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Sustained-release oral morphine to alleviate persistent dyspnea in patients with chronic respiratory insufficiency due to amyotrophic lateral sclerosis outside the administration of ventilatory assistance: prospective multicenter randomized, placebo-controlled study, parallel arms (OPIDYS-ALS).
EU CTIS ID: 2025-522546-52-00
What this study is testing
The primary objective is to show that oral sustained-release morphine reduces the unpleasantness of the worst episode of dyspnea experienced during a given day, four weeks after inclusion in the study.
- Therapeutic confirmatory (Phase III)
A plain-language read of the study's public EU CTIS listing. The study team confirms the details.
Who can take part
You may be able to join if
- age over 18 ;
- known diagnosis of amyotrophic lateral sclerosis irrespective of the clinical form of the disease, its severity and its progression;
- chronic respiratory insufficiency with home nocturnal non-invasive mask ventilation established for at least 6 hours per night since 3 months or more (no upper limit);
- self-report of dyspnea while breathing unassisted during the day (i.e outside nocturnal ventilation), either at rest or for minimal efforts, with a rating of 2 or more on a dyspnea unpleasantness numerical rating scale;
- affiliation to a social security regime (patients on "aide médicale d'état" will not be included);
- ability to understand participants' information;
You likely can't join if
- Woman of childbearing potential, unless they are using reliable methods of contraception stable for a minimum of 2 months prior to first administration and willing to use it for the entire duration of the study and for one month after the last dosing.
- Conditions with increased potential for gastrointestinal perforation
- Clinically important disruptions of the blood-brain barrier
- permanent dependency on ventilatory assistance (more than 20 hours a day);
- Myocardial infarction within the past 6 months
- Patients treated with strong CYP3A4 inducers (e.g. carbamazepine, rifampin, St. John’s Wort)
See the full eligibility criteria
Who can join
- age over 18 ;
- known diagnosis of amyotrophic lateral sclerosis irrespective of the clinical form of the disease, its severity and its progression;
- chronic respiratory insufficiency with home nocturnal non-invasive mask ventilation established for at least 6 hours per night since 3 months or more (no upper limit);
- self-report of dyspnea while breathing unassisted during the day (i.e outside nocturnal ventilation), either at rest or for minimal efforts, with a rating of 2 or more on a dyspnea unpleasantness numerical rating scale;
- affiliation to a social security regime (patients on "aide médicale d'état" will not be included);
- ability to understand participants' information;
- prior signing of informed consent .
What rules you out
- Woman of childbearing potential, unless they are using reliable methods of contraception stable for a minimum of 2 months prior to first administration and willing to use it for the entire duration of the study and for one month after the last dosing.
- Conditions with increased potential for gastrointestinal perforation
- Clinically important disruptions of the blood-brain barrier
- permanent dependency on ventilatory assistance (more than 20 hours a day);
- Myocardial infarction within the past 6 months
- Patients treated with strong CYP3A4 inducers (e.g. carbamazepine, rifampin, St. John’s Wort)
- History of opioid abuse
- presence of a tracheostomy;
- inability to read and understand the rating scales and questionnaires correctly; the inability to personally fill scoring forms in not a non-inclusion criterion if a caregiver is identified and can provide for this action;
- known contraindications to the administration of morphine or other opioids (Acute or severe respiratory depression, acute bronchial asthma, paralytic ileus, gastrointestinal obstruction, coma, severe central nervous system depression, known hypersensitivity to morphine or other opioids, acute alcohol intoxication, concomitant use of monoamine oxidase inhibitors or within 14 days of their discontinuation, head injury, raised intracranial pressure, acute abdomen, severe hepatic impairment, severe renal impairment, uncontrolled seizures, delirium tremens, severe hypotension, shock, biliary colic, pancreatitis, pregnancy at or near term, breastfeeding, inability to swallow or risk of aspiration, use in opioid-naïve patients at high doses)
- another indication for the administration of morphine
- known severe hepatocellular insufficiency (with encephalopathy)
- known contraindications to the administration of naloxegol ((Known or suspected gastrointestinal obstruction, risk of recurrent gastrointestinal obstruction, hypersensitivity to naloxegol or excipients, concomitant use of strong CYP3A4 inhibitors (Ketoconazole, itraconazole, posaconazole, voriconazole, clarithromycin, telithromycin, ritonavir, cobicistat, indinavir, nelfinavir, saquinavir, atazanavir, nefazodone, boceprevir, telaprevir, grapefruit juice) severe hepatic impairment (Child–Pugh class C)
- Patients with rare hereditary problems of galactose intolerance, total lactase deficiency or glucose-galactose malabsorption.
- known renal insufficiency at inclusion time (confirmed by the last biology by a creatinine clearance < 30 ml/min calculated with the Cockcroft-Gault formula)
- Women who are pregnant, breastfeeding, or plan to become pregnant while in the trial.
- known uncontrolled epilepsy
- swallowing difficulties severe enough to prevent the oral administration of drugs
- participation in another interventional clinical trial evaluating a health product or any randomized clinical trial
- under legal protection measure (tutorship or curatorship) and patient deprived of freedom
- prior diagnosis of concurrent chronic respiratory disease, such as asthma, chronic obstructive pulmonary disease or restrictive lung disease; this criterion will be appreciated by the investigator from the participants medical charts and no further diagnostic procedure will be required;
- episode of acute respiratory deterioration resolved less than 3 weeks before inclusion;
- Hypercapnia associated with an arterial blood pH below 7.38
The study team makes the final eligibility decision.
Questions & answers
Do participants get paid in this trial?
This listing doesn't specify compensation. Many trials still reimburse travel or offer a stipend, so it's worth asking the study team when you connect.
Is it free to join, and do I need insurance?
Searching and applying through BridgeMD is free. In clinical trials the study-related treatment and visits are generally provided at no cost to you. You usually don't need insurance to take part - confirm specifics with the study team.
How long does this study last?
The listing doesn't state an exact length. The study team walks you through the schedule and number of visits before you decide to enroll.
Who can join this trial?
This study is enrolling all sexes, 65+ years, 18-64 years. The study team makes the final eligibility decision.
Explore other conditions
BridgeMD is an information and trial-matching tool - not medical advice, and not the study sponsor. Details come from EU CTIS; the study team decides eligibility.