ClinicalTrials.gg
CompletedNCT03293069FAIR-ALS IIUpdated Dec 5, 2025

Conservative Iron Chelation as a Disease-modifying Strategy in Amyotrophic Lateral Sclerosis

A Phase 2/3 interventional study of Deferiprone and Placebo Oral Tablet in Amyotrophic Lateral Sclerosis, sponsored by University Hospital, Lille. Completed at 15 sites in France. Open to participants aged 18 Years to 75 Years. Per ClinicalTrials.gov, last updated 2025-12-05.

Sponsored by University Hospital, Lille · Phase 2/3, Interventional, and Treatment

Phase
Phase 2/3
Study type
Interventional
Enrollment
372
Allocation
Randomized
Ages
18 Years to 75 Years
Sex
All
01

Study summary

The alteration of iron metabolism is reported in animal models of amyotrophic lateral sclerosis (ALS) as well as in sporadic and genetic forms (SOD1 and C9orf72) of ALS. The high iron concentration of the brain, due to its high energy demand (high oxygen consumption), makes motor neurons particularly vulnerable to energy deficit and oxidative stress. Post-mortem examinations and MRI scans in patients with ALS have found signs of iron accumulation in the central motor tract; and a high level of serum ferritin, which is a marker of iron levels, is associated with a lower prognosis. In ALS mouse models, the use of iron chelators has demonstrated neuroprotection and increased life expectancy, suggesting that elimination of excess iron from the brain can prevent neuronal loss and, consequently, a slow progression of the disease. Conservative chelation of iron refers to a modality whereby much of the iron that binds to the chelator is redistributed in the body rather than exhausted. Using a chelator, deferiprone, with this feature, in a safety pilot study, a very good safety profile was observed. Deferiprone eliminated excess iron from brain regions, reduced oxidative damage and cell death associated with regional iron deposits with no apparent negative impact on the iron levels needed. Now, the efficacy of this new therapeutic modality of neuroprotection is being evaluated in a randomized, double-blind, placebo-controlled, multicenter study.

02

Conditions studied

  • Amyotrophic Lateral Sclerosis

Keywords

  • Conservative Iron Chelation
  • Disease-modifying Strategy
03

In context

Amyotrophic Lateral Sclerosis

978 studies on the registry are indexed under Amyotrophic Lateral Sclerosis; 277 are open to participants now.

This study's enrollment of 372 is above the median of 38 across 662 interventional studies indexed under Amyotrophic Lateral Sclerosis.

Browse Amyotrophic Lateral Sclerosis studies →

Lead sponsor

University Hospital, Lille is the lead sponsor of 631 studies on the registry; 142 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years to 75 Years
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Categorized as; possible, laboratory supported probable, probable, or definite ALS (revised El Escorial criteria)
  • Spinal and bulbar forms of ALS
  • Duration of the disease of less than 18 months since the first symptoms of motor deficit or amyotrophy (isolated cramps or fasciculation will not be considered).
  • Duration of the disease of less than 6 months since the diagnosis
  • An upright slow vital capacity ≥ 75% of the predicted value for age, height, and sex or at least one test on inspiratory pressure ≥ 60% of the predicted value for age, height, and sex which could be either maximal inspiratory pressure or a SNIFF test. (The best predictive test is sniff test but sometime patients are not able to do it.) (In case of a limit abnormal value for one of them, it will be recommended that patient re-assessment occurs three months later).
  • A mild functional handicap score for ALSFRS-R ≥36
  • An upright slow vital capacity > 70% of the predicted value for age, height, and sex and
  • Able to swallow (required for oral treatment)
  • Patients weight included between 40 kg and 130 kg
  • If the patient is under riluzole, it has to be for at least 1 month before inclusion with stable dose (to rule out the principal risk of hepatitis)

Exclusion criteria

Exclusion Criteria:

  • Patients with high frequency of comorbidity or vital risks that may reasonably impair
  • Progressing axis I psychiatric disorders (psychosis, hallucinations, substance addiction, bipolar disorder, severe depression, suicidal ideation), in accordance with the . Before entry into the study, exclusion or stabilization of conditions must occur for patients suffering from mild or moderate depressive episodes (not in remission) or severe and uncontrolled anxiety.
  • Dementia according to the Diagnostic and Statistical Manual of Mental Disorders
  • Exposure to any other experimental drug up to 30 days before day 1
  • Due to the risk of agranulocytosis (estimated at 2%) caused by the Medicinal Products (IMPs) and the unknown mechanism by which this agranulocytosis is induced, combining Deferiprone with other medicinal products known to cause agranulocytosis (as described in the IB) will not be allowed. Such medicinal products include clozapine as well as some NSAIDs (e.g. Phenylbutazone or Metamizole), antithyroid agents, sulfonamide antibiotics or methotrexate.
  • A history of relapsing neutropenia
  • Patients with agranulocytosis or with a history of agranulocytosis.
  • to Deferiprone
  • Patients with anaemia (regardless of latter aetiology) or a history of another haematological disease. Haemochromatosis is not an exclusion criterion if controlled.
  • Pregnant or breastfeeding women or women of not taking highly effective .
  • Kidney or liver failure.
  • Inability to provide .
  • Participation in another clinical trial within 1 month prior to inclusion in the study
  • Patients under trusteeship
Terms in these criteria, in plain language(7)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Life expectancy

The study doctor’s estimate of how long someone is likely to live. Criteria use it so that people can stay in the study long enough for it to answer its question.

DSM diagnostic criteria

The American Psychiatric Association’s manual of mental health diagnoses. DSM-5 (2013, revised as DSM-5-TR in 2022) replaced DSM-IV, and some studies still name the older edition. “Meets DSM criteria for …” means diagnosed by that edition’s diagnostic criteria, usually by a clinician in an interview.

Investigational drug or device

A drug or device being studied in a clinical trial.

It may be new, or already approved and being studied for another use, dose or form. Criteria often leave out people who took part in another study of one within a recent period, commonly 30 days or five half-lives.

Hypersensitivity

An allergy, or another reaction of the immune system, to a substance. “Hypersensitivity to the study drug” means a known allergic reaction to it — not every side effect a medicine can have.

Childbearing potential

Able to become pregnant: from the first period until menopause, unless permanently unable to through surgery (removal of the womb, or of both ovaries or both fallopian tubes).

Criteria for people of childbearing potential usually ask for a negative pregnancy test and for contraception during the study and for a time after it.

Contraception

Ways of preventing pregnancy. “Highly effective” methods fail less than 1% of the time a year when used correctly — for example an IUD or an implant.

Criteria usually say which methods count and how long to keep using them after the last dose, sometimes for male participants too. Some studies accept a partner’s vasectomy if it was confirmed successful and that person is the participant’s only sexual partner.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

05

Study design

Phase
Phase 2 / Phase 3
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Double (Participant, Investigator)
Enrollment
372 participants (actual)

Study arms

  • Experimental
    Deferiprone

    Half of participants will receive twice-daily oral deferiprone taken over 12 months.

    Drug: Deferiprone

  • Placebo comparator
    Placebo

    Half of participants will receive the placebo Twice-daily oral placebo taken over 12 months

    Drug: Placebo Oral Tablet

Interventions

  • One 600 mg delayed-release tablets of deferiprone twice a day, for at 30 mg/kg/day

    Also known as: DFP

  • DrugPlacebo Oral Tablet

    the placebo twice daily morning and evening.

06

What researchers measure

Primary outcomes

  1. CAFS score (Combined Assessment of Function and Survival)

    CAFS score based on changes in amyotrophic lateral sclerosis functional rating scale (ALSFRS-R) total scores and time to death from baseline (randomization visit) to 12 months

    Time frame: at 12 months

Secondary outcomes

  1. Changes in ALS Functional Rating Scale-Revised (ALSFRS-R) total score

    Time frame: Baseline, at 12 months

  2. All-cause and respiratory insufficiency mortality

    Time to death for all cause or respiratory insufficiency (defined as tracheostomy or the use of non-invasive ventilation for ≥ 23 h per day for 14 consecutive days) from baseline until 12 month

    Time frame: at 12 months

  3. Changes in muscle strength

    Muscle strength measurements are determined by the overall mega-score for handheld dynamometry and manual muscular testing with a validated medical device provided

    Time frame: Baseline, at 12 months

  4. Change in the slow vital capacity

    The slow vital capacity is measure by the maximum amount of air that can be exhaled following a deep breath. Reflecting the Respiratory insufficiency.

    Time frame: Baseline, at 12 months

  5. Changes in body weight

    Time frame: Baseline, at 12 months

  6. Change in Quality of life

    Quality of life assessed using the five-item form of the ALS assessment questionnaire (ALSAQ-5) from baseline to 12 months

    Time frame: Baseline, at 12 months

  7. DSMIV criteria

    Dementia (yes/no)

    Time frame: at 12 months

  8. Fronto-Temporal Dementia (FTD) criteria

    Using the revised guidelines for the diagnosis of behavioral variant frontotemporal dementia based on recent literature and collective experience by Rascovsky K et al 2011; Lamarre AK et al 2013

    Time frame: at 12 months

  9. Change in Montreal Cognitive Assessment (MoCA)

    MoCA evaluated of mild cognitive dysfunction.

    Time frame: Baseline, at 12 months

  10. Change in Edinburgh Cognitive and Behavioural Amyotrophic Lateral Sclerosis Screen (ECAS)

    ECAS determine cognitive and behavioral changes of patients suffering from Amyotrophic Lateral Sclerosis. With ECAS, ALS-specific (fluency, executive functions and social cognition, language) and ALS-nonspecific (memory, visuospatial functions) functions can be analyzed to enable the distinction from other diseases with cognitive and behavioral impairments.

    Time frame: Baseline, at 12 months

07

Study locations

15 sites
  • Chr Angers
    Angers, France
  • Chru Brest
    Brest, France
  • Hopital Pierre Wertheimer - Hcl - Bron
    Bron, France
  • Chu Cote de Nacre - Caen
    Caen, France
  • Chu de Clermont-Ferrand
    Clermont-Ferrand, France
  • Hôpital Roger Salengro, CHU
    Lille, 59000, France
  • C H U Dupuytren Limoges
    Limoges, France
  • Aphm Hopital La Timone
    Marseille, France
  • Chu de Nancy
    Nancy, France
  • Chu de Nice Hopital Pasteur
    Nice, France
  • Hu Pitie Salpetriere Aphp
    Paris, 75013, France
  • Hopital de Hautepierre
    Strasbourg, 67091, France
  • Chu de Bordeaux - Talence
    Talence, France
  • Chu Toulouse
    Toulouse, 31300, France
  • Chu de Tours
    Tours, France
08

References and documents

Publications

  • Saini A, Chawla PA. Breaking barriers with tofersen: Enhancing therapeutic opportunities in amyotrophic lateral sclerosis. Eur J Neurol. 2024 Feb;31(2):e16140. doi: 10.1111/ene.16140. Epub 2023 Nov 17. PubMed 37975798 ↗
09

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Ran from Jan 2019 to primary completion in Nov 2023, 57 months.

Of 22 phase 2/3 interventional studies under Amyotrophic Lateral Sclerosis, half reached primary completion within 25 months of starting (the median), counting those still running; a quarter within 18 and three quarters within 109. This study's 57 months is above that.

How these figures are worked out, and which studies are left out of them.

Registered
Sep 21, 2017
First posted
Sep 26, 2017
StartActual
Jan 30, 2019
Primary completionActual
Nov 11, 2023
CompletionActual
May 6, 2024
Last update
Dec 5, 2025
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Dec 5, 2025, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT03293069
Collaborators
Ministry of Health, France
Responsible party
Sponsor
First posted
Sep 26, 2017
Start date
Jan 30, 2019
Primary completion
Nov 11, 2023
Completion
May 6, 2024
Last update
Dec 5, 2025

Study contacts

David Devos, MD,PhD
principal investigator · University Hospital, Lille

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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Studies of the drug tested here: Deferiprone

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