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NeuroSense – PrimeC

Background

PrimeC is a combination therapy composed of two FDA approved drugs: ciprofloxacin and celecoxib. PrimeC is reported to act by regulating several biological mechanisms associated with motor neuron degeneration in ALS such as inflammation and iron accumulation (ref: Neurosense website and alsnewstoday). 

PrimeC has shown promising data in preclinical models of ALS. Data from Justin Ichida’s lab at University of Southern California (USC) showed that PrimeC was able to increase cell survival rate in patient derived neurons in a dish (ref: PR Newswire). Additionally, PrimeC treated zebrafish carrying ALS-causing gene mutations, showed improvement in their swimming abilities compared to their untreated peers (ref: Goldsthein et al., 2020). 

NeuroSense launched two phase 1 and one phase 2aclinical trials at single centers in the US and Israel to test the safety and tolerability of PrimeC in humans. Data showed that PrimeC was safe and well tolerated after 12 months (Ref: Salomon-Zimri et al., 2023, ClinicalTrials.gov ID: NCT05232461 , NCT04090684 and  NCT04165850)

Trial Design and Results

In 2022 NeuroSense started a Phase 2b, double-blind clinical trial (PARADIGM) in 69 subjects with ALS. The trial was randomized at a 2:1 ratio to receive PrimeC or placebo for 6 months followed by a 12-month open label extension period (Ref: ClinicalTrials.gov ID: NCT0535790): 

  • The drug or placebo were administered orally twice a day. Subjects were evaluated every 2 months for safety, tolerability, and various efficacy measurements as secondary outcomes (Ref: ClinicalTrials.gov ID: NCT0535790). 
  • This was a multicenter and international study that took place in Italy, Canada and Israel (Ref: ClinicalTrials.gov ID: NCT0535790). 
  • In December 2023, NeuroSense published two press releases indicating that at the 6-month timepoint patients treated with PrimeC showed a slowing of disease that did not reach significance. More specifically, a 29% difference in ALS Functional Rating Scale (ALSFRS) and a 13% difference in the slow vital capacity (SVC, a measurement of respiratory function) was observed (Ref: Neurologylive). Further analysis of the per protocol population reported stronger improvement in the ALSFRS and SVC score (Ref: Neurologylive).
  • In July 2024, NeuroSense published a third press release stating that data from the Opel Label Extension (OLE) showed a decline in ALSFRS score and survival for people who had been taking PrimeC from the start of the trial compared to those who had started on placebo (ref: PR Newswire). Through 2024 NeuroSense met with different regulatory agencies and is now planning a larger phase 3 clinical trial to evaluate Prime C efficacy.

Summary

These clinical studies demonstrate safety and tolerability of PrimeC in people with ALS (Ref: Salomon-Zimri et al., 2023). The secondary functional measures potentially suggest clinical benefit; however, the trial was underpowered for efficacy measures so further trials are necessary for assessing PrimeC efficacy. It is important to note that no peer review data is available on the phase 2b trial and that the data reported here was only published in press releases. Until peer reviewed data is available, it will not be possible to draw any conclusion from the studies here described. 

The Scientific Advisory Council, therefore, encourages NeuroSense to publish their results in a peer reviewed journal and looks forward to the results of the planned phase 3 clinical trial that should allow better understanding of Prime C efficacy. 

Sources

PrimeC boosts survival of motor neurons derived from ALS patients, ALSnewstoday – https://alsnewstoday.com/news/primec-shows-potential-to-slow-als-progression-interim-data-reveal/

Neurosense website – https://www.neurosense-tx.com/primec/ 

PR Newswire – https://www.prnewswire.com/news-releases/neurosenses-primec-demonstrates-outstanding-effect-on-als-survival-in-innovative-ipsc-model-301946965.html 

Goldshtein et al., 2020 – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7545590/

Salomon-Zimri et al., 2022 –https://www.tandfonline.com/doi/full/10.1080/21678421.2022.2119868

