How Clinical Trials Work

Clinical trials are health-related research studies that are conducted on humans.

ALS researchers run clinical trials for several reasons:

  • To determine whether an experimental drug is safe, tolerable or effective at slowing or stopping the progression of the disease.
  • To collect samples from ALS patients that can uncover biomarkers or clues to why certain people develop the disease.
  • To gain insights into the challenges pALS face with regard to communication and/or mobility and potential technological interventions to address those challenges.

Though the goals of each clinical trial vary, they generally follow a standard process.

  • Pre-trial screening: Participants are evaluated by the clinical trial team, which may include doctors, nurses, social workers, and other health care professionals. At this time, you'll be given specific instructions that you must follow during the trial.
  • The trial: Participants follow their specific trial protocol for the duration of the study. During this time, which could be anywhere from 6 months to a year or more, they are regularly monitored by their clinical trial team.
  • Post-trial: Many participants stay in touch with their clinical trial team even after the trial has been completed.

Clinical trials proceed through three phases (enrollment typical for ALS trials in parentheses):

Phase I: Researchers test an experimental drug or treatment in a small group of people (12-40) for the first time, to evaluate its safety, determine a safe dosage range, and identify side effects.

Phase 2: The experimental drug or treatment is given to a larger group of people (50-100) to test its effectiveness and further evaluate its safety, usually for a longer period of time that previously.

Phase 3: The experimental drug or treatment is given to large groups of people (600-1,000) to confirm its effectiveness, monitor side effects, compare it to the current standard of care, and collect any information that will ensure safe usage. Typically, a determination of effectiveness is issued by regulatory agencies following the completion of this phase.

What's in it for me?

For many ALS patients, participating in clinical trials gives them the sense of having some control over the course of their disease and an active hand in their treatment. There are other benefits as well. You'll have access to therapeutics before they've reached the marketplace and high-level medical care at top research hospitals. But perhaps most importantly, you'll know that your participation is a priceless contribution to the search for an ALS cure.

Of course, taking part in a clinical trial has its risks as well. You may face unpleasant, serious or even life-threatening side effects to an experimental treatment, which may, in the end, prove to be ineffective. And the trial protocol may require a lot of commitment on your part: trips to the research site, hospital stays, or complicated regimens of medications.

Ultimately, the decision to participate or not is a highly personal one. Before you decide, find out as much as you can about the trial, including who your health care team will be, what kind of care you'll receive during the trial, and how much it will cost. You may also want to visit our forums to talk to other pALS who have experience with clinical trials.

Find out more about clinical trials

If you’re interested in learning more about how clinical trials work, who’s offering them, and/or how to decide whether or not to take part in one, check out the links below.

Click here to view the clinical trials frequently asked questions.
Click here to view US FDA clinical trial page.
Click here to view NIH clinical trial registry.
How to evaluate a clinical trial >
Ask an Expert >

Learn more about ALS clinical trials

Go >

Webinar: The Clinical Trial Process:

This 60 minute webinar features Drs. Steve Perrin and Merit Cudkowicz speaking candidly and thoroughly about the clinical trial process experienced by ALS patients. They review the meaning of common terminology and offer instructive insight into how to better prepare for the process by reviewing current examples of trials enrolling ALS patients today. Go >

“I was a human lab rat”

What's it really like to participate in a clinical trial?

PALS share their stories. More >

I choose to participate in a trial for multiple reasons:

  1. PALS desperately need an effective treatment. There are multiple promising drugs, currently. But, the only way to obtain FDA approval is via proving safety and efficacy in human clinical trials. So, I chose to participate to advance the pursuit of an effective therapy.
  2. Though trials are not intended for treatment of participants, this is a large motivating factor. Most trials have at least a 50% chance of affecting disease progression or duration. But even if one ends up on a placebo arm, they are serving an important role.
  3. When presented with an opportunity to choose among multiple trials, I think of it as similar to an election, and choose the trial I believe holds the most promise for resulting in approval of the most effective therapy. There are too few participants, so I believe choosing "just any trial" can inadvertently slow progress towards effective therapies.

What is participation like? To me participation is very similar to a combination of frequent ALS clinic visits with lab work and of course with the addition of taking a drug.

-Rob (North Carolina)