A Clinical Trial to Investigate the Safety and Tolerability, Efficacy, Pharmacokinetics, Pharmacodynamics and Immunogenicity of 2 Dose Regimens of ARGX-117 in Adults with Multifocal Motor Neuropathy

Phase 2

Completed

• Conditions: Multifocal Motor Neuropathy
• Interventions: Biological: ARGX-117; Other: Placebo

• Registration Number: NCT05225675
• Lead Sponsor: argenx

Brief Summary

This is a phase 2, randomized, double-blinded, placebo-controlled, parallel-group, multicenter trial to evaluate the safety and efficacy of 2 dose regimens of ARGX-117 versus placebo, in participants with MMN previously stabilized with IVIg (intravenous immunoglobulin).

Detailed Description

Not available

Study Timeline

• Study First Submitted: 2021-11-05
• Study First Submitted QC: 2022-02-03
• Study First Posted: 2022-02-04
• Study Start: 2022-03-31
• Primary Completion: 2024-06-04
• Study Completion: 2024-06-04
• Status Verified: 2024-10
• Last Update Submitted: 2024-10-17
• Last Update Posted: 2024-10-18

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 54

Inclusion Criteria

1. Capable of giving signed informed consent form (ICF)
2. Male/female at least 18 years of age at the time the informed consent form (ICF) is signed
3. Probable or definite MMN according to the European Federation of Neurological Societies (EFNS)/Peripheral Nerve Society (PNS) (EFNS/PNS) 2010 guidelines at screening confirmed by the MMN Confirmation Committee (MCC)
4. Receiving a stable IVIg regimen for at least 3 months before screening or recently initiated IVIg treatment
5. IVIg treatment dependency confirmation by the MMN Confirmation Committee (MCC)
6. Immunization with the first meningococcal vaccine and pneumococcal vaccine, and the single Haemophilus influenza type B vaccine must be performed at least 14 days before IMP administration at V1 according to local country-specific immunization schedules. A documented history of vaccination against Neisseria meningitides, Haemophilus influenza type B, and streptococcus pneumonia will be permitted
7. Contraceptive use by men and women should be consistent with local regulations regarding the methods of contraception for those participating in clinical studies

Exclusion Criteria

1. Any coexisting condition which may interfere with the outcome assessments

2. Clinical signs or symptoms suggestive for neuropathies other than MMN such as motor neuron disease or other inflammatory neuropathies

3. Severe psychiatric disorder, history of suicide attempt, or current suicidal ideation that in the opinion of the investigator could create undue risk to the participant or could affect adherence with the trial protocol.

4. Clinically significant uncontrolled active or chronic bacterial, viral, or fungal infection during the screening and/or IVIg monitoring period (IVMP).

5. Any other known autoimmune disease that, in the opinion of the investigator, would interfere with an accurate assessment of clinical symptoms of MMN or put the participant at undue risk (eg, SLE).

6. History of malignancy unless resolved by adequate treatment with no evidence of recurrence for ≥3 years before the first administration of the IMP. Participants with the following carcinomas will be eligible:

   1. Adequately treated basal cell or squamous cell skin cancer
   2. Carcinoma in situ of the cervix
   3. Carcinoma in situ of the breast
   4. Incidental histological finding of prostate cancer

7. Clinical evidence of other significant serious diseases, have had a recent major surgery (including a splenectomy at any time), or who have any other condition in the opinion of the investigator, that could confound the results of the trial or put the participant at undue risk

8. Prior/concomitant therapy

   1. Cyclophosphamide and/or rituximab and/or eculizumab and/or mycophenolate mofetil within 3 months prior to screening
   2. Use of an investigational product within 3 months or 5 half-lives (whichever is longer) before the first dose of the IMP.

