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A Study of the Safety and Effectiveness of Efgartigimod in Patients With Primary Sjögren's Syndrome (pSS)

Phase 2
Completed
Conditions
Primary Sjögren's Syndrome
Interventions
Biological: Placebo
Biological: Efgartigimod
Registration Number
NCT05817669
Lead Sponsor
argenx
Brief Summary

The purpose of this study is to assess the efficacy and safety of human FcRn blocking therapy with efgartigimod compared to placebo, in participants with pSS.

Detailed Description

Primary Sjogren Syndrome (pSS) is an autoimmune disease with still unmet treatment needs. Efgartigimod, a human FcRn antagonist, has the potential to successfully treat pSS and improve disease manifestations by the reduction of IgG autoantibodies and immune complexes in pSS. The study design is randomized, double-blinded, and placebo-controlled to evaluate the effect of efgartigimod administered as an IV infusion compared to placebo. The study consists of a treatment period when all participants will receive infusions of IP/placebo for 24 weeks. At the end of the randomized treatment period, eligible participants may roll over to an OLE study or remain in this study through the end of the 56-day follow-up period.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
34
Inclusion Criteria
  • Is at least the legal age of consent for clinical trials when signing the informed consent form
  • Is capable of providing signed informed consent and complying with protocol requirements
  • Agrees to use contraceptive measures consistent with local regulations and measures described in the protocol
  • Meets the following criteria at screening: ACR/EULAR 2016 pSS who met criteria ≤7 years before screening; ESSDAI ≥5; Anti-Ro/SS-A positive; Residual salivary flow (UWSF rate >0 and/or SWSF rate >0.10)
Exclusion Criteria
  • Known autoimmune disease or any medical condition that, in the investigator's judgment,would interfere with an accurate assessment of clinical symptoms of pSS or puts the participant at undue risk
  • History of malignancy unless considered cured by adequate treatment with no evidence of recurrence for ≥3 years before the first administration of IMP.
  • Adequately treated participants with the following cancers may be included at any time: Basal cell or squamous cell skin cancer; Carcinoma in situ of the cervix; Carcinoma in situ of the breast; Incidental histological finding of prostate cancer (TNM stage T1a or T1b) Clinically significant uncontrolled active acute or chronic bacterial, viral, or fungal infection
  • Positive serum test at screening for an active infection with any of the following: HBV that is indicative of an acute or chronic infection, unless associated with a negative HBsAg or negative HBV DNA test; HCV based on HCV antibody assay unless a negative RNA test is available; HIV based on test results of a CD4 count of <200 cells/mm3 that are associated with an AIDS-defining condition, HIV based on test results of a CD4 count of >200 cells/mm3 not adequately treated with antiviral therapy
  • Clinically significant disease, recent major surgery (within 3 months of screening), or intention to have surgery during the study; or any other medical condition that, in the investigator's opinion, would confound the results of the study or put the participant at undue risk
  • Immunoglobulin G (IgG) levels cannot be below a certain threshold ( 4g/L)
  • Positive covid test at study start
  • Some of the medications such as vaccines with live components or medicines that may be prescribed cannot be taken either shortly before or during this study
  • Current participation in another interventional clinical study or previously participation in an efgartigimod clinical study and treatment with ≥1 dose of IMP
  • Known hypersensitivity to IMP or 1 of its excipients
  • History (within 12 months of screening) of current alcohol, drug, or medication abuse as assessed by the investigator
  • Pregnant or lactating state or intention to become pregnant during the study
  • Secondary Sjögren's syndrome overlap syndromes where another confirmed autoimmune rheumatic or systemic inflammatory condition is the primary diagnosis
  • Chinese traditional medicine with known immunomodulatory action

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Placebo armPlacebopatients receiving infusions of placebo IV
Efgartigimod IV armEfgartigimodpatients receiving infusions of Efgartigimod IV
Primary Outcome Measures
NameTimeMethod
Proportion of CRESS responders on ≥3 of 5 items at week 24up to week 24

The 5 items are Systemic disease activity: clinESSDAI; Patient-reported symptoms: ESSPRI; Tear gland function: Schirmer's test and OSS; Salivary gland function: UWSF rate and SGUS; Serology (serum IgG and/or RF)

Secondary Outcome Measures
NameTimeMethod
Change in ESSDAI score at week 24up to 24 weeks
Change in B/B+T cell ratio at week 24up to 24 weeks
Clinically significant changes in vital sign measurementsUp to 35 weeks

weight in kg, Systolic Blood Pressure in mmHg, Diastolic Blood Pressure in mmHg, pulse in bpm

Incidence and severity of TEAEs, AESIs, and SAEs by SOC and PTup to 35 weeks

To evaluate the safety of efgartigimod IV compared to placebo in participants with pSS

Proportion of participants with minimal clinically important improvement in ESSDAI: improvement of ≥3 points in ESSDAI score at week 24up to 24 weeks
Proportion of participants with minimal clinically important improvement in clinESSDAI: improvement of ≥3 points in clinESSDAI score at week 24up to 24 weeks
Change in the relative counts of lymphocytic infiltrate (stained for CD45) at week24up to 24 weeks
Change in clinESSDAI score at week 24up to 24 weeks
Change in ESSPRI score at week 24up to 24 weeks
Proportion of participants with STAR score of ≥5 at week 24up to 24 weeks
Clinically significant changes in ECG resultsUp to 35 weeks

Heart Rate in bpm, QRS in ms, PR in ms, QTc in ms

Clinically significant changes in clinical laboratory safety evaluationsUp to 35 weeks

Chemistry, Haematology, HbA1C in %, Urinalysis, beta-hCG mUI/mL

Proportion of participants with low disease activity: ESSDAI score of <5 at week 24up to 24 weeks
Proportion of participants with low disease activity: clinESSDAI score of <5 at week 24up to 24 weeks
Proportion of participants with minimal clinically important improvement in ESSPRI: decrease of 1 point or ≥15% at week 24up to 24 weeks

Trial Locations

Locations (17)

ETG Lublin

🇵🇱

Lublin, Poland

Clinical Research Center Spółka z ograniczoną odpowiedzialnością Medic-R Sp.k.

🇵🇱

Poznan, Poland

MICS Centrum Medyczne Warszawa

🇵🇱

Warszawa, Poland

Reumed Spolka z o.o.

🇵🇱

Lublin, Poland

Universitair Ziekenhuis Gent

🇧🇪

Gent, Belgium

Debreceni Egyetem

🇭🇺

Debrecen, Hungary

Vita Verum Medical Egeszsegugyi Szolgaltato Bt.

🇭🇺

Szekesfehervar, Hungary

Universitair Medisch Centrum Groningen , Dept of Rheumatology and Clinical Immunology

🇳🇱

Groningen, Netherlands

MCBK Iwona Czajkowska Anna Podrażka- Szczepaniak S.C.

🇵🇱

Grodzisk Mazowiecki, Poland

Ambulatorium Barbara Bazela

🇵🇱

Elblag, Poland

FutureMeds Krakow

🇵🇱

Krakow, Poland

Centrum Medyczne Plejady

🇵🇱

Kraków, Poland

Centrum Medyczne Pratia Poznan

🇵🇱

Skórzewo, Poland

Centrum Medyczne Reuma Park

🇵🇱

Warsaw, Poland

FutureMeds Targowek

🇵🇱

Warsaw, Poland

KO-Med - Centrum Badań Medycznych NIGRiR

🇵🇱

Warszawa, Poland

FutureMeds Wroclaw

🇵🇱

Wroclaw, Poland

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