ROAR-HMB is an open-label pilot trial of a supplement called HMB (β-hydroxy-β-methylbutyrate) in people living with ALS. The researchers are evaluating its safety and tolerability, and whether it can lower insulin-like growth factor binding protein 7 (IGFBP7) and neurofilament light chain (NfL) levels and slow ALSFRS-R progression.

This is a widely inclusive, three-center pilot trial that will enroll 100 people. Duke University (25 people) and Temple University (25 people) are traditional sites that consent, screen and follow participants in person. EverythingALS (50 people) is a decentralized site that offers virtual consenting, screening and follow-up. The total time commitment is 9 months. HMB is given at a dose of 3g daily.