Research & Clinical Trials — The Stop ALD Foundation

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But it is urgent that we invest in research that will advance new therapies, as well as new tools for early diagnosis and educational campaigns that will raise awareness so that children with ALD can be identified as early as possible, while there is the best hope of  a beneficial treatment.</p><p>Advancing such research is the goal of the Stop ALD Foundation. Like a venture capital firm, we identify gaps in the development process, seek out creative solutions to fill those gaps, and deliver the resources that can develop these great ideas into concrete projects, and projects into therapies that can transform the lives of children with ALD and their families.</p>","image":"//images.squarespace-cdn.com/content/v1/52e89bfae4b06b90fc8aa357/1395608857481-B450M7Q6MBY0IP5B98EW/TheSTOP++ALD+Foundation+Logo.jpg","@context":"http://schema.org","@type":"WebSite"}</script><script type="application/ld+json">{"legalName":"The Stop ALD Foundation","address":" Suite 2000\nHouston, TX 77002\nUSA","email":"info@stopald.org","telephone":"+1.713.756.3232","sameAs":["http://www.facebook.com/stopald","https://twitter.com/StopALD"],"@context":"http://schema.org","@type":"Organization"}</script><script type="application/ld+json">{"address":" Suite 2000\nHouston, TX 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sqs-col-12 span-12"><div class="sqs-block html-block sqs-block-html" data-block-type="2" id="block-f9976fca89ae076e33ac"><div class="sqs-block-content"> <div class="sqs-html-content"> <h1 style="white-space:pre-wrap;"><strong>Current Treatment Research</strong></h1><p class="" style="white-space:pre-wrap;">Scientists are still searching for comprehensive treatments for ALD and AMN. For the ALD cerebral onset, an approach is needed that would overcome some of the limitations and risks of stem cell transplantation and offer a wider therapeutic window than current transplantation or Lorenzo’s oil. For AMN, the adult version of ALD, options are needed to help with symptoms and prevent further deterioration.</p><h1 style="white-space:pre-wrap;">Exciting topline results from a Phase 2/3 trial on a new treatment for adrenomyeloneuropathy (AMN)</h1><p class="" style="white-space:pre-wrap;">On January 26, 2021, Minoryx Therapeutics, <a href="https://www.minoryx.com/media/minoryx_presents_topline_results_from_phase_2-3_%E2%80%9Cadvance%E2%80%9D_study_demonstrating_significant_clinical_benefit_of_leriglitazone_in_adrenomyeloneuropathy_(amn)/" target="_blank">announced</a> an exciting development and topline results from a Phase 2/3 clinical trial they had conducted. The study evaluated leriglitazone, a novel, selective PPARγ agonist, in male patients with adrenomyeloneuropathy (AMN), a neurodegenerative disease causing progressive spastic paraparesis and autonomic nervous system dysfunction. Additionally, AMN patients are at risk of developing progressive cerebral lesions, a devastating form of the disease leading to rapid severe disability and fatal if left untreated. </p><p class="" style="white-space:pre-wrap;">The ADVANCE trial was a pivotal multicenter, double-blind and placebo-controlled study conducted in the United States and Europe. 116 patients were enrolled and randomized to either leriglitazone or placebo treatment in a 2:1 ratio. The treatment duration was 96 weeks and 96 patients completed the study. About 90% of patients elected to move into the open label extension where data will continue to be collected. Treatment with leriglitazone demonstrated PPARg engagement in all patients within the target range required for efficacy as assessed by a biomarker (adiponectin).</p><p class="" style="white-space:pre-wrap;">For more information on the exciting topline results of this study please <a href="https://www.minoryx.com/media/minoryx_presents_topline_results_from_phase_2-3_%E2%80%9Cadvance%E2%80%9D_study_demonstrating_significant_clinical_benefit_of_leriglitazone_in_adrenomyeloneuropathy_(amn)/">read their news release.</a></p><h1 style="white-space:pre-wrap;"><strong>Gene Therapy</strong></h1><p class="" style="white-space:pre-wrap;">One of the most promising treatments on the horizon for ALD is gene therapy. This involves inserting the corrected genetic sequence with the appropriate ‘blueprints’ into cells. The repaired cells will then produce the ALD protein that had been missing or defective prior to treatment, and the disease process will halt or moderately reverse.</p><p class="" style="white-space:pre-wrap;">Since stem cell transplants (using donor bone marrow or umbilical cord blood) has been shown to halt the disease process, the idea behind gene therapy is to use a patient’s own stem cells rather than those of a donor.  This involves temporarily removing the stem cells from the person with ALD, inserting the corrected genetic sequence into these cells, and putting them back into the patient.</p><p class="" style="white-space:pre-wrap;">If a patient uses their own corrected stem cells, rather than a donor’s stem cells, it is called an ‘autologous transplantation’. In an autologous transplantation cells are removed from an individual and reimplanted in that same individual. Because each person is their own donor, all of the problems and risks that arise from using an outside donor for stem cells can be obviated or significantly lessened.</p><p class="" style="white-space:pre-wrap;"><a href="/how-gene-therapy-works">Click here</a> to learn more about <a href="/how-gene-therapy-works">how gene therapy works</a>.</p><p class="" style="white-space:pre-wrap;">Successful gene therapy would yield the same positive results of stem cell transplantation, for many more patients, with far fewer risks.</p><p class="" style="white-space:pre-wrap;">Early trials are very preliminary, but they appear very promising so far. Four boys with ALD have been treated with gene therapy in France; the first received his transplant in September 2006, and the second in early 2007. The results of the first two boys were published in Science November 2009.</p><p class="" style="white-space:pre-wrap;">While gene therapy may be of great therapeutic value prior to the onset or at the early stages of ALD symptoms, it will not address the needs of boys who are only diagnosed after significant disease progression.</p><p class="" style="white-space:pre-wrap;"><strong>Advantages of Autologous Transplants</strong></p> </div> </div></div><div class="sqs-block image-block sqs-block-image" data-block-type="5" id="block-4056e052b4a6d87bc3ac"><div class="sqs-block-content"> <div class=" image-block-outer-wrapper layout-caption-hidden design-layout-inline combination-animation-none individual-animation-none individual-text-animation-none " data-test="image-block-inline-outer-wrapper" > <figure class=" sqs-block-image-figure intrinsic " style="max-width:641px;" > <div class="image-block-wrapper" data-animation-role="image" > <div class="sqs-image-shape-container-element has-aspect-ratio " style=" position: relative; padding-bottom:79.25116729736328%; overflow: hidden;-webkit-mask-image: -webkit-radial-gradient(white, black); " > <img data-stretch="false" data-src="https://images.squarespace-cdn.com/content/v1/52e89bfae4b06b90fc8aa357/1395632149786-92UQ43OALJB1TL8EOONV/image-asset.png" data-image="https://images.squarespace-cdn.com/content/v1/52e89bfae4b06b90fc8aa357/1395632149786-92UQ43OALJB1TL8EOONV/image-asset.png" data-image-dimensions="641x508" data-image-focal-point="0.5,0.5" alt="" data-load="false" elementtiming="system-image-block" src="https://images.squarespace-cdn.com/content/v1/52e89bfae4b06b90fc8aa357/1395632149786-92UQ43OALJB1TL8EOONV/image-asset.png" width="641" height="508" alt="" sizes="(max-width: 640px) 100vw, (max-width: 767px) 100vw, 100vw" style="display:block;object-fit: cover; width: 100%; height: 100%; object-position: 50% 50%" onload="this.classList.add("loaded")" srcset="https://images.squarespace-cdn.com/content/v1/52e89bfae4b06b90fc8aa357/1395632149786-92UQ43OALJB1TL8EOONV/image-asset.png?format=100w 100w, https://images.squarespace-cdn.com/content/v1/52e89bfae4b06b90fc8aa357/1395632149786-92UQ43OALJB1TL8EOONV/image-asset.png?format=300w 300w, https://images.squarespace-cdn.com/content/v1/52e89bfae4b06b90fc8aa357/1395632149786-92UQ43OALJB1TL8EOONV/image-asset.png?format=500w 500w, https://images.squarespace-cdn.com/content/v1/52e89bfae4b06b90fc8aa357/1395632149786-92UQ43OALJB1TL8EOONV/image-asset.png?format=750w 750w, https://images.squarespace-cdn.com/content/v1/52e89bfae4b06b90fc8aa357/1395632149786-92UQ43OALJB1TL8EOONV/image-asset.png?format=1000w 1000w, https://images.squarespace-cdn.com/content/v1/52e89bfae4b06b90fc8aa357/1395632149786-92UQ43OALJB1TL8EOONV/image-asset.png?format=1500w 1500w, https://images.squarespace-cdn.com/content/v1/52e89bfae4b06b90fc8aa357/1395632149786-92UQ43OALJB1TL8EOONV/image-asset.png?format=2500w 2500w" loading="lazy" decoding="async" data-loader="sqs"> </div> </div> </figure> </div> </div></div><div class="sqs-block html-block sqs-block-html" data-block-type="2" id="block-fc46a9c3035adb420bb9"><div class="sqs-block-content"> <div class="sqs-html-content"> <h1 style="white-space:pre-wrap;"><strong>Mucomyst (acetylcysteine)</strong></h1><p class="" style="white-space:pre-wrap;">Other new treatment options, that may provide hope even after the disease has begun to ravage the brain, are also being studied. In early 2007, scientists from the University of Minnesota reported that treatment with a drug called Mucomyst (acetylcysteine), appears to provide protection from rapid neurological decline in the advanced form of ALD. (<a href="http://www.nature.com/bmt/journal/v39/n4/full/1705571a.html" target="_blank">Bone Marrow Transplantation (2007) 39, 211–215. doi:10.1038/sj.bmt.170557)</a> (Mucomyst is generally used in the treatment of various lung diseases in which mucus makes breathing difficult.) Previously, boys with ALD as advanced as the three boys in this study had all died within a year of stem cell transplantation, but these boys saw their condition stabilize. This may mean that treatment with Mucomyst could allow a larger group of ALD patients, with more advanced brain damage, to successfully receive stem cell transplantation.</p><h1 style="white-space:pre-wrap;"><strong>ALDR Upregulation</strong></h1><p class="" style="white-space:pre-wrap;">Other possibilities now being studied by scientists funded by the Foundation include ALDR upregulation, in which a gene very similar to the ALD gene, which already exists in a normal form in people with ALD, could be ‘upregulated.’ By increasing the activity of the normal gene, we hope to be able to compensate for the deficiencies of the abnormal gene.</p><h1 style="white-space:pre-wrap;"><strong>Mesenchymal Stem Cell Therapy</strong></h1><p class="" style="white-space:pre-wrap;">Scientists at several institutions are studying the use of mesenchymal stem cells (MSC’s) in treating ALD. These cells are multipotent precursor cells that can differentiate into many different types of cells. Cultured from adults’ bone marrow, they may have promise in treating ALD when delivered directly into the blood, spinal cord, and brains of people with the disease. Clinicians at University of Minnesota plan to initiate a study where boys who were diagnosed fairly late in the disease process would be treated with MSC’s. The intention is to halt the rapid deterioration and potentially allow for a transplant to be effective.</p><h1 style="white-space:pre-wrap;"><strong>Myelin Restoration</strong></h1><p class="" style="white-space:pre-wrap;"><a href="http://www.myelin.org/" target="_blank">The Myelin Project</a> is pursuing research into therapies that could actually restore the lost myelin, potentially reversing the damage done by the disease. They are funding two avenues of potential remyelinating therapies: transplantation of myelin-forming cells, and drugs that would replace the lost myelin.</p><h1 style="white-space:pre-wrap;"><strong>Antioxidants</strong></h1><p class="" style="white-space:pre-wrap;">Oxidative stress has been shown to play a key role in the deterioration seen in AMN. Several agents are being investigated.</p><h1 style="white-space:pre-wrap;"><strong>Clinical Trials</strong></h1><p class="" style="white-space:pre-wrap;">Please find below a list of current clinical trials.</p><ul data-rte-list="default"><li><p class="" style="white-space:pre-wrap;">All <strong>adrenoleukodystrophy (ALD) and adrenomyeloneuropathy (AMN) </strong>clinical trials on <strong>Clinicaltrial.gov</strong> can be found <a href="https://clinicaltrials.gov/ct2/results?cond=Adrenoleukodystrophy&term=&cntry=&state=&city=&dist=" target="_blank">here</a>.</p></li></ul><h2 style="white-space:pre-wrap;"><strong>Highlighted trials </strong></h2><p class="" style="white-space:pre-wrap;"><a href="https://www.bluebirdbio.com/" target="_blank"><strong>Bluebird Bio</strong></a><strong><br></strong>Info on current Bluebird Bio trials can be found <a href="https://www.bluebirdbio.com/medical-professionals/our-clinical-trials/" target="_blank">here</a>.</p><p style="margin-left:40px;white-space:pre-wrap;" class="">Bluebird Bio has a gene therapy program for childhood cerebral ALD (CCALD), As of October 2018, Clinicaltrials.gov shows "enrolling by invitation", so if a patient qualifies for a stem cell transplant they may want to reach out to BlueBird.</p><p class="" style="white-space:pre-wrap;"><a href="http://www.minoryx.com/" target="_blank"><strong>Minoryx</strong></a><strong><br></strong>Info on current Minoryx trials can be found <a href="http://www.minoryx.com/min-102/" target="_blank">here</a>.</p><p style="margin-left:40px;white-space:pre-wrap;" class="">Minoryx has a trial enrolling patients with adrenomyeloneuropathy (AMN).</p><p class="" style="white-space:pre-wrap;"><a href="https://clinicaltrials.gov/ct2/show/NCT02595489" target="_blank"><strong>Stanford</strong></a><strong><br></strong>Info on current Stanford trial can be found <a href="https://clinicaltrials.gov/ct2/show/NCT02595489" target="_blank">here</a>.</p><p style="margin-left:40px;white-space:pre-wrap;" class="">Stanford is conducting a vitamin D trial for boys with ALD.</p><p class="" style="white-space:pre-wrap;"><a href="https://www.poxelpharma.com/" target="_blank"><strong>Poxel</strong></a><strong><br></strong>Info on current Poxel trials can be found <a href="https://www.poxelpharma.com/en_us/product-pipeline" target="_blank">here</a>.</p><p style="margin-left:40px;white-space:pre-wrap;" class="">In August 2018 Poxel <a href="https://www.businesswire.com/news/home/20180829005794/en/Poxel-Expands-Metabolic-Pipeline-Strategic-Acquisition-Agreement" target="_blank">acquired</a> DRX-065 from DeuteRx. DRX-065 completed a FDA Phase I safety study.</p><p class="" style="white-space:pre-wrap;"><a href="http://orpheris.com/" target="_blank"><strong>Orpheris</strong></a> <br>Info on current Orepheus trials can be found <a href="http://orpheris.com/pipeline/op101.php" target="_blank">here</a>.</p><p style="margin-left:40px;white-space:pre-wrap;" class="">Orpheris has a compound for childhood cerebral ALD (CCALD) which is finished FDA Phase I safety. </p><p class="" style="white-space:pre-wrap;"><a href="https://www.neurovia-inc.com/" target="_blank"><strong>NeuroVia</strong></a><strong><br></strong>Info on current NeuroVia trials can be found <a href="https://www.neurovia-inc.com/clinical-trials/" target="_blank">here</a>.</p><p style="margin-left:40px;white-space:pre-wrap;" class="">NeuroVia had a trial for childhood cerebral ALD (CCALD). As of October 2018 the study is on hold meaning they are not recruiting patients and the study is not currently active. </p> </div> </div></div></div></div></div> </section> <div class="sqs-layout sqs-grid-12 columns-12 empty" data-layout-label="Research & Clinical Trials Footer Content" data-type="block-field" id="collection-532f6ce2e4b04d947b0addc3"><div class="row sqs-row"><div class="col sqs-col-12 span-12"></div></div></div>  <div class="info-footer-wrapper clear"> <div class="info-footer"> <div class="sqs-layout sqs-grid-12 columns-12 empty" data-layout-label="Info Footer Content" data-type="block-field" data-updated-on="1395639618818" id="infoFooterBlock"><div class="row sqs-row"><div class="col sqs-col-12 span-12"></div></div></div> <div id="socialLinks" class="social-links sqs-svg-icon--list" data-content-field="connected-accounts"> <a href="http://www.facebook.com/stopald" target="_blank" class="sqs-svg-icon--wrapper facebook"> <div> <svg class="sqs-svg-icon--social" viewBox="0 0 64 64"> <use class="sqs-use--icon" xlink:href="#facebook-icon"></use> <use class="sqs-use--mask" xlink:href="#facebook-mask"></use> </svg> </div> </a> <a href="https://twitter.com/StopALD" target="_blank" class="sqs-svg-icon--wrapper twitter"> <div> <svg class="sqs-svg-icon--social" viewBox="0 0 64 64"> <use class="sqs-use--icon" xlink:href="#twitter-icon"></use> <use class="sqs-use--mask" xlink:href="#twitter-mask"></use> </svg> </div> </a> </div> </div> </div> <footer id="footer" class="clear"> <div class="sqs-layout sqs-grid-12 columns-12" data-layout-label="Footer Content" data-type="block-field" data-updated-on="1395639683170" id="footerBlock"><div class="row sqs-row"><div class="col sqs-col-12 span-12"><div class="sqs-block html-block sqs-block-html" data-block-type="2" id="block-7d9d7fddc71929b3cf64"><div class="sqs-block-content"> <div class="sqs-html-content"> <p>Copyright (c) 2004 - Present by The Stop ALD Foundation. 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