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RecruitingInterventionalPhase 2/Phase 3

An Open-Label Uncontrolled Multicenter Study to Evaluate the Pharmacokinetics, Pharmacodynamics, Safety and Activity of Nipocalimab in Children Aged 2 to Less Than 18 Years With Generalized Myasthenia Gravis

NCT ID: NCT05265273Sponsor: Janssen Research & Development, LLCLast updated: 2026-03-13

Summary

The purpose of this study is to determine the effect of nipocalimab on total serum immunoglobulin G (IgG) in pediatric participants 2 to less than (\<) 18 years of age (globally) and 8 to \<18 years of age (for Unites Stated (US) sites only), the safety and tolerability of treatment with nipocalimab in children and adolescents and to evaluate the pharmacokinetics (PK) of nipocalimab in children and adolescents with generalized myasthenia gravis (gMG) who have an insufficient clinical response to ongoing, stable standard-of-care therapy.

Arms & interventions

  • DrugNipocalimab

    Nipocalimab will be administered as an IV infusion.

Outcome measures

Primary

  • Change from Baseline in Total Serum Immunoglobulin-G (IgG) Levels

    Change from baseline in total serum IgG levels were reported.

    Time frame: Up to 3 years

  • Number of Participants with Infectious Adverse Events (AEs)

    Number of participants with infectious AEs will be reported. An AE is any untoward medical occurrence in a participant participating in a clinical study that does not necessarily have a causal relationship with the pharmaceutical/biological agent under study.

    Time frame: Up to 3 years

  • Number of Participants with Serious AEs (SAEs)

    Number of participants with SAEs will be reported. A SAE is any AE that results in: death, persistent or significant disability/incapacity, requires inpatient hospitalization or prolongation of existing hospitalization, is life-threatening experience, is a congenital anomaly/birth defect, is suspected transmission of any infectious agent via a medicinal product, is medically important to prevent one of the outcomes listed above.

    Time frame: Up to 3 years

  • Number of Participants with Adverse Events of Special Interests (AESIs)

    Number of participants with AESIs will be reported. Treatment-emergent AEs associated with the following situations are considered an AESI: a) infections that are severe or require intravenous (IV) anti-infective or operative/invasive intervention; b) hypoalbuminemia with albumin less than (\<)20 grams per liter (g/L) \[\<\] 2.0 grams per deciliter \[g/dL\]) c) opportunistic infections and d) Serious and non-serious deep-vein thrombosis (DVT) and/or pulmonary embolism (PE). Any AE occurring at or after the initial administration of study intervention through end of study is treatment emergent.

    Time frame: Up to 3 years

  • Number of Participants with Abnormalities in Clinical Laboratory Tests

    Number of participants with abnormalities in clinical laboratory tests (including chemistry, hematology, coagulation, and urinalysis) will be reported.

    Time frame: Up to 3 years

  • Number of Participants with Abnormalities in Vital Signs

    Number of participants with abnormalities in vital signs including sitting pulse/heart rate, sitting systolic and diastolic blood pressure, and oral temperature (degrees Celsius) will be reported.

    Time frame: Up to 3 years

  • Number of Participants with Abnormalities in Physical Examination

    Number of participants with abnormalities in physical examinations including height, weight, assessments of the skin, head, eyes, ears, nose, throat, neck, thyroid, lungs, heart, abdomen, lymph nodes and extremities will be reported.

    Time frame: Up to 3 years

  • Serum Concentration of Nipocalimab over Time

    Serum samples will be analyzed to determine concentrations of nipocalimab using a validated, specific, and sensitive immunoassay method.

    Time frame: Up to 3 years

  • Clearance (CL) of Nipocalimab

    CL is defined as the volume of serum from which nipocalimab is completely removed per unit time.

    Time frame: Up to 3 years

  • Volume of Distribution (V) of Nipocalimab

    V is defined as the representation of nipocalimab's propensity to either remain in the serum or redistribute to other tissue compartments.

    Time frame: Up to 3 years

  • Half-life (t1/2) of Nipocalimab

    t1/2 is defined as the time it takes for nipocalimab's active substance in the body to reduce by half.

    Time frame: Up to 3 years

  • Steady-state Peak Concentration (Cpeak,ss) of Nipocalimab

    Cpeak,ss is defined as the peak serum concentration of nipocalimab at steady state.

    Time frame: Up to 3 years

  • Steady-state Trough concentration (Ctrough,ss) of Nipocalimab

    Ctrough,ss will be reported. It is defined as the observed serum concentration of nipocalimab just prior to the beginning of a dosing interval at steady state.

    Time frame: Up to 3 years

  • Steady-state Area Under the Curve (AUCss) of Nipocalimab

    AUCss is defined as the area under the curve for nipocalimab at steady state.

    Time frame: Up to 3 years

Secondary

  • Change from Baseline in Myasthenia Gravis -Activities of Daily Living (MG-ADL) Score

    Time frame: Up to 3 years

  • Change in the Quantitative Myasthenia Gravis (QMG) Score

    Time frame: Up to 3 years

  • European Quality of Life 5-Dimension Youth (EQ-5D-Y) Tool Score

    Time frame: Up to 3 years

  • Neurological Quality of Life (Neuro-QoL) Pediatric Fatigue Score

    Time frame: Up to 3 years

  • Patient Global Impression of Severity (PGI-S) Score

    Time frame: Up to 3 years

  • Patient Global Impression of Change (PGI-C) Score

    Time frame: Up to 3 years

  • Number of Participants with Anti-Drug Antibodies [ADAs] to Nipocalimab

    Time frame: Up to 3 years

  • Number of Participants with Neutralizing Antibodies (NAbs) to Nipocalimab

    Time frame: Up to 3 years

  • Number of Participants with Vaccine Antibody Titers to Diphtheria or Tetanus

    Time frame: Up to 3 years

Eligibility criteria

Sex: AllAge: 2 Years to 17 YearsHealthy volunteers: No
Key Inclusion Criteria: * Age: For US sites only: 8 to \< 18 years * Diagnosis of myasthenia gravis (MG) with generalized muscle weakness meeting the clinical criteria for generalized myasthenia gravis (gMG) as defined by the Myasthenia Gravis Foundation of America (MGFA) Clinical Classification Class IIa/b, IIIa/b, or IVa/b at screening * Has a positive serologic test for acetylcholine receptor (anti-AChR) antibodies or muscle-specific tyrosine kinase (anti-MuSK) antibodies at screening * A participant using herbal, naturopathic, traditional Chinese remedies, ayurvedic or nutritional supplements, or medical marijuana (with a doctor's prescription) is eligible if the use of these medications is acceptable to the Investigator. These remedies must remain at a stable dose and regimen throughout the study * Has sufficient venous access to allow drug administration by infusion and blood sampling as per the protocol * Participants should have a body weight and body mass index between 5th and 95th percentile for age and sex. Obese participants greater than 95th percentile and underweight participants below 5th percentile may participate following medical clearance * A female of childbearing potential must have a negative highly sensitive serum (beta-human chorionic gonadotropin \[beta-hCG\]) at Screening and a negative urine pregnancy test at Day 1 prior to administration of study intervention Key Exclusion Criteria: * Has a history of severe and/or uncontrolled hepatic (example, viral/alcoholic/ autoimmune hepatitis/ cirrhosis/ and/or metabolic liver disease), gastrointestinal, renal, pulmonary, cardiovascular (including congenital heart diseases), psychiatric, neurological musculoskeletal disorder, any other medical disorder(s) (example, diabetes mellitus), risk factors for thrombosis events (example, a history of venous thromboembolism \[VTE\] or antiphospholipid syndrome, or a personal or family history of heritable coagulation disorder such as factor V leiden, protein S or protein C deficiency, atrial fibrillation/flutter, major orthopedic surgery or significant trauma that may increase the risk of VTE, is expected to be immobilized for prolonged periods of time), or has clinically significant abnormalities in screening laboratory, that might interfere with participant's full participation in the study, and/ or might jeopardize the safety of the participant or the validity of the study results * Has any confirmed or suspected clinical immunodeficiency syndrome not related to treatment of his/her generalized myasthenia gravis (gMG), or has a family history of congenital or hereditary immunodeficiency unless confirmed absent in the participant * Has had a thymectomy within 12 months prior to screening, or thymectomy is planned during the Active treatment Phase of the study * Has shown a previous severe immediate hypersensitivity reaction, such as anaphylaxis to therapeutic proteins (example, monoclonal antibodies) * Has experienced myocardial infarction, unstable ischemic heart disease, or stroke within 12 weeks of screening

Study locations (11)

Phoenix Children's Hospital

Phoenix, Arizona, 85016

Recruiting

Childrens Hospital Los Angeles

Los Angeles, California, 90027

Recruiting

Lucile Packard Children's Hospital Stanford

Palo Alto, California, 94304

Recruