Evaluation of MN-166 (Ibudilast) for 12 Months Followed by an Open-label Extension for 6 Months in Patients With ALS

Major Inclusion Criteria:

- Male or female subjects age 18 - 80 years, inclusive;

- Diagnosis of familial or sporadic ALS as defined by the El Escorial-Revised (2000)
research diagnostic criteria for ALS [clinically definite, clinically probable,
probable-laboratory-supported];

- ALS onset of ≤18 months from first clinical signs of weakness prior to screening;

- If currently using riluzole, subject must be on a stable dose for at least 30 days
prior to initiation of study drug;

- If currently using edaravone, subject should have completed at least 14 days of their
initial treatment cycle prior to initiation of study drug;

- Last documented pulmonary function test result (i.e., slow vital capacity or forced
vital capacity) must be greater than or equal to 70% predicted;

- Able to swallow study medication capsules;

- No known allergies to the study drug or its excipients;

- Received pneumococcal vaccine within 6 years prior to starting clinical trial.

Major Exclusion Criteria:

- Confirmed hepatic insufficiency or abnormal liver function (AST and/or ALT >3 times
upper limit of normal);

- Currently diagnosed with a clinically significant psychiatric disorder or dementia
that would preclude evaluation of symptoms;

- Currently use or treated with parenteral (intramuscular or intravenous) high dose (>25
mg/week) Vitamin B12 within 30 days prior to study drug administration;

- Poor peripheral venous access that will limit the ability to draw blood as judged by
the Investigator;

- Currently participating, or has participated in a study with an investigational or
marketed compound or device within 30 days or 5 half-lives, whichever is shorter,
prior to signing the informed consent;

- Use of tracheostomy or >22/24-hour ventilatory support.