ClinicalTrial.gov ID: NCT04165850-

https://clinicaltrials.gov/study/NCT04165850?term=PrimeC&cond=ALS&rank=3

ClinicalTrial.gov ID: NCT05232461 – https://www.clinicaltrials.gov/study/NCT05232461

ClinicalTrial.gov ID: NCT04090684-

https://clinicaltrials.gov/study/NCT04090684?term=PrimeC&cond=ALS&rank=2

ClinicalTrial.gov ID: NCT0535790-

https://clinicaltrials.gov/study/NCT05357950?cond=ALS&term=NST003&rank=1

Press release (Sept 2022) – https://neurosense.investorroom.com/2022-09-19-NeuroSense-Announces-Peer-Reviewed-Publication-of-PrimeC-Phase-IIa-ALS-Study-in-Amyotrophic-Lateral-Sclerosis-and-Frontotemporal-Degeneration

Press release (Dec 5th 2023) https://www.neurologylive.com/view/als-candidate-primec-meets-primary-safety-secondary-endpoints-phase-2b-paradigm-study 

Press release (Dec 14th 2023) – https://finance.yahoo.com/news/neurosense-reports-data-statistically-significant-142400043.html 

Press release (July 2024) – https://www.prnewswire.com/news-releases/neurosense-demonstrates-statistically-significant-efficacy-and-survival-benefits-in-people-living-with-als-the-promising-results-from-the-12-month-paradigm-study-highlight-primecs-potential-as-a-disease-modifying-drug-302186838.html

International Alliance of ALS/MND Associations
February 2025


The original language of communication is English and any translation cannot be guaranteed for accuracy of messaging.

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Drugs in Development

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  • BrainStorm Cell Therapeutics – NurOwn
  • Clene Nanomedicine – CNM-Au8
  • Collaborative Medicinal Development – CuATSM
  • ILB – Tikomed
  • Kadimastem – AstroRx
  • Methylcobalamin
  • Mitsubishi Tanabe Pharma America – Oral Edaravone
  • Neuronata-R/Lenzumestrocel
  • NeuroSense – PrimeC
  • Neuvivo – NP001
  • T Regulatory Cell Therapies
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  • SOD1 Therapies & Trials

