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ION363

Phase 3

Amyotrophic Lateral Sclerosis | Small molecule | Neurology |Ionis Pharmaceuticals, Inc.|Last Updated: Feb 18, 2026

Success Probability
Approval Probability 71%
TA Base Rate26%
Adjusted LOA41%
ML RiskLOW_RISK
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Market & Valuation
rNPV $3.2B
Market Size $9.4B
Revenue Basis $1.6B
Competitors 6
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Trial Design
RandomizedDouble-BlindPLACEBO_CONTROLLEDDMCBiomarker
Total Trials1
Total Enrollment89
FDA Designations
No designations recorded
Clinical Trials (1)
NCT IDTitlePhaseStatusEnrollmentVelocityDesignStartCompletionLast UpdatedSitesCountries
NCT04768972FUSION: A Study to Evaluate the Efficacy, Safety, Pharmacokinetics and Pharmacodynamics of ION363 in Amyotrophic Lateral Sclerosis Participants With Fused in Sarcoma Mutations (FUS-ALS)PHASE3 ACTIVE NOT_RECRUITING 89Jun 14, 2021Mar 1, 2028Feb 18, 202625 United States, Belgium +14
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Study Endpoints
Primary Endpoints
Change from Baseline (Day 1) through Study Day 505 in Part 1 in functional impairment
Baseline, Day 505 in Part 1

Functional impairment to be measured by joint rank analysis of the combined assessment of: In-clinic Amyotrophic Lateral Sclerosis Functional Rating Scale-Revised (ALSFRS-R) total score, time of rescue or discontinuation from Part 1 and entering Part 2 due to a deterioration in function, and ventilation assistance-free survival (VAFS). ALSFRS-R measures functional disease severity. The scale measures four functional domains, bulbar function, gross motor skills, fine motor skills, and respiratory function. The assessment will contain 12 questions scored from 0 (no function) to 4 (full function), with a total possible score of 48, which will indicate the highest level of function. ALSFRS-R will be a part of the combined assessment of joint rank analysis to assess efficacy in Part 1.

Secondary Endpoints
Change from Baseline in ALS Assessment Questionnaire, 5-item (ALSAQ-5)
Baseline, Day 505 in Part 1
Change from Baseline in the in-clinic Amyotrophic Lateral Sclerosis Functional Rating Scale-Revised (ALSFRS-R)
Baseline, Day 505 in Part 1
Survival and Ventilation Assistance-Free Survival (VAFS)
Up to Day 505 in Part 1
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Study Design & Arms
AllocationRANDOMIZED
MaskingDOUBLE
ModelPARALLEL
PurposeTREATMENT
Treatment Arms
ArmTypeDescription
ION363EXPERIMENTALION363 will be administered by lumbar intrathecal (IT) bolus injection every 12 weeks, with an additional loading dose at 4 weeks, over a 60-week double-blind treatment period in Part 1; every 12 weeks for 84 weeks in the open-label extension treatment period (Part 2), with an additional loading dose administered 4 weeks after the first dose. Patients may continue to receive open-label ION363 every 12 weeks in Part 3 for up to 3 additional years or until ION363 becomes commercially available in the patient's country or until the Sponsor discontinues the development program, whichever occurs earlier.
PlaceboPLACEBO_COMPARATORPlacebo will be administered by lumbar IT bolus injection every12 weeks, with an additional loading dose at 4 weeks, over a 60-week double-blind treatment period (Part 1).
Interventions
NameTypeDescription
ION363DRUGION363 will be administered by IT bolus injection.
PlaceboDRUGPlacebo will be administered by IT bolus injection.
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Eligibility Criteria
Age Range10 Years — N/A
SexALL
Healthy VolunteersNo
Study Sites25

Inclusion Criteria for Part 1: 1. Participants must be ≥10 years of age at the time of informed consent and have signs or symptoms consistent with an ALS disease (in the opinion of the Investigator). 2. Genetic mutation in FUS confirmed by a testing laboratory that is Clinical Laboratory Improvemen...

Countries:United StatesBelgiumBrazilCanadaGermanyIrelandItalyJapanNetherlandsPolandSouth KoreaSpainSwedenSwitzerlandTaiwanUnited Kingdom
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Recent Changes (Last 90 Days)
LOWMay 26, 2026NCT04768972primaryCompletionDate: changed
LOWMay 24, 2026NCT04768972studyFirstPostDate: changed