml iH Qd\*5 days, 3 months interval for 4 times

Interventions

Granulocyte Colony Stimulating Factor

Granulocyte Colony Stimulating Factor,5ug/kg/day iH Qd\*5 days,3 months interval for 4 times

Intervention Type: DRUG

NS

NS 1ml iH Qd\*5 days, 3 months interval for 4 times

Intervention Type: DRUG

Eligibility Criteria

Inclusion Criteria

• All subjects must have a verifiable diagnosis of ALS of 0.5 to 2 years' duration. The diagnosis must be supported by the Revised Criteria of the World Federation of Neurology. The grades of diagnosis must be clinically definite ALS or clinically probable ALS.
• All subjects must be over age 18 and below 65.
• The ALS is mildly to moderate based on ALS Health State Scale.
• Electrophysiological features show CMAP amplitude of motor nerve normal or mild declining.
• Serum creatine kinase is normal or mild upper, less than 500U/L.

Exclusion Criteria

• If anyone of the above eligibility requirements is not met
• Use of any other investigational agent within 30 days beginning the treatment phase of this study
• Severe cardiac, pulmonary, hepatic or/and hematic disease
• HIV positivity or signs and symptoms consistent with HIV infection
• Pregnant or nursing women
• History of cancer with less than 5 years documentation of a disease-free state
• History of anaphylactic reaction or hypersensitivity to G-CSF or proteins derived from E.coli
• Alcohol or drug abuse in recent 1 year
• Can't understand or obey the rules of treatment
• Blood donor in recent 30 days

• Minimum Eligible Age: 18 Years
• Maximum Eligible Age: 65 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Peking University

OTHER

Sponsor Role: lead

Principal Investigators

Dongsheng Fan, MD

Role: STUDY_CHAIR

Peking University Third Hospital

Locations

Dongsheng Fan

Beijing, Beijing Municipality, China

Countries

China

References

Fan DS, Zhang J, Deng M, Kang DX, Zheng JY, Xu YS, Lu M, Fu Y, Shen Y, Zhang YS, Zhang HG. [Basic and clinical researches on amyotrophic lateral sclerosis/motor neuron disease]. Beijing Da Xue Xue Bao Yi Xue Ban. 2009 Jun 18;41(3):279-81. Chinese.

Reference Type: DERIVED

PMID: 19727208 (View on PubMed)

Other Identifiers

R01-123456-1

Identifier Type: -

Identifier Source: org_study_id