EXPErimental medicine Route To Success in Amyotrophic Lateral Sclerosis (EXPERTS-ALS)

This trial is open to adults aged 18 and older who have a confirmed diagnosis of ALS. To take part, your condition must fall within a specific disease progression range determined by your study doctor. If you are taking riluzole, you must have been on a stable dose for at least one month before starting, or have chosen not to take it.

You cannot join if you are taking part in another drug trial, or if you have other serious illnesses affecting your heart, liver, or kidneys that could make taking the study medicines unsafe. You also cannot join if you have another active condition that alters nerve protein levels in the blood.

Because the study compares different medicines, you must be medically able to take at least two of the drugs being tested. Those who need breathing machines for more than 22 hours a day, or who are pregnant or breastfeeding, are not eligible to take part.

If you join the study, you will take an active study drug for up to six months. There is no dummy pill (placebo), so you and your doctor will know exactly which medication you are receiving. Before you start, the team will check your medical history and take baseline measurements, including blood tests.

During the six months, you will attend hospital visits so the medical team can monitor your health and check for any side effects. To make taking part easier, appointments at week four and week eight can often be done from home by phone or video call. You will also have three fasting blood tests: one at the start, one at week 12, and one at week 24. For these visits, you will be asked not to eat from 8:30 pm the evening before and drink only water until after your morning blood test.

Travel costs for hospital visits can be reimbursed. The study team will stay in regular contact with you, and you can stop taking the medication or leave the study at any point without it affecting your usual NHS care.