Rozanolixizumab, a neonatal Fc receptor blocker approved by the FDA in June 2023 for generalized myasthenia gravis (gMG), is being evaluated for self-administration to improve patient independence and quality of life. The Phase 3 MG0020 study, presented at the 2024 American Association of Neuromuscular & Electrodiagnostic Medicine (AANEM) meeting, explores the feasibility and patient preference for self-administration using a syringe driver and manual push method.
The open-label, crossover study randomly assigned patients to once-weekly rozanolixizumab for 18 consecutive weeks, including a 6-week training period followed by two 6-week self-administration periods. Patients were trained on both the syringe driver and manual push methods before being randomized 1:1 to either method, subsequently crossing over to the alternative method.
Study Design and Endpoints
The primary endpoint of the MG0020 study was the success of self-administration, defined as the patient's ability to select the correct injection site, administer the medication subcutaneously, and deliver the correct dose. Secondary endpoints included adverse reactions, injection site reactions, Myasthenia Gravis-Activities of Daily Living (MG-ADL) scores, IgG levels, medication errors, and patient preferences between self-administration methods and healthcare provider-administered infusions.
Patient-Centered Therapy
Rachana K. Gandhi Mehta, MBBS, an assistant professor of neurology at the Wake Forest School of Medicine and lead investigator of the study, emphasized the growing interest in patient-centered therapies. "If patients could self-administer rozanolixizumab, they’d gain more independence, allowing them to do infusions at home without relying on nurses or traveling to an infusion center," Mehta stated.
The syringe driver method, previously used by nurses in the MycarinG study, allows for precise dose delivery and controlled infusion rates. Patients receive six weeks of training on both methods to ensure proper usage. The study enrolled both seropositive and seronegative gMG patients willing to try self-administration methods.
Implications for Myasthenia Gravis Treatment
Recent approvals of targeted treatments like complement inhibitors and FcRn receptor blockers reflect a shift toward more precise immunotherapies for myasthenia gravis. The potential availability of self-administration options could significantly enhance patients' quality of life by providing greater flexibility and reducing the need for frequent clinic visits. The results of the MG0020 study, currently under analysis, are anticipated to provide valuable insights into the feasibility and benefits of self-administered rozanolixizumab for gMG patients.
