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SAN DIEGO (Feb. 19, 2021) Hospital Corpsman 3rd Class Adan Garcia, a cardiovascular technologist (left), and Hospital Corpsman 1st Class Andres Aquino, a cardiovascular technologist student (right), both assigned to Naval Medical Center San Diego (NMCSD), discuss how to steer an
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Phase 3 Pridopidine Trial for ALS Begins Enrollment

A global phase 3 clinical trial of the experimental ALS drug pridopidine has begun, with the first participant enrolled at Mass General Brigham under lead investigator Dr. Sabrina Paganoni, co‑director of Mass General Hospital’s Neurological Clinical Research Institute. The PREVAiLS trial, sponsored by Prilenia Therapeutics and Ferrer, will recruit about 500 patients with early, rapidly progressive ALS at up to 60 treatment centers in 13 countries to test whether the sigma‑1 receptor agonist can safely slow functional decline, preserve speech and prolong survival. This confirmatory study follows a prior phase 2 HEALEY ALS Platform Trial in which pridopidine failed its primary endpoint over 24 weeks but showed signs of benefit in an early, fast‑progressing subgroup, and the drug was generally well tolerated with side effects overlapping common ALS symptoms. Paganoni stresses that PREVAiLS incorporates key design lessons from that earlier work and is currently believed to be the only actively recruiting phase 3 ALS study, though definitive conclusions must wait until data collection and analysis are complete. ALS Association research chief Kuldip Dave says the launch underscores an “urgent need” for new therapies, noting that earlier diagnosis and treatment offer the best chance to preserve patients’ function and quality of life while the community pushes toward a cure.

ALS and Neurodegenerative Disease Research Clinical Trials and FDA Pipeline

📌 Key Facts

  • The PREVAiLS phase 3 trial of pridopidine has enrolled its first ALS participant at Mass General Brigham.
  • The study will include approximately 500 early, rapidly progressive ALS patients across up to 60 centers in 13 countries.
  • Pridopidine, a sigma‑1 receptor agonist, previously showed tolerability and a possible benefit signal in a fast‑progressing subgroup in the phase 2 HEALEY ALS Platform Trial despite missing its main endpoint.

📊 Relevant Data

In 2016, the prevalence of ALS in the United States was 5.0 per 100,000 population (age-adjusted), with 16,424 identified cases.

Prevalence of amyotrophic lateral sclerosis (ALS), United States, 2016 — CDC

ALS prevalence is higher among Whites (5.7 per 100,000) compared to Blacks (2.7 per 100,000) and other racial/ethnic minorities in the United States, with Whites comprising about 85% of cases while being 76% of the population.

Prevalence of amyotrophic lateral sclerosis (ALS), United States, 2016 — Taylor & Francis Online

ALS is more common in males than females, with a male-to-female ratio of approximately 1.5:1 in the United States.

Racial Disparities in the Diagnosis and Prognosis of ALS Patients in the United States — Springer Link

Advanced age is a major risk factor for ALS, with the highest prevalence in persons aged 70-79 years (19.5 per 100,000) compared to 0.6 per 100,000 in those aged 18-39.

Prevalence of amyotrophic lateral sclerosis in the United States using established and novel methodologies, 2017 — Taylor & Francis Online

Genetic predisposition accounts for about 5-10% of ALS cases (familial ALS), with mutations in genes like SOD1 and C9orf72, while environmental factors such as smoking and exposure to pesticides may contribute to sporadic cases.

Genetic and Environmental Factors influencing the prevalence of Amyotrophic Lateral Sclerosis (ALS) — Unlocking Life's Code

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