9. Positive serum test at screening for an active viral infection with any of the following conditions:

   1. Hepatitis B virus (HBV) that is indicative of an acute or chronic infection
   2. Hepatitis C virus (HCV) based on HCV antibody assay
   3. HIV based on test results that are associated with an AIDS-defining condition

10. Current or history of (ie, within 12 months of screening) alcohol, drug, or medication abuse

11. Known hypersensitivity reaction to 1 of the components of the IMP or any of its excipients

12. Female participants with a positive serum or urine pregnancy test, lactating females, and those who intend to become pregnant during the trial or within 15 months after last dose of the IMP

13. ALT or AST ≥2 × upper limit of normal and total bilirubin ≥1.5 × upper limit of normal of the central laboratory reference range

14. An estimated glomerular filtration rate of ≤60 mL/min/1.73m2

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
ARGX-117	ARGX-117	Intravenous administration of ARGX-117
Placebo	Placebo	Intravenous administration of placebo

Primary Outcome Measures

Name	Time	Method
Safety outcomes based on adverse event (AE) monitoring and other safety assessments	16 weeks

Secondary Outcome Measures

Name	Time	Method
Proportion of participants with a GS (grip strength) decrease of 8 kilopascal (kPa) or more over 3 consecutive days	16 weeks
Maximum serum concentrations (Cmax)	16 weeks
AUC (area under curve) of the change from baseline in mMRC (modified Medical Research Council)-10 sum score	16 weeks
Value baseline in the mMRC (modified Medical Research Council)-14 sum score	16 weeks
Proportion of participants showing a deterioration of 1 or more points in at least 2 muscle groups as assessed by the mMRC (modified Medical Research Council)-14 sum score	16 weeks
Proportion of participants with no deterioration in 2 or more muscle groups as assessed by mMRC (modified Medical Research Council)-14 sum score	16 weeks
Values baseline in GS (grip strength)	16 weeks	The baseline for the grip strength is a 3-day moving average per hand, measured as an average of 3 contractions daily, each lasting 3 seconds.; Measurement of GS will be done using the Martin vigorimeter in kPa.
Percent change from baseline in GS (grip strength)	16 weeks	The baseline for the grip strength is a 3-day moving average per hand, measured as an average of 3 contractions daily, each lasting 3 seconds.; Measurement of GS will be done using the Martin vigorimeter in kPa.
Time to the first retreatment with IVIg since the final IVIg treatment of the IVIg monitoring period	16 weeks
Change from baseline in the average score of the 2 most important muscle groups as assessed by the mMRC (modified Medical Research Council)-14 sum score	16 weeks
Change from baseline in GS (grip strength)	16 weeks	The baseline for the grip strength is a 3-day moving average per hand, measured as an average of 3 contractions daily, each lasting 3 seconds.; Measurement of GS will be done using the Martin vigorimeter in kPa.
Change from baseline in the mMRC (modified Medical Research Council)-14 sum score	16 weeks
Values baseline in the average time for upper extremity (arm and hand) function (9-Hole Peg Test [9-HPT], or timed Peg Board Test)	16 weeks
Change from baseline in the average time for upper extremity (arm and hand) function (9-Hole Peg Test [9-HPT], or timed Peg Board Test)	16 weeks
Serum titer levels of binding antibodies (BAbs) against ARGX-117	16 weeks
Change from baseline in the chronic acquired polyneuropathy patient-reported index (CAP-PRI)	16 weeks
Values baseline in free C2, total C2, functional complement activity (CH50)	16 weeks
Change from baseline in quality of life using EQ-5D-5L visual analog scale	16 weeks
AUC (area under curve) of the change from baseline in GS (grip strength)	16 weeks
Values baseline in the Rasch-built overall disability scale for MMN (MMN-RODS©)	16 weeks
Change from baseline in the Rasch-built overall disability scale for MMN (MMN-RODS©)	16 weeks
Proportion of participants by level of severity on each dimension of the EQ-5D-5L scale	16 weeks
Change from baseline in free C2, total C2, functional complement activity (CH50)	16 weeks
Area Under The Curve (AUC)	16 weeks

Trial Locations

Locations (39)

HonorHealth Research Institute-Neuroscience Research; 🇺🇸 Maitland, Florida, United States

George Washington Medical Faculty Associates; 🇺🇸 Washington, District of Columbia, United States

University of South Florida Carol and Frank Morsani Center for Advanced Healthcare; 🇺🇸 Tampa, Florida, United States

California Pacific Medical Center-Forbes Norris MDA/ALS Research Center; 🇺🇸 San Francisco, California, United States

NorthShore University HealthSystem; 🇺🇸 Glenview, Illinois, United States

University of Kansas Medical Center; 🇺🇸 Kansas City, Kansas, United States

University of Minnesota Delware Clinic Research Unit; 🇺🇸 Minneapolis, Minnesota, United States

University of North Carolina at Chapel Hill; 🇺🇸 Chapel Hill, North Carolina, United States

Cleveland Clinic; 🇺🇸 Cleveland, Ohio, United States

Perelman Center for Advanced Medicine-University of Penssylvania; 🇺🇸 Philadelphia, Pennsylvania, United States

Austin Neuromuscular Center; 🇺🇸 Austin, Texas, United States

West Virginia University Medicine; 🇺🇸 Morgantown, West Virginia, United States

Medizinische Universitat Wien Universitatsklienik fur Neurologie; 🇦🇹 Vienna, Austria

AZ Sint-Lucas; 🇧🇪 Ghent, Belgium

Genge Partners Montreal; 🇨🇦 Québec, Canada

Toronto General Hospital; 🇨🇦 Toronto, Canada

CHU de Bordeaux-Hopital Pellegrin; 🇫🇷 Bordeaux, France

CHRU de Lille-Hopital Roger Salengro; 🇫🇷 Lille, France

CHU de Nice-Hopital Pasteur 2; 🇫🇷 Nice, France

Hopital Pitie Salpetriere; 🇫🇷 Paris, France

Katholisches Klinikum Bochum; 🇩🇪 Bochum, Germany

Universitatsklinikum Essen; 🇩🇪 Essen, Germany

Universitatsmedzin Gottingen, Klinik fur Neurologie; 🇩🇪 Göttingen, Germany

Medizinische Hochschule Hannover Klinik Fur Neurologie; 🇩🇪 Hannover, Germany

Universitatsklinikum Munster; 🇩🇪 Münster, Germany

IRCCS Ospedale San Raffaele; 🇮🇹 Milan, Italy

Azienda Ospedaliero Univeritaria Pisana-UOS Neurologia; 🇮🇹 Pisa, Italy

Azienda Ospedaliera Sant'Andrea-UOS Malattie Neuromuscolari; 🇮🇹 Rome, Italy

Instituto Clinico Humanitas (IRCCS); 🇮🇹 Rozzano, Italy

Amsterdam UMC location AMC, Dep of Neurology; 🇳🇱 Amsterdam, Netherlands

University Medical Centre Utrecht; 🇳🇱 Utrecht, Netherlands

Michalscy I Partnerzy Lekarze Spolka Partnerska; 🇵🇱 Kraków, Poland

Uniwersyteckie centrum kliniczne Warszawskiego; 🇵🇱 Warsaw, Poland

Hospital Universitario Vall d'Herbon; 🇪🇸 Barcelona, Spain

Hospital de la Santa Creu I Santa Pau -Sevicio Neurologia; 🇪🇸 Barcelona, Spain

Hospital Universitari I Politecnic La Fe de Valencia-Servicio Neurologia; 🇪🇸 Valencia, Spain

Queen Elisabeth University Hospital; 🇬🇧 Glasgow, United Kingdom

University College London Hospital; 🇬🇧 London, United Kingdom

Oxford University Hospitals NHS Trust-Jonh Radcliffe Hospital; 🇬🇧 Oxford, United Kingdom