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The NO-ALS study

A phase-II, multicentre, double-blinded randomised clinical trial of oral NR and pterostilbene in early ALS.

Disease: ALS

Type of study: Interventional trial

Coordinating investigators: Tale L. Bjerknes & Ole-Bjørn Tysnes

Study directors: Ole-Bjørn Tysnes & Charalampos Tzoulis

Background: There are currently no neuroprotective treatments for ALS with a significant impact on disease progression. Previous research by the PD Node and others has nominated NAD-replenishment therapy as a promising neuroprotective strategy against neurodegeneration. Moreover, a recently published small trial using a combination of the NAD-precursor nicotinamide riboside (NR) and sirtuin booster pterostilbene, showed encouraging findings in ALS. To test the potential of this strategy as a neuroprotective therapy for ALS, we are running the NO-ALS trial. 

The primary objective of the NO-ALS study is to determine whether a high dose of oral NR/pterostilbene delays disease progression in ALS measured by the revised ALS-FRS (ALS functioning rating scale). 

Design: NO-ALS is a multicentre, phase II randomised double-blinded clinical trial, comparing combined oral NR and pterostilbene to placebo in early ALS. A total of 180 patients will be nation-wide recruited to study arm 1. 

Primary endpoint: Between-group difference in the change in total ALS-FRS score between baseline and end of study. 

Status: Patients have been included since October 2020. By the end of 2024, a total of 277 patients have been included, 143 in study arm 1 which requires 180 included patients. The study is expected to close inclusion by the end of 2024. Four new NO-ALS centres have joined since 2022 (Bodø, Lillehammer, Molde and Kristiansand).

Participating centres 

  • Haukeland University Hospital, Bergen
  • Akershus University Hospital, Lørenskog
  • Oslo University Hospital, Oslo
  • Drammen Hospital, Vestre Viken
  • St. Olav’s University Hospital, Trondheim
  • Stavanger University Hospital, Stavanger
  • University Hospital of North Norway, Tromsø
  • Førde Central Hospital, Førde 
  • Haugesund Hospital, Haugesund 
  • Nordland Hospital Trust, Bodø 
  • Innlandet Hospital Trust, Lillehammer 
  • Molde Hospital 
  • Sørlandet Hospital Trust, Kristiansand 

Funding 

  • The Regional Health Authority of Western Norway (Helse Vest)
  • KLINBEFORSK 
  • The Research Council of Norway, Neuro-SysMed 
  • Haukeland University Hospital 
  • The University of Bergen 
  • Participating hospitals
Last updated 12/2/2024