Skip to main content
OpenTrials
Recruiting

NCT Number: NCT07161999

Study of COYA 302 for the Treatment of ALS

The ALSTARS trial will be conducted across 20-25 sites in the US and Canada, and will evaluate the safety and efficacy of an investigational treatment called COYA 302 for adults with Amyotrophic Lateral Sclerosis (ALS).

COYA 302 is an investigational and proprietary biologic combination therapy with a dual immunomodulatory mechanism of action intended to enhance the anti-inflammatory function of regulatory T cells (Tregs) and suppress the inflammation produced by activated monocytes and macrophages. It is comprised of low dose interleukin-2 (LD IL-2) and DRL_AB (a biosimilar candidate for abatacept). Participants will be randomly assigned to receive one of 2 regimens of COYA 302 or placebo (an inactive substance) in a 1:1:1 ratio for 24 weeks in the double-blind (DB) period. Those who complete this part of the study will be eligible to receive one of the two regimens of COYA 302 for an additional 24 weeks in a blinded active extension phase (EXT).

The study will assess changes in disease progression using established ALS clinical outcome measures, including the ALS Functional Rating Scale-Revised (ALSFRS-R), neurofilament (NfL), maximal inspiratory pressure (MIP), slow vital capacity (SVC), and neurological assessments. Additional objectives include evaluation of biomarkers and safety through routine clinical assessments and adverse event monitoring.

Recruiting

Interested in participating?

Request Info

Key information

Age range

18 year–80 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Phase 2

Primary location

University of British Columbia, Vancouver, British Columbia, Canada

Loading trial locations.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Key Inclusion Criteria:

  • Sporadic or familial ALS, diagnosed as clinically probable, lab-supported probable, or definite ALS according to the revised El Escorial criteria
  • Male or female participants aged 18 to 80
  • Time since onset of ALS symptoms ≤28 months from Screening.
  • ALSFRS-R total score ≥35 at Screening
  • Rate of progression at baseline between -0.5 and -1.5 points per month on ALSFRS-R total score.
  • SVC ≥70% of predicted capacity.
  • Participants receiving riluzole must be on a stable dose for at least 30 days prior to Screening, with intent to stay on stable dosage throughout the study. If not on a stable dose of riluzole for at least 30 days prior to Screening, willing to refrain from initiation of the agent for the duration of the trial.
  • Participants receiving edaravone (intravenous [IV] or oral, RADICAVA®) must have completed at least one treatment cycle prior to Screening, with intent to remain on stable dosage throughout the study. If participant has not completed at least one treatment cycle of edaravone at the time of Screening, willing to refrain from initiation of the agent for the duration of the trial.
  • Participants receiving tofersen (QALSODY®) must have completed 90 days of treatment prior to Screening, with intent to remain on stable dosage throughout the study. If participant has not completed at least 90 days of tofersen at the time of Screening, willing to refrain from initiation of the agent for the duration of the trial.

Key Exclusion Criteria:

  • Any clinically significant and/or unstable medical (including active systemic infections requiring treatment), surgical, or psychiatric condition or laboratory abnormality other than ALS, in the judgement of the Investigator.
  • Active suicidality (e.g., any suicide attempts within the past 12 months or any current suicidal intent, including a plan, as assessed by the C-SSRS, score of "YES" on questions 4 or 5; and/or based on clinical evaluation by the Investigator).
  • Alanine aminotransferase (ALT) or aspartate aminotransferase (AST) levels greater than 3 times the upper limit of normal (ULN).
  • Significant renal impairment as determined by estimated glomerular filtration rate (eGFR) of <60 mL/min.
  • Pre-existing chronic obstructive pulmonary disease or significant pulmonary impairment including those with an FEV1 ≤ 2 liters or < 75% predicted for height and age, in the judgement of the Investigator.
  • Clinically significant history of cardiac function impairment including cardiac ejection fraction below 40%, ventricular wall motion abnormalities, or coronary artery disease.
  • Any organ allografts.
  • A positive tuberculosis (TB) test indicating a latent TB infection or a positive test for viral hepatitis.
  • Currently receiving or have received abatacept treatment within 75 days prior to Screening.
  • Currently receiving or have received interleukin-2 (IL-2) treatment within 30 days prior to Screening.
  • Currently receiving or expected to receive immunosuppressant therapy (e.g., cyclosporine, sirolimus, tacrolimus, mycophenolate mofetil, systemic steroids) over the course of the study.
  • Planning to receive a live vaccine during the study or within 3 months of discontinuation.
  • Current participation in another interventional clinical trial and/or participation in any investigational medication or device clinical trial within 30 days prior to Screening or 5 half-lives of elimination of the investigational medication, whichever is longer.
  • Previous participation in any COYA 302 (LD rhIL-2 and DRL_AB) study.
  • Uncontrolled autoimmune condition.
  • Presence of an indwelling central catheter.

NOTE: Other protocol defined Inclusion/Exclusion criteria may apply.

Treatment and study plan

COYA 302

Drug

Administered as specified in the treatment arm.

Other names: LD rhIL-2 and CTLA-4 Ig

Placebo

Drug

Administered as specified in the treatment arm.

Primary outcomes

  1. The change in disease progression as measured by the Revised ALS Functional Rating Scale (ALSFRS-R)

    Time frame: Baseline to Week 24

    The ALSFRS-R is an ordinal rating scale used to determine a participant's subjective assessment of their capability and independence with 12 functional activities. The maximal score is 48.

Secondary outcomes

  1. Serum neurofilament light chain (NfL)

    Time frame: Baseline to Week 24

    Serum NfL will be quantified as a biomarker of neuroaxonal injury.

  2. Maximal Inspiratory Pressure (MIP)

    Time frame: Baseline to Week 24

    MIP is a measure of respiratory muscle strength and will be evaluated as an indicator of pulmonary function decline.

  3. Combined Assessment of Function and Survival (CAFS)

    Time frame: Baseline to Week 24

    CAFS is a ranked analysis combining functional decline (ALSFRS-R change) and survival status to provide a composite efficacy endpoint.

  4. Slow Vital Capacity (SVC)

    Time frame: Baseline to Week 24

    SVC is a measure of respiratory function.

Study contacts

Contact information is provided by the study sponsor or research team.

Medical Director

CONTACT

[email protected]

800-587-8170

Sponsors and collaborators

Lead sponsor

Coya Therapeutics

Industry

Registry information

Official study title

Phase 2, Randomized, Double-Blind, Placebo-Controlled, Multi-Center, 24-Week Study With Additional 24-Week Blinded Active Extension to Evaluate the Safety and Efficacy of COYA 302 for the Treatment of Amyotrophic Lateral Sclerosis (ALS)

Acronym: ALSTARS

Important dates

Study start
2025
Primary completion
2027
Study completion
2027
First posted
Sep 9, 2025
Registry last updated
May 20, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

Published trials that share one or more normalized conditions with this study.