after joining the study, you will undergo a series of baseline assessments. these include a review of your medical history, physical examination, measurement of vital signs (such as blood pressure and heart rate), laboratory blood tests, and a 12‑lead ecg (electrocardiogram) to record the electrical activity of the heart.

the purpose of these assessments is to establish your health status before any medication is taken.

you will begin taking nb‑4746 capsules by mouth. the exact dose, frequency, and duration are determined by the study protocol and will be explained by the study staff.

the phase ib portion of the trial lasts for 28 days, during which you will continue the assigned medication daily.

each day you will swallow the prescribed capsule of nb‑4746 with water. if you are assigned to the placebo group, you will receive a matching capsule that does not contain active drug.

the medication is taken orally, and you should follow the timing instructions provided (for example, with or without food).

throughout the 28‑day period you will attend scheduled clinic visits. at each visit the study team will check for any treatment‑emergent adverse events (new or worsening symptoms), record vital signs, repeat laboratory tests, and perform a 12‑lead ecg.

these visits may occur weekly or as otherwise specified by the protocol.

at the conclusion of the 28‑day treatment period a final safety assessment is performed. this includes a summary of any adverse events, a review of vital signs, laboratory results, and the 12‑lead ecg.

the data are used to assess the safety profile of nb‑4746 in participants with amyotrophic lateral sclerosis.

participants may continue receiving nb‑4746 in a phase 2 or open label extension phase. the same oral capsule is taken for a longer period, with ongoing safety monitoring similar to the phase ib visits.

during this phase the focus remains on tracking adverse events, vital signs, laboratory tests, and 12‑lead ecg results.