  • Timmy, ALS Liga

    Timmy, ALS Liga

  • Brigitte Wernli,  Association ALS Switzerland,  Diagnosed 2014

    Brigitte Wernli, Association ALS Switzerland, Diagnosed 2014

  • Wendy Hendrickson, ALS Hope Foundation, USA

    Wendy Hendrickson, ALS Hope Foundation, USA

  • João Marcos Andrietta, Diagnosed 2008 , ABrELA, Brazil

    João Marcos Andrietta, Diagnosed 2008 , ABrELA, Brazil

  • Margreth Burger-Saile, Diagnosed 2011,  ALS Schweiz,  Switzerland

    Margreth Burger-Saile, Diagnosed 2011, ALS Schweiz, Switzerland

  • Carlos Alberto Arango, Colombia

    Carlos Alberto Arango, Colombia

  • Michael Lee, Australia

    Michael Lee, Australia

  • Lombana, Spain

    Lombana, Spain

  • Ian and Teresa Roberts

    Ian and Teresa Roberts

  • Jorge Melo, ABrELA, Brazil

    Jorge Melo, ABrELA, Brazil

  • Joanne Pratt, Diagnosed 2011 , MND Australia

    Joanne Pratt, Diagnosed 2011 , MND Australia

  • Luis Antonio Pimenta Lima, Brazil

    Luis Antonio Pimenta Lima, Brazil

  • Natalya Rybakova, Russia

    Natalya Rybakova, Russia

  • Denis Blais, Diagnosed 2015 , ALS Canada

    Denis Blais, Diagnosed 2015 , ALS Canada

  • Juvenal Bayona Romero

    Juvenal Bayona Romero

  • Yolanda Armendariz, Diagnosed 2017 , FYADENMAC, Mexico

    Yolanda Armendariz, Diagnosed 2017 , FYADENMAC, Mexico

  • Antonio Ventriglia,  ALS Liga Belgium,  Diagnosed 2013

    Antonio Ventriglia, ALS Liga Belgium, Diagnosed 2013

  • Leon Ryba, Asociación ELA Argentina

    Leon Ryba, Asociación ELA Argentina

  • Mauril Bélanger, Diagnosed 2015 , ALS Canada

    Mauril Bélanger, Diagnosed 2015 , ALS Canada

  • Maurice Leclerc, Canada

    Maurice Leclerc, Canada

  • Guoqiang Xu, Diagnosed 2016 , Shaanxi ALS Association, China

    Guoqiang Xu, Diagnosed 2016 , Shaanxi ALS Association, China

  • Conny van der Meijden, Diagnosed 2001,  ALS Netherlands

    Conny van der Meijden, Diagnosed 2001, ALS Netherlands

  • Mahmood Anwar, UK

    Mahmood Anwar, UK

  • JP

    JP

  • Josée Kolijn-de Man, Diagnosed 2015 , ALS Patients Connected, The Netherlands

    Josée Kolijn-de Man, Diagnosed 2015 , ALS Patients Connected, The Netherlands

  • Sharon Corosanite, Diagnosed 2014 , ALS Hope Foundation, USA

    Sharon Corosanite, Diagnosed 2014 , ALS Hope Foundation, USA

  • Richard Clark, MND New Zealand,  Diagnosed 2011

    Richard Clark, MND New Zealand, Diagnosed 2011

  • Malcolm Buck, Australia

    Malcolm Buck, Australia

  • Leon Ryba, Argentina

    Leon Ryba, Argentina

  • Norm MacIsaac,  ALS Society of Canada,  ALS Society of Quebec,  Diagnosed 2014

    Norm MacIsaac, ALS Society of Canada, ALS Society of Quebec, Diagnosed 2014

  • Brian Lovell, Diagnosed 2011 . MND Australia

    Brian Lovell, Diagnosed 2011 . MND Australia

  • Sally Pauls, Diagnosed 2006 , Les Turner ALS Foundation

    Sally Pauls, Diagnosed 2006 , Les Turner ALS Foundation

  • David Bishop

    David Bishop

  • Amparo Muriel Engativa, Colombia

    Amparo Muriel Engativa, Colombia

  • Danny Reviers, Diagnosed 1979 , ALS Liga België, Belgium

    Danny Reviers, Diagnosed 1979 , ALS Liga België, Belgium

  • Steve Gallagher, ALS Society of Canada

    Steve Gallagher, ALS Society of Canada
    Picture1

  • Wilfried Leusing

    Wilfried Leusing

  • Jack Buzby, USA

    Jack Buzby, USA

  • Anita Forte, Les Turner ALS Foundation, USA

    Anita Forte, Les Turner ALS Foundation, USA

  • Mauril Belanger

    Mauril Belanger

  • Wiebke Braach, Deutsche Gesellschaft für Muskelkranke, Germany

    Wiebke Braach, Deutsche Gesellschaft für Muskelkranke, Germany

  • Teddy Hanono Annie, Apoyo Integral Gila A.C., Diagnosed 2018, Mexico

    Teddy Hanono Annie, Apoyo Integral Gila A.C., Diagnosed 2018, Mexico

  • Olga Cosentino, Diagnosed 2013,  Asociación ELA Argentina

    Olga Cosentino, Diagnosed 2013, Asociación ELA Argentina

  • Hollister

    Hollister
    hollister

  • Steven Spencer, Diagnosed 2014 , MND New Zealand

    Steven Spencer, Diagnosed 2014 , MND New Zealand

  • Joyce Rusinak, Forbes Norris ALS Center, USA

    Joyce Rusinak, Forbes Norris ALS Center, USA

  • Duncan Bayly , MND Australia

    Duncan Bayly , MND Australia

  • Dr Shelly Hoover

    Dr Shelly Hoover

  • Tammy Moore and Eddy Lefrancois

    Tammy Moore and Eddy Lefrancois

  • Osiel Mendoza, Diagnosed 2016 ,  ALS Therapy Development Institute, USA

    Osiel Mendoza, Diagnosed 2016 , ALS Therapy Development Institute, USA

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