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

Primary Purpose

Generalized Myasthenia Gravis

Status
Active
Phase
Phase 3
Locations
International
Study Type
Interventional
Intervention
efgartigimod PH20 SC
Sponsored by
argenx
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Generalized Myasthenia Gravis

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

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:

    1. Male participants:

      - Male participants are not allowed to donate sperm from signing the informed consent (ICF) until the end of study.

    2. Female participants:

      • 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 screening
    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

Sites / Locations

  • Investigator site 6 - US0010032
  • Investigator Site 47 - US0010021
  • Investigator Site 45 - US0010108
  • Investigator site 4 - US0010110
  • Investigator Site 39 - US0010006
  • Investigator Site 41 - US0010015
  • Investigator Site 46 - US0010111
  • Investigator Site 38 - US0010003
  • Investigator Site 44 - US0010077
  • Investigator Site 42 - US0010019
  • Investigator site 7 - US0010008
  • Investigator Site 43 - US0010066
  • Investigator Site 40 - US0010009
  • Investigator site 5 - BE0320007
  • Investigator site 24 - CZ4200005
  • Investigator site 2 - GEO9950002
  • Investigator Site 1 - GEO9950001
  • Investigator site 3 - GEO9950003
  • Investigator Site 32 - GEO9950004
  • Investigator Site 33 - GEO9950016
  • Investigator Site 25 - DE490006
  • Investigator Site 26 - DE490009
  • Investigator site 10 - HU0360013
  • Investigator site 9 - HU0360012
  • Investigator site 11 - IT0390003
  • Investigator Site 34 - IT0390007
  • Investigator Site 35 - IT0390008
  • Investigator site 12 - JP0810002
  • Investigator Site 36 - JP0810055
  • Investigator site 8 - JP0810004
  • Investigator Site 28- JP0810059
  • Investigator site 14 - JP0810007
  • Investigator Site 27 - JP0810008
  • Investigator site 13 - JP0810005
  • Investigator site 15 - JP0810009
  • Investigator site 16 - NL0310001
  • Investigator site 17 - PL0480001
  • Investigator site 19 - PL0480007
  • Investigator site 22 - PL0480065
  • Investigator site 18 - PL0480005
  • Investigator site 20 - PL0480018
  • Investigator site 21 - PL0480022
  • Investigator Site 29- RU0070002
  • Investigator Site 30 - RU0070014
  • Investigator Site 37 - ES0340021
  • Investigator Site 31 - ES0340038
  • Investigator site 23 - ES0340039

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

efgartigimod PH20 SC

Arm Description

Patients receiving efgartigimod PH20 subcutaneous (SC) treatment

Outcomes

Primary Outcome Measures

Incidence and severity of Adverse Events (AEs)
Incidence of Serious Adverse Events (SAEs)
Incidence of Adverse Events of Special Interest (AESI)

Secondary Outcome Measures

Myasthenia Gravis Activities of Daily Living (MG-ADL) total score changes from baseline
the higher the score, the more impairment
Cycle baseline over time by cycle (for MG-ADL)
Percentage change in levels of total immunoglobulin G (IgG) from baseline
Cycle baseline over time by cycle (for total immunoglobulin G (IgG)
Percentage change of anti-acetylcholine receptor antibodies (AChR-Ab) from baseline
Cycle baseline over time by cycle in AChR-Ab seropositive participants (for acetylcholine receptor binding autoantibodies (AChR-Ab))
Efgartigimod serum concentrations
Incidence of anti-drug antibodies (ADAs) to efgartigimod over time
Prevalence of anti-drug antibodies (ADAs) to efgartigimod over time
Incidence of neutralizing antibodies (NAbs) against efgartigimod over time
Prevalence of neutralizing antibodies (NAbs) against efgartigimod over time
Incidence of ADAs to rHuPH20 over time
Prevalence of ADAs to rHuPH20 over time
Incidence of NAbs against rHuPH20 over time
Prevalence of NAbs against rHuPH20 over time
Changes in total Myasthenia Gravis Quality of Life Questionnaire (15-item scale revised) (MG-QoL15r) from baseline
Cycle baseline by cycle (for MG-QoL15r)
Changes in EuroQoL 5 Dimensions 5-Level (EQ-5D-5L) visual analog scale (VAS) score from baseline
Cycle baseline by cycle (for EQ-5D-5L)
EQ-5D-5L responses over time by cycle
Number of participants who performed self-administration at home over time by cycle
Percentage of participants who performed self-administration at home over time by cycle
Number of caregivers who administered the injection to the participant at home over time by cycle
Percentage of caregivers who administered the injection to the participant at home over time by cycle
Number of training visits needed for the participant or caregiver to be competent to start administering efgartigimod PH20 SC
Number of self- or caregiver-supported study drug administration among all study treatment visits at home
Percentage of self- or caregiver-supported study drug administration among all study treatment visits at home

Full Information

First Posted
March 11, 2021
Last Updated
March 29, 2023
Sponsor
argenx
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1. Study Identification

Unique Protocol Identification Number
NCT04818671
Brief Title
Evaluating the Long-Term Safety and Tolerability of Efgartigimod PH20 SC Administered Subcutaneously in Patients With Generalized Myasthenia Gravis
Acronym
ADAPTSC+
Official Title
A Long-Term, Single-Arm, Open-label, Multicenter Phase 3 Study to Evaluate the Safety and Tolerability of Multiple Subcutaneous Injections of Efgartigimod PH20 SC in Patients With Generalized Myasthenia Gravis
Study Type
Interventional

2. Study Status

Record Verification Date
March 2023
Overall Recruitment Status
Active, not recruiting
Study Start Date
April 26, 2021 (Actual)
Primary Completion Date
December 31, 2024 (Anticipated)
Study Completion Date
December 31, 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
argenx

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

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).

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Generalized Myasthenia Gravis

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
183 (Actual)

8. Arms, Groups, and Interventions

Arm Title
efgartigimod PH20 SC
Arm Type
Experimental
Arm Description
Patients receiving efgartigimod PH20 subcutaneous (SC) treatment
Intervention Type
Biological
Intervention Name(s)
efgartigimod PH20 SC
Intervention Description
Subcutaneous injection with efgartigimod PH20 SC
Primary Outcome Measure Information:
Title
Incidence and severity of Adverse Events (AEs)
Time Frame
Up to 3.5 years
Title
Incidence of Serious Adverse Events (SAEs)
Time Frame
Up to 3.5 years
Title
Incidence of Adverse Events of Special Interest (AESI)
Time Frame
Up to 3.5 years
Secondary Outcome Measure Information:
Title
Myasthenia Gravis Activities of Daily Living (MG-ADL) total score changes from baseline
Description
the higher the score, the more impairment
Time Frame
Up to 3.5 years
Title
Cycle baseline over time by cycle (for MG-ADL)
Time Frame
Up to 3.5 years
Title
Percentage change in levels of total immunoglobulin G (IgG) from baseline
Time Frame
Up to 3.5 years
Title
Cycle baseline over time by cycle (for total immunoglobulin G (IgG)
Time Frame
Up to 3.5 years
Title
Percentage change of anti-acetylcholine receptor antibodies (AChR-Ab) from baseline
Time Frame
Up to 3.5 years
Title
Cycle baseline over time by cycle in AChR-Ab seropositive participants (for acetylcholine receptor binding autoantibodies (AChR-Ab))
Time Frame
Up to 3.5 years
Title
Efgartigimod serum concentrations
Time Frame
Up to 3.5 years
Title
Incidence of anti-drug antibodies (ADAs) to efgartigimod over time
Time Frame
Up to 3.5 years
Title
Prevalence of anti-drug antibodies (ADAs) to efgartigimod over time
Time Frame
Up to 3.5 years
Title
Incidence of neutralizing antibodies (NAbs) against efgartigimod over time
Time Frame
Up to 3.5 years
Title
Prevalence of neutralizing antibodies (NAbs) against efgartigimod over time
Time Frame
Up to 3.5 years
Title
Incidence of ADAs to rHuPH20 over time
Time Frame
Up to 3.5 years
Title
Prevalence of ADAs to rHuPH20 over time
Time Frame
Up to 3.5 years
Title
Incidence of NAbs against rHuPH20 over time
Time Frame
Up to 3.5 years
Title
Prevalence of NAbs against rHuPH20 over time
Time Frame
Up to 3.5 years
Title
Changes in total Myasthenia Gravis Quality of Life Questionnaire (15-item scale revised) (MG-QoL15r) from baseline
Time Frame
Up to 3.5 years
Title
Cycle baseline by cycle (for MG-QoL15r)
Time Frame
Up to 3.5 years
Title
Changes in EuroQoL 5 Dimensions 5-Level (EQ-5D-5L) visual analog scale (VAS) score from baseline
Time Frame
Up to 3.5 years
Title
Cycle baseline by cycle (for EQ-5D-5L)
Time Frame
Up to 3.5 years
Title
EQ-5D-5L responses over time by cycle
Time Frame
Up to 3.5 years
Title
Number of participants who performed self-administration at home over time by cycle
Time Frame
Up to 3.5 years
Title
Percentage of participants who performed self-administration at home over time by cycle
Time Frame
Up to 3.5 years
Title
Number of caregivers who administered the injection to the participant at home over time by cycle
Time Frame
Up to 3.5 years
Title
Percentage of caregivers who administered the injection to the participant at home over time by cycle
Time Frame
Up to 3.5 years
Title
Number of training visits needed for the participant or caregiver to be competent to start administering efgartigimod PH20 SC
Time Frame
Up to 3.5 years
Title
Number of self- or caregiver-supported study drug administration among all study treatment visits at home
Time Frame
Up to 3.5 years
Title
Percentage of self- or caregiver-supported study drug administration among all study treatment visits at home
Time Frame
Up to 3.5 years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: 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. Previously participated in antecedent studies ARGX-113-2001 or ARGX-113-1705 and are eligible for roll over. 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: 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. 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) Has any of the following medical conditions: Clinically significant uncontrolled chronic bacterial, viral, or fungal infection at roll-over 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 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) 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 Received a live-attenuated vaccine within 28 days prior to study entry or plan to receive a live-attenuated vaccine during the study A known hypersensitivity reaction to efgartigimod, rHuPH20, or any of its excipients
Facility Information:
Facility Name
Investigator site 6 - US0010032
City
Carlsbad
State/Province
California
ZIP/Postal Code
92011
Country
United States
Facility Name
Investigator Site 47 - US0010021
City
Palo Alto
State/Province
California
ZIP/Postal Code
94304
Country
United States
Facility Name
Investigator Site 45 - US0010108
City
Boca Raton
State/Province
Florida
ZIP/Postal Code
33428
Country
United States
Facility Name
Investigator site 4 - US0010110
City
Port Charlotte
State/Province
Florida
ZIP/Postal Code
33952
Country
United States
Facility Name
Investigator Site 39 - US0010006
City
Tampa
State/Province
Florida
ZIP/Postal Code
41076
Country
United States
Facility Name
Investigator Site 41 - US0010015
City
Kansas City
State/Province
Kansas
ZIP/Postal Code
66160
Country
United States
Facility Name
Investigator Site 46 - US0010111
City
Amherst
State/Province
New York
ZIP/Postal Code
14226
Country
United States
Facility Name
Investigator Site 38 - US0010003
City
Chapel Hill
State/Province
North Carolina
ZIP/Postal Code
27514
Country
United States
Facility Name
Investigator Site 44 - US0010077
City
Durham
State/Province
North Carolina
ZIP/Postal Code
27710
Country
United States
Facility Name
Investigator Site 42 - US0010019
City
Cleveland
State/Province
Ohio
ZIP/Postal Code
44195
Country
United States
Facility Name
Investigator site 7 - US0010008
City
Cordova
State/Province
Tennessee
ZIP/Postal Code
38018
Country
United States
Facility Name
Investigator Site 43 - US0010066
City
Austin
State/Province
Texas
ZIP/Postal Code
78759
Country
United States
Facility Name
Investigator Site 40 - US0010009
City
San Antonio
State/Province
Texas
ZIP/Postal Code
78229
Country
United States
Facility Name
Investigator site 5 - BE0320007
City
Gent
ZIP/Postal Code
9000
Country
Belgium
Facility Name
Investigator site 24 - CZ4200005
City
Brno
ZIP/Postal Code
625 00
Country
Czechia
Facility Name
Investigator site 2 - GEO9950002
City
Tbilisi
ZIP/Postal Code
0112
Country
Georgia
Facility Name
Investigator Site 1 - GEO9950001
City
Tbilisi
ZIP/Postal Code
0114
Country
Georgia
Facility Name
Investigator site 3 - GEO9950003
City
Tbilisi
ZIP/Postal Code
0114
Country
Georgia
Facility Name
Investigator Site 32 - GEO9950004
City
Tbilisi
ZIP/Postal Code
0160
Country
Georgia
Facility Name
Investigator Site 33 - GEO9950016
City
Tbilisi
ZIP/Postal Code
016
Country
Georgia
Facility Name
Investigator Site 25 - DE490006
City
Berlin
ZIP/Postal Code
10117
Country
Germany
Facility Name
Investigator Site 26 - DE490009
City
Münster
ZIP/Postal Code
48149
Country
Germany
Facility Name
Investigator site 10 - HU0360013
City
Budapest
ZIP/Postal Code
1082
Country
Hungary
Facility Name
Investigator site 9 - HU0360012
City
Budapest
ZIP/Postal Code
1204
Country
Hungary
Facility Name
Investigator site 11 - IT0390003
City
Milano
ZIP/Postal Code
20133
Country
Italy
Facility Name
Investigator Site 34 - IT0390007
City
Napoli
ZIP/Postal Code
80138
Country
Italy
Facility Name
Investigator Site 35 - IT0390008
City
Roma
ZIP/Postal Code
00189
Country
Italy
Facility Name
Investigator site 12 - JP0810002
City
Chiba
State/Province
Chiba-Shi
ZIP/Postal Code
260-8677
Country
Japan
Facility Name
Investigator Site 36 - JP0810055
City
Sapporo
State/Province
Hokkaido
ZIP/Postal Code
063-0005
Country
Japan
Facility Name
Investigator site 8 - JP0810004
City
Hanamaki
State/Province
Iwate
ZIP/Postal Code
025-0082
Country
Japan
Facility Name
Investigator Site 28- JP0810059
City
Ota-Ku
State/Province
Tokyo
ZIP/Postal Code
143-8541
Country
Japan
Facility Name
Investigator site 14 - JP0810007
City
Osaka
ZIP/Postal Code
565-0871
Country
Japan
Facility Name
Investigator Site 27 - JP0810008
City
Sapporo
ZIP/Postal Code
060 8542
Country
Japan
Facility Name
Investigator site 13 - JP0810005
City
Sendai-shi
ZIP/Postal Code
983-8520
Country
Japan
Facility Name
Investigator site 15 - JP0810009
City
Tokyo
ZIP/Postal Code
160-0023
Country
Japan
Facility Name
Investigator site 16 - NL0310001
City
Leiden
ZIP/Postal Code
2333
Country
Netherlands
Facility Name
Investigator site 17 - PL0480001
City
Gdańsk
ZIP/Postal Code
80-952
Country
Poland
Facility Name
Investigator site 19 - PL0480007
City
Katowice
ZIP/Postal Code
40-123
Country
Poland
Facility Name
Investigator site 22 - PL0480065
City
Kraków
ZIP/Postal Code
31-426
Country
Poland
Facility Name
Investigator site 18 - PL0480005
City
Kraków
ZIP/Postal Code
31-505
Country
Poland
Facility Name
Investigator site 20 - PL0480018
City
Lublin
ZIP/Postal Code
20-093
Country
Poland
Facility Name
Investigator site 21 - PL0480022
City
Warsaw
ZIP/Postal Code
02-097
Country
Poland
Facility Name
Investigator Site 29- RU0070002
City
Novosibirsk
ZIP/Postal Code
630087
Country
Russian Federation
Facility Name
Investigator Site 30 - RU0070014
City
Saint Petersburg
ZIP/Postal Code
194354
Country
Russian Federation
Facility Name
Investigator Site 37 - ES0340021
City
Barcelona
ZIP/Postal Code
08035
Country
Spain
Facility Name
Investigator Site 31 - ES0340038
City
Barcelona
ZIP/Postal Code
08041
Country
Spain
Facility Name
Investigator site 23 - ES0340039
City
Valencia
ZIP/Postal Code
46026
Country
Spain

12. IPD Sharing Statement

Plan to Share IPD
Undecided

Learn more about this trial

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

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