Triumeq in Amyotrophic Lateral Sclerosis

NCT ID: NCT05193994

Last Updated: 2025-07-11

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

TERMINATED

Clinical Phase

PHASE3

Total Enrollment

419 participants

Study Classification

INTERVENTIONAL

Study Start Date

2022-02-24

Study Completion Date

2025-06-30

Brief Summary

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To determine if Triumeq improves survival in Amyotrophic Lateral Sclerosis (ALS) compared with placebo

Detailed Description

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This Randomised Double-Blind Placebo Controlled trial seeks to investigate whether the combination medicine Triumeq (dolutegravir 50mg, abacavir 600mg, lamivudine 300mg), already sold in Australia for HIV treatment is effective in delaying progression of theAmyotrophic Lateral Sclerosis (ALS) disease and if it is safe and well tolerated in patients with ALS. This medication is very commonly prescribed for patients with HIV. The secondary aim of this study is to assess patient's health outcomes whilst taking this medication for their ALS.

Conditions

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Amyotrophic Lateral Sclerosis

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Participants will be randomised in a 2:1 ratio to receive either triumeq or placebo
Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Investigators
Double-blind

Study Groups

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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

Group Type EXPERIMENTAL

Dolutegravir, Abacavir and Lamivudine

Intervention Type DRUG

Dolutegravir 50mg, Abacavir 600mg and Lamivudine 300mg.

Placebo

4 capsules to be taken orally once daily (all 4 at the same time). Maximum duration is 24months

Group Type PLACEBO_COMPARATOR

Placebo

Intervention Type DRUG

Matching placebo.

Interventions

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Dolutegravir, Abacavir and Lamivudine

Dolutegravir 50mg, Abacavir 600mg and Lamivudine 300mg.

Intervention Type DRUG

Placebo

Matching placebo.

Intervention Type DRUG

Other Intervention Names

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Triumeq

Eligibility Criteria

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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.

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.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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King's College London

OTHER

Sponsor Role collaborator

Stichting TRICALS Foundation

OTHER

Sponsor Role collaborator

Macquarie University, Australia

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Julian Gold, MD, FFPHM

Role: PRINCIPAL_INVESTIGATOR

Macquarie University

Locations

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MQ Health Neurology

North Ryde, New South Wales, Australia

Site Status

Neuroscience Research Australia (NeuRA)

Randwick, New South Wales, Australia

Site Status

Sunshine Coast University Hospital

Birtinya, Queensland, Australia

Site Status

Royal Brisbane and Women's Hospital

Herston, Queensland, Australia

Site Status

Flinders Medical Centre

Bedford Park, South Australia, Australia

Site Status

Launceston General Hospital

Launceston, Tasmania, Australia

Site Status

Calvary Health Care Bethlehem

Caulfield South, Victoria, Australia

Site Status

The Perron Institute

Nedlands, Western Australia, Australia

Site Status

Beaumont Hospital

Dublin, , Ireland

Site Status

UMC Utrecht

Utrecht, , Netherlands

Site Status

Christchurch Hospital

Christchurch, , New Zealand

Site Status

Dunedin Hospital

Dunedin, , New Zealand

Site Status

Clinical Trials Unit, Tauranga Hospital

Tauranga, , New Zealand

Site Status

Wellington Regional Hospital

Wellington, , New Zealand

Site Status

Univerzitetni klinični center Ljubljana

Ljubljana, , Slovenia

Site Status

Hospital del Mar

Barcelona, , Spain

Site Status

Hospital Universitario y Politecnico la Fe

Valencia, , Spain

Site Status

Studiecenheten at Akademiskt specialistcentrum

Stockholm, , Sweden

Site Status

University of Edinburgh, Anne Rowling Regenerative Nuerology Clinic

Edinburgh, , United Kingdom

Site Status

The Walton Centre

Liverpool, , United Kingdom

Site Status

University College London Hospital

London, , United Kingdom

Site Status

King's College Hospital

London, , United Kingdom

Site Status

St George's Hospital

London, , United Kingdom

Site Status

Oxford University Hospital

Oxford, , United Kingdom

Site Status

Plymouth University Hospital

Plymouth, , United Kingdom

Site Status

Royal Preston Hospital

Preston, , United Kingdom

Site Status

Sheffield Teaching Hospital

Sheffield, , United Kingdom

Site Status

Royal Stoke Hotel

Stoke, , United Kingdom

Site Status

Countries

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Australia Ireland Netherlands New Zealand Slovenia Spain Sweden United Kingdom

References

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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.

Reference Type BACKGROUND
PMID: 31284774 (View on PubMed)

Other Identifiers

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2020-005069-15

Identifier Type: EUDRACT_NUMBER

Identifier Source: secondary_id

LIGHTHOUSE II

Identifier Type: -

Identifier Source: org_study_id

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