Safety and Gut Microbiota Analysis of an Oral Microbiotherapy in Patients With Amyotrophic Lateral Sclerosis (IASO)
Safety, Tolerability and Gut microbIota AnalysiS of an Oral Microbiotherapy in Amyotrophic Lateral Sclerosis; an Open-label Phase 1b Pilot Trial
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
This is a prospective, single arm, open-label study.
The target population includes subjects with a recent disease onset defined as the time from first motor deficit at screening of at least 6 months and up to 24 months and removing very rapid/slow progressors based on the ALS Functional Rating Scale - Revised (ALSFRS-R) progression slope.
After a screening period (clinical examination, blood sampling), subject will come for a baseline visit (clinical examination, blood and feces sampling) and to initiate a bowel preparation phase. Five days later, subject will come back to the study site (clinical examination, blood sampling) to initiate a first Maat033 treatment period of 28-day. Ten days after MaaT033 treatment initiation a remote visit is included (feces sampling) to check the subject safety/tolerability. After the first Maat033 treatment period, subject will come to the study site (clinical examination, blood and feces sampling) to initiate the second MaaT033 treatment period of 28-day. At the end of the second Maat033 treatment period subjects will come to the study site (clinical examination, blood and feces sampling) and start a 28-day follow-up period without treatment.
Study completion is defined when all subjects enrolled completed the study follow-up period (clinical examination, blood and feces sampling) or earlier if a subject discontinued the study.
Study Type
Enrollment (Actual)
Phase
- Phase 1
Contacts and Locations
Study Locations
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Lille, France, 59037
- Centre Hospitalier Universitaire de Lille - CIC
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Paris, France, 75013
- Hôpital de la Pitié-Salpêtrière - CIC Neuroscience
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Male or female subjects aged between18 and 80 years
- ALS meeting the revised El Escorial criteria for possible, probable, laboratory-supported probable, or definite ALS (familial or sporadic)
- Time since first motor deficit at screening: at least 6 months, up to 24 months
- Slope of progression of ALS Functional Rating Scale - revised (ALSFRS-R) from date of symptom onset to date of screening test (ΔFS/number of months) between [0.4 and 1.1]
- Able to swallow study treatments (including capsules without opening or chewing them) as per the investigator's assessment
- SVC (Slow Vital Capacity) equal to or greater than 70% of the predicted normal value for sex, height, and age at the screening visit
- If taking riluzole, subject must be on a stable dose for ≥30 days
- Signature of written informed consent by subject
Exclusion Criteria:
- Subjects with a non-invasive ventilation, a tracheotomy and /or a gastrostomy
- Known autoimmune diseases, inflammatory disorders (SLE, Rheumatoid arthritis, connective tissue disorder) or chronic infections (HIV, hepatitis B, or C infection, Tuberculosis)
- Known hypersensitivity to rifaximin or macrogol or any of its components
- Known allergy or intolerance to trehalose, maltodextrin or Polyethylene Glycol (PEG)
- Documented hepatic impairment (Alanine Transaminase/ Aspartate Transaminase > 5N)
- Subject with white blood cells < 4000/ mm3; Polynuclear neutrophils < 1.5 G/ L
- Active infection requiring systemic antimicrobial therapy within 2-week prior to screening visit
- Active infection requiring systemic antimicrobial therapy between screening and baseline
- Medical condition requiring proton pump inhibitors (PPIs)
- Gastrointestinal obstruction or perforation
- Any gastro-intestinal bleeding in the past 3 months
- Gastric emptying disorders (gastroparesis)
- Toxic megacolon
- Severe forms of inflammation of the intestinal tract, including Crohn's disease and ulcerative colitis
- Severe vital organ dysfunctions unrelated to ALS and not compatible with experimental treatment, as per the investigator's assessment
- Subjects with negative IgG serology for Epstein Barr virus (EBV)
- Women of childbearing potential1 without effective contraceptive protection
- Nursing or pregnant women
- Any condition that, in the opinion of the investigator, may interfere with full participation in the study, including administration of study drug (and its preparation procedure) and attendance at required study visits; represent a significant risk to the subject; or interfere with the interpretation of study data
- Enrollment in another trial or expanded access program that may interfere with this study
- Guardianship/legal protection/curatorship of subjects
- Vulnerable subjects such as: persons deprived of liberty, persons in intensive care units unable to provide informed consent prior to the procedure
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
|---|---|
|
Experimental: MaaT033
Route of administration: oral (capsule) Between D-5 to D-1: Bowel preparation with Macrogol and Rifamixin Between D1 to D28: MaaT033 treatment period 1 Between D28 to D56: MaaT033 treatment period 2 |
MaaT033 is a Microbiome Ecosystem Therapy (MET), composed of allogeneic, full-ecosystem pooled biotherapeutic gut microbiota.
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Safety and tolerability: Incidence of Treatment Emergent Adverse Events (TEAE) grade >3, according to Common Terminology Criteria for Adverse Events (CTCAE) version 5.0
Time Frame: Day 84
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To assess the safety and tolerability of MaaT033 treatment
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Day 84
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Changes in gut microbiota profile
Time Frame: From Day -5 to Day 84 (at Day -5, Day 10, Day 28, Day 56 and Day 84)
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Analysis of fecal samples to assess gut microbiota alpha- and beta-diversity indices
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From Day -5 to Day 84 (at Day -5, Day 10, Day 28, Day 56 and Day 84)
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Changes in levels of biomarkers in blood
Time Frame: From Day -5 to Day 84
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From Day -5 to Day 84
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Changes in levels of fecal calprotectin
Time Frame: From Day -5 to Day 84
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Changes from baseline (Day -5) of fecal calprotectin at Day 10, Day 28, Day 56 and Day 84
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From Day -5 to Day 84
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Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Gaelle Bruneteau, MD, PhD, Hôpital de la Pitié-Salpêtrière - CIC Neuroscience
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- MPNS01
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
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