GSE209696
Ropinirole hydrochloride identified by iPSC drug discovery for amyotrophic lateral sclerosis: a single-centered, randomized, double-blind, placebo-controlled phase 1/2a trial
We assessed the safety and efficacy of ropinirole, a candidate drug for amyotrophic lateral sclerosis (ALS) identified using induced pluripotent stem cells (iPSCs) technology, by a randomized controlled trial (UMIN000034954). Twenty participants were randomly assigned to ropinirole or placebo for 24 weeks in the double-blind period, followed by a 24-week open-label active extension period. Primary outcomes were safety and tolerability. Secondary outcomes evaluated the therapeutic effects of ropinirole. Adverse events were mostly those previously reported, with similar rates in both groups. Participants in the ropinirole group had lived an additional 27.9 weeks without disease progression compared with the placebo group at 12 months. We validated and confirmed the efficacy of ropinirole in patients with ALS using the largest publicly available real-world registry database of ALS (PRO-ACT). The iPSCs-derived motor neurons from the participants showed the D2R expression and the potential involvement of the SREBP2-cholesterol synthetic pathway in the therapeutic effects. Overall design: Motor neurons were differenciated from iPS cells derived from sporadic ALS patients and performed total RNA-sequencing under the conditions of cell culture with and without ropinirole hydrochloride.