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Tamoxifen Treatment in Patients With Motor Neuron Disease

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ClinicalTrials.gov Identifier: NCT02166944
Recruitment Status : Completed
First Posted : June 18, 2014
Last Update Posted : September 19, 2019
Sponsor:
Information provided by (Responsible Party):
Taipei Medical University Shuang Ho Hospital

Study Description
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Brief Summary:
The aim of this study is to survey the effect of Tamoxifen in motor neuron disease (MND) patients, amyotrophic lateral sclerosis (ALS) with regular riluzole usage. TDP-43 is related to ALS. Increased the ubiquitinated or phosphorylated TDP-43 can cause animal model of ALS, and TDP43 can be degraded either by proteasome or autophagy pathway system. Autophagy pathway can be activated by mTOR inhibition, resulting in ameliorating TDP-43 accumulation and rescue in motor function in animal model. Tamoxifen had shown ability of enhance both proteasome and autophagy pathway, therefore the investigators assume that Tamoxifen probably can ameliorate TDP-43 accumulation and inclusion body formation in ALS.

Condition or disease Intervention/treatment Phase
Amyotrophic Lateral Sclerosis ALS Functional Ration Scale TAR-DNA-binding Protein-43 Tamoxifen mTOR Drug: tamoxifen 40 mg daily for one year Phase 1 Phase 2

Detailed Description:

The investigators will assess the ALSFR-s in ALS patients at start, 1, 3, 6 and 12 months and correlate the score to the neurological outcome of the patients with and without tamoxifen treatment at dose of 40mg daily for one year.

The study will be able to prove the investigators hypothesis: Tamoxifen, a protease and autophagy enhancer, has synergic effect with riluzole in ALS patients to slowing the progression of neurological dysfunction, and respiratory insufficiency.

Study Design
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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 20 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Primary Purpose: Treatment
Official Title: The Study of Tamoxifen Treatment in Patients With Motor Neuron Disease
Actual Study Start Date : April 2014
Actual Primary Completion Date : September 17, 2019
Actual Study Completion Date : September 18, 2019

Resource links provided by the National Library of Medicine


Arms and Interventions
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Arm Intervention/treatment
Experimental: tamoxifen
tamoxifen 40 mg daily for one year
 Drug: tamoxifen 40 mg daily for one year
both arms with riluzole daily
Other Name: Nolvadex
Placebo Comparator: placebo
placebo drugs
 Drug: tamoxifen 40 mg daily for one year
both arms with riluzole daily
Other Name: Nolvadex


Outcome Measures
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Primary Outcome Measures :
  1. Change from Baseline in Amyotrophic Lateral Sclerosis Functional Ration Scales (ALSFRS) at 1, 3, 6,12 months [ Time Frame: Baseline, month 1, 3, 6, 12 ]
    Amyotrophic Lateral Sclerosis Functional Ration Scales (ALSFRS) measured by a neurologist


Secondary Outcome Measures :
  1. Change from Baseline in pulmonary function test at 1, 3, 6,12 months [ Time Frame: baseline, month 1, 3, 6, 12 ]

    Expiratory reserve volume (ERV) Forced vital capacity (FVC) Forced expiratory volume (FEV) Forced expiratory flow 25% to 75% Functional residual capacity (FRC) Maximum voluntary ventilation (MVV)

    • Residual volume (RV)
    • Peak expiratory flow (PEF).
    • Slow vital capacity (SVC)
    • Total lung capacity (TLC)


Other Outcome Measures:
  1. Change from Baseline in blood TDP43 related biomarkers at 1, 3, 6,12 months [ Time Frame: baseline, month 1, 3, 6, 12 ]

Eligibility Criteria
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Ages Eligible for Study:   20 Years to 80 Years   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  1. Clinical diagnosed and confirmed ALS patients, with regular follow up and oral form riluzole at National Taiwan University or Shuang- Ho Hospital for more than 6 months.
  2. Age ≧20 years old

Exclusion Criteria:

  1. Patients who had already ventilator dependent, not regular followed up for more than 6 months or against medical advice, refuse to follow up at neurology department will be excluded in this study.
  2. Patients with now or previous usage of Tamoxifen
  3. Patients with any contraindications of Tamoxifen usage
  4. Patients with other internal medicine illiness
Contacts and Locations
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Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT02166944


Locations
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Taiwan
Po-Chih Chen
New Taipei City, Taiwan
Sponsors and Collaborators
Taipei Medical University Shuang Ho Hospital
Investigators
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Principal Investigator: Chaur-Jong Hu, M.D. Shung Ho Hospital, Taipei Meidcal University
More Information
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Responsible Party: Taipei Medical University Shuang Ho Hospital
ClinicalTrials.gov Identifier: NCT02166944    
Other Study ID Numbers: 201307022
First Posted: June 18, 2014    Key Record Dates
Last Update Posted: September 19, 2019
Last Verified: June 2014
Keywords provided by Taipei Medical University Shuang Ho Hospital:
amyotrophic lateral sclerosis
ALS functional ration scale
TAR-DNA-binding protein-43
tamoxifen
mTOR
Additional relevant MeSH terms:
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Motor Neuron Disease
Amyotrophic Lateral Sclerosis
Sclerosis
Pathologic Processes
Neurodegenerative Diseases
Nervous System Diseases
Neuromuscular Diseases
Spinal Cord Diseases
Central Nervous System Diseases
TDP-43 Proteinopathies
Proteostasis Deficiencies
 Metabolic Diseases
Tamoxifen
Estrogen Antagonists
Hormone Antagonists
Hormones, Hormone Substitutes, and Hormone Antagonists
Physiological Effects of Drugs
Antineoplastic Agents, Hormonal
Antineoplastic Agents
Selective Estrogen Receptor Modulators
Estrogen Receptor Modulators
Bone Density Conservation Agents