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Evaluating the Long-Term Safety and Tolerability of Efgartigimod PH20 SC Administered Subcutaneously in Patients With Generalized Myasthenia Gravis

Phase 3
Completed
Conditions
Generalized Myasthenia Gravis
Interventions
Biological: efgartigimod PH20 SC
Registration Number
NCT04818671
Lead Sponsor
argenx
Brief Summary

The purpose of this study is to evaluate the long-term safety and tolerability of efgartigimod PH20 SC 1000 mg, and the clinical efficacy, PD, pharmacokinetics (PK), immunogenicity, impact on the quality of life (QoL) of the participants, treatment satisfaction, and administration method preference, and the feasibility of self- and caregiver-supported administration of the SC injection.

Treatment duration: 3-week treatment periods, repeated as needed with at least 28 days in between treatment periods

Health measurements: total levels of immunoglobulin G (IgG), Acetylcholine receptor binding autoantibodies (AChR-Ab) levels, Myasthenia Gravis Activities of Daly Living (MG-ADL).

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
183
Inclusion Criteria
  1. Must be capable of giving signed informed consent, which includes compliance with the requirements and restrictions listed in the informed consent form (ICF) and in this protocol.

  2. Previously participated in antecedent studies ARGX-113-2001 or ARGX-113-1705 and are eligible for roll over.

  3. Contraceptive use by men and women should be consistent with local regulations regarding the methods of contraception for those participating in clinical studies and:

    • Women of Child bearing potential (WOCBP) must have a negative urine pregnancy test at baseline before investigational medicinal product (IMP) can be administered.
Exclusion Criteria
  1. The participant was discontinued early from studies ARGX-113-2001 or ARGX-113-1705, unless the reason for discontinuation from study ARGX-113-1705 was to roll over into study ARGX-113-2002.

    a. Participants who, in the investigator's judgment, are not benefiting from efgartigimod IV in study ARGX-113-1705 Part B are not eligible for roll over into ARGX-113-2002.

  2. Are pregnant or lactating, or intend to become pregnant during the study or within 90 days after the last dose of investigational medicinal product (IMP)

  3. Has any of the following medical conditions:

    1. Clinically significant uncontrolled chronic bacterial, viral, or fungal infection at roll-over

    2. Any other known autoimmune disease that, in the opinion of the investigator, would interfere with accurate assessment of clinical symptoms of myasthenia gravis or put the participant at undue risk

    3. History of malignancy unless deemed cured by adequate treatment with no evidence of reoccurrence for ≥3 years before the first administration of investigational medicinal product (IMP).

      Participants with the following cancers can be included at any time:

      • adequately treated basal cell or squamous cell skin cancer
      • carcinoma in situ of the cervix
      • carcinoma in situ of the breast
      • incidental histological findings of prostate cancer (TNM classification of malignant tumors stage T1a or T1b)
    4. Clinical evidence of other significant serious diseases, or the participant has had a recent major surgery, or who have any other condition that, in the opinion of the investigator, could confound the results of the study or put the participant at undue risk

  4. Received a live-attenuated vaccine within 28 days prior to study entry or plan to receive a live-attenuated vaccine during the study

  5. A known hypersensitivity reaction to efgartigimod, rHuPH20, or any of its excipients

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
efgartigimod PH20 SCefgartigimod PH20 SCPatients receiving efgartigimod PH20 subcutaneous (SC) treatment
Primary Outcome Measures
NameTimeMethod
Incidence of Adverse Events of Special Interest (AESI)Up to 3.5 years
Incidence and severity of Adverse Events (AEs)Up to 3.5 years
Incidence of Serious Adverse Events (SAEs)Up to 3.5 years
Secondary Outcome Measures
NameTimeMethod
Percentage of caregivers who administered the injection to the participant at home over time by cycleUp to 3.5 years
Number of training visits needed for the participant or caregiver to be competent to start administering efgartigimod PH20 SCUp to 3.5 years
Myasthenia Gravis Activities of Daily Living (MG-ADL) total score changes from baselineUp to 3.5 years

