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 daysprior to initiation of study drug;

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

• Last documented pulmonary function test result (i.e., slow vital capacity or forcedvital 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 timesupper limit of normal);

• Currently diagnosed with a clinically significant psychiatric disorder or dementiathat 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 bythe Investigator;

• Currently participating, or has participated in a study with an investigational ormarketed 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.