Amyotrophic lateral sclerosis is a progressive disease that kills motor neurons, the nerve cells that control voluntary muscles. About 5,000 people in the US are diagnosed each year. Current FDA-approved drugs — riluzole, edaravone, and the combination relyvrio — slow progression modestly but don't stop the disease.
What's actually going on in research
Trials are testing antisense therapies for genetic forms of ALS, stem cell treatments to support dying motor neurons, drugs that reduce inflammation in the brain and spinal cord, and treatments aimed at the protein clumps found in most ALS cases. Researchers are also studying whether targeting multiple disease pathways at once can produce larger benefits than single drugs.
Genetic ALS treatments
Antisense drugs that lower production of mutant proteins are in trials for SOD1, C9orf72, and FUS forms of ALS. Tofersen was FDA-approved in 2023 for SOD1 ALS, the first treatment for a genetic form.
Stem cell therapies
Transplanted stem cells may release protective factors that keep motor neurons alive longer. Trials are testing cells injected into the spinal cord or delivered intravenously.
TDP-43 targeting
Most ALS cases show clumps of TDP-43 protein in motor neurons. Trials are testing drugs that prevent TDP-43 from misfolding or that help cells clear the clumps.
What to know before you search
Eligibility typically depends on time since diagnosis, rate of progression, breathing function, and whether you have a known genetic mutation.
What types of trials are currently open
- Drug trials — Testing oral or intravenous drugs aimed at slowing motor neuron loss, often by reducing inflammation, protecting cells from stress, or clearing toxic proteins.
- Gene therapy trials — Testing antisense drugs or gene-silencing approaches for people with specific genetic mutations that cause familial ALS.
- Stem cell trials — Testing whether transplanted stem cells can protect remaining motor neurons and extend function.
- Device and support trials — Testing breathing devices, communication tools, or ways to manage symptoms like muscle cramps and excess saliva.
- Biomarker studies — Tracking markers in blood or spinal fluid to understand disease progression and predict who might respond to treatment.
Recently added Amyotrophic Lateral Sclerosis trials
An Early Feasibility Study of a Robotically Implanted Brain-Computer Interface for Neural Control of External Devices in Spinal Cord Injury, Amyotrophic Lateral Sclerosis, and Chronic Ischemic Stroke
The purpose of this study is to evaluate the safety and preliminary effectiveness of the N1 System, a fully implanted brain-computer interface placed in the motor cortex with the R1 Robot. The study builds on knowledge gained in a previous clinical investigation of this system. It enrolls adults with severe upper-limb impairment from spinal cord injury, amyotrophic lateral sclerosis (ALS), or chronic ischemic stroke. Participants use neural signals recorded by the N1 Implant to control a computer cursor or virtual keyboard. The study will describe serious adverse device effects and will assess digital daily activities, computer-control performance, independent use of the system, and participant-, clinician-, and caregiver-reported outcomes. Up to 10 participants will be enrolled at up to five sites in the United States and followed for about 2 years after implantation, or about 3 years if they choose extended follow-up. There is no comparison group; each participant's results are compared with their own baseline.
Register for Medical Data, Functional Scales, and Care Outcomes in ALS, SMA, and Other Motor System Disorders
This observational registry collects existing medical and routine care data from people with amyotrophic lateral sclerosis (ALS), spinal muscular atrophy (SMA), and other motor system disorders. The registry includes information about disease course, functional abilities, medications, medical devices, therapeutic services, nutrition, breathing support, and nursing care. It may also include patients' assessments of their treatment and care. The main goal is to describe how people with these conditions are treated and supported in routine clinical practice. The collected data will be used to study care delivery, patient outcomes, and changes in care over time. The findings may help answer research questions and support the future development of treatment standards and clinical care guidelines. This registry does not require any additional medical, nursing, or therapeutic intervention. It uses data generated during routine care and may include information reported by patients or a person authorized by them. The registry is operated by Ambulanzpartner Soziotechnologie APST GmbH in cooperation with Charité - Universitätsmedizin Berlin.
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