the higher the score, the more impairment

Percentage change in levels of total immunoglobulin G (IgG) from baselineUp to 3.5 years
Cycle baseline over time by cycle (for total immunoglobulin G (IgG)Up to 3.5 years
Percentage change of anti-acetylcholine receptor antibodies (AChR-Ab) from baselineUp to 3.5 years
Cycle baseline over time by cycle (for MG-ADL)Up to 3.5 years
Prevalence of neutralizing antibodies (NAbs) against efgartigimod over timeUp to 3.5 years
Number of participants who performed self-administration at home over time by cycleUp to 3.5 years
Prevalence of ADAs to rHuPH20 over timeUp to 3.5 years
Cycle baseline over time by cycle in AChR-Ab seropositive participants (for acetylcholine receptor binding autoantibodies (AChR-Ab))Up to 3.5 years
Prevalence of anti-drug antibodies (ADAs) to efgartigimod over timeUp to 3.5 years
Incidence of neutralizing antibodies (NAbs) against efgartigimod over timeUp to 3.5 years
Incidence of ADAs to rHuPH20 over timeUp to 3.5 years
Incidence of NAbs against rHuPH20 over timeUp to 3.5 years
EQ-5D-5L responses over time by cycleUp to 3.5 years
Percentage of self- or caregiver-supported study drug administration among all study treatment visits at homeUp to 3.5 years
Efgartigimod serum concentrationsUp to 3.5 years
Prevalence of NAbs against rHuPH20 over timeUp to 3.5 years
Number of self- or caregiver-supported study drug administration among all study treatment visits at homeUp to 3.5 years
Incidence of anti-drug antibodies (ADAs) to efgartigimod over timeUp to 3.5 years
Cycle baseline by cycle (for MG-QoL15r)Up to 3.5 years
Changes in EuroQoL 5 Dimensions 5-Level (EQ-5D-5L) visual analog scale (VAS) score from baselineUp to 3.5 years
Cycle baseline by cycle (for EQ-5D-5L)Up to 3.5 years
Number of caregivers who administered the injection to the participant at home over time by cycleUp to 3.5 years
Changes in total Myasthenia Gravis Quality of Life Questionnaire (15-item scale revised) (MG-QoL15r) from baselineUp to 3.5 years
Percentage of participants who performed self-administration at home over time by cycleUp to 3.5 years

Trial Locations

Locations (47)

Investigator Site 26 - DE490009

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Münster, Germany

Investigator Site 1 - GEO9950001

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Tbilisi, Georgia

Investigator Site 33 - GEO9950016

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Tbilisi, Georgia

Investigator site 3 - GEO9950003

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Tbilisi, Georgia

Investigator Site 28- JP0810059

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Ota-Ku, Tokyo, Japan

Investigator site 2 - GEO9950002

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Tbilisi, Georgia

Investigator Site 32 - GEO9950004

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Tbilisi, Georgia

Investigator Site 45 - US0010108

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Boca Raton, Florida, United States

Investigator site 4 - US0010110

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Port Charlotte, Florida, United States

Investigator Site 44 - US0010077

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Durham, North Carolina, United States

Investigator Site 42 - US0010019

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Cleveland, Ohio, United States

Investigator Site 40 - US0010009

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San Antonio, Texas, United States

Investigator site 6 - US0010032

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Carlsbad, California, United States

Investigator Site 47 - US0010021

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Palo Alto, California, United States

Investigator Site 41 - US0010015

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Kansas City, Kansas, United States

Investigator Site 46 - US0010111

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Amherst, New York, United States

Investigator Site 39 - US0010006

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Tampa, Florida, United States

Investigator Site 38 - US0010003

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Chapel Hill, North Carolina, United States

Investigator Site 43 - US0010066

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Austin, Texas, United States

Investigator site 7 - US0010008

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Cordova, Tennessee, United States

Investigator site 5 - BE0320007

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Gent, Belgium

Investigator Site 25 - DE490006

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Berlin, Germany

Investigator site 24 - CZ4200005

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Brno, Czechia

Investigator site 10 - HU0360013

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Budapest, Hungary

Investigator site 9 - HU0360012

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Budapest, Hungary

Investigator Site 34 - IT0390007

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Napoli, Italy

Investigator Site 35 - IT0390008

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Roma, Italy

Investigator site 11 - IT0390003

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Milano, Italy

Investigator site 12 - JP0810002

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Chiba, Chiba-Shi, Japan

Investigator site 8 - JP0810004

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Hanamaki, Iwate, Japan

Investigator Site 36 - JP0810055

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Sapporo, Hokkaido, Japan

Investigator site 14 - JP0810007

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Osaka, Japan

Investigator site 21 - PL0480022

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Warsaw, Poland

Investigator Site 27 - JP0810008

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Sapporo, Japan

Investigator site 15 - JP0810009

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Tokyo, Japan

Investigator site 17 - PL0480001

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Gdańsk, Poland

Investigator site 16 - NL0310001

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Leiden, Netherlands

Investigator site 13 - JP0810005

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Sendai-shi, Japan

Investigator site 22 - PL0480065

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Kraków, Poland

Investigator site 18 - PL0480005

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Kraków, Poland

Investigator site 20 - PL0480018

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Lublin, Poland

Investigator Site 37 - ES0340021

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Barcelona, Spain

Investigator Site 29- RU0070002

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Novosibirsk, Russian Federation

Investigator Site 30 - RU0070014

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Saint Petersburg, Russian Federation

Investigator Site 31 - ES0340038

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Barcelona, Spain

Investigator site 23 - ES0340039

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Valencia, Spain

Investigator site 19 - PL0480007

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Katowice, Poland

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