Ciprofloxacin/Celecoxib Combination in Patients With ALS

Open Label, Off Label Study to Evaluate the Safety, Tolerability and Preliminary Efficacy of Ciprofloxacin/Celecoxib Combination in Patients With ALS

This is an open label, off label study, to provide interested ALS patients with Ciprofloxacin/Celecoxib fixed dose combination, while assessing safety and tolerability, routine disease progression measures (ALSFRS-R and Vital Capacity).

Study Overview

• Status: Completed
• Conditions: ALS (Amyotrophic Lateral Sclerosis)
• Intervention / Treatment: Drug: Fixed dose combination Ciprofloxacin/Celecoxib

Detailed Description

Patients will be prescribed a fixed dose combination of Ciprofloxacin and Celecoxib to be taken twice daily, and will be monitored for safety and tolerability. Additionally, routine progression measures will be assessed.

• Study Type: Interventional
• Enrollment (Actual): 10
• Phase: Phase 1

Contacts and Locations

Study Locations

• United States
  • Arizona
    • Phoenix, Arizona, United States, 85013
      • Barrow Neurological Institute

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 75 years (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

1. Able to comprehend and willing to sign an Informed Consent Form (ICF)
2. Males or females between the ages of 18 and 75 years of age, inclusive
3. Diagnosis of familial or sporadic ALS (defined as meeting the possible, laboratory-supported probable, probable, or definite criteria for a diagnosis of ALS according to the World Federation of Neurology El Escorial criteria) less than 5 years prior to baseline
4. Patients may be on Riluzole and/or Edaravone; 30 days of stable use is required to make safety assessments more reliable
5. Upright Forced Vital Capacity (FVC) ≥ 50% of predicted for age, height and sex at screening
6. Patient is able to swallow tablets/ capsules
7. A caregiver (if one is needed)
8. Female patients must be post-menopausal (≥ 1 year) OR sterilized, OR if of childbearing potential (i.e., females who have had their first period unless they are anatomically and physiologically incapable to become pregnant), must have a negative pregnancy test, and agree to use contraceptive drugs or devices (e.g., diaphragm plus spermicide, or oral contraceptives) for the duration of the study and 10 weeks after the last treatment dose AND require male partners to use a condom during sexual intercourse

Exclusion Criteria:

1. A past history of adverse reaction/hypersensitivity to either NSAIDs, celecoxib or fluoroquinolones, ciprofloxacin
2. Any known clinically significant abnormal gastric mucosal initial gastroscopic of an erosion, ulcer or tumor or/and GI disorder
3. Known history of impaired renal function.
4. Known or suspected congestive heart and/or coronary heart disease, previous history of myocardial infarction, uncontrolled arterial hypertension, or rhythm abnormalities requiring permanent treatment
5. Known history of QT/QTc prolongation, Torsade de pointes (TdP) (e.g. heart failure, hypokalemia, family history of Long QT syndrome) and the use of concomitant medications that prolong the QT/QTc interval.
6. Known or suspected diagnosis or family history of epilepsy

7. Presence at screening of any medically significant cardiac, pulmonary, musculoskeletal, or psychiatric illness that might interfere with the patient's ability to comply with study procedures or that might confound the interpretation of clinical safety data, including, but not limited to:

   1. Mean systolic blood pressure >180 mm Hg; mean diastolic blood pressure >100 mm Hg (measurements taken after few min rest) that persist on 3 successive measurements taken at least 2 minutes apart
   2. NYHA Class II or greater congestive heart failure
   3. Chronic obstructive pulmonary disease or asthma requiring daily use of bronchodilator medications
   4. Poorly controlled or brittle diabetes mellitus
   5. Cognitive impairment, related to ALS or otherwise, sufficient to impair the patient's ability to understand and/or comply with study procedures and provide informed consent
8. Female who is pregnant or breastfeeding or with intention of becoming pregnant during the course of the study
9. Any impairment or social circumstance that, in the opinion of the Investigator, would render the patient not suitable to participate in the study
10. Patient, patient's parent(s), or patient's legal guardian(s) is/are unable to understand the nature, scope, and possible consequences of the study
11. Patient is participating in (or plans to participate in) any other investigational drug trial, or plans to be exposed to any other investigational agent, device and/or procedure, from 30 days prior to Screening through study completion

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Fixed dose Ciprofloxacin and Celecoxib; Fixed dose Ciprofloxacin and Celecoxib capsule to be taken twice daily, total dose 748mg/day	Drug: Fixed dose combination Ciprofloxacin/Celecoxib; Fixed dose Ciprofloxacin and Celecoxib capsule to be taken twice daily, total dose 748mg/day; Other Names: PrimeC

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Number of participants with one or more treatment-emergent adverse events	Treatment emergent adverse event is any medical event associated with the drug	15 months
Number of patients who discontinued treatment prematurely	Number of patients whose treatment is stopped prematurely for any reason	15 months
Number of patients who discontinued treatment prematurely due to adverse events	Number of patients whose treatment is stopped prematurely specifically due to adverse events	15 months
Number of patients with significant abnormal laboratory values		15 months

Collaborators and Investigators

• Sponsor: NeuroSense Therapeutics Ltd.
• Investigators: Principal Investigator: Jeremy Shefner, MD, PhD, Barrow Neurological Institute

Study record dates

Study Major Dates

• Study Start (Actual): December 9, 2019
• Primary Completion (Actual): September 27, 2021
• Study Completion (Actual): January 20, 2022

Study Registration Dates

• First Submitted: August 29, 2019
• First Submitted That Met QC Criteria: September 12, 2019
• First Posted (Actual): September 16, 2019

Study Record Updates

• Last Update Posted (Actual): February 1, 2022
• Last Update Submitted That Met QC Criteria: January 30, 2022
• Last Verified: January 1, 2022

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Metabolic Diseases; Central Nervous System Diseases; Nervous System Diseases; Neuromuscular Diseases; Neurodegenerative Diseases; Spinal Cord Diseases; TDP-43 Proteinopathies; Proteostasis Deficiencies; Motor Neuron Disease; Amyotrophic Lateral Sclerosis; Physiological Effects of Drugs; Molecular Mechanisms of Pharmacological Action; Anti-Infective Agents; Peripheral Nervous System Agents; Enzyme Inhibitors; Analgesics; Sensory System Agents; Anti-Inflammatory Agents, Non-Steroidal; Analgesics, Non-Narcotic; Anti-Inflammatory Agents; Antirheumatic Agents; Cyclooxygenase Inhibitors; Antineoplastic Agents; Topoisomerase II Inhibitors; Topoisomerase Inhibitors; Anti-Bacterial Agents; Cytochrome P-450 Enzyme Inhibitors; Cyclooxygenase 2 Inhibitors; Cytochrome P-450 CYP1A2 Inhibitors; Celecoxib; Ciprofloxacin
• Other Study ID Numbers: NST001

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: No

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: Yes
• Studies a U.S. FDA-regulated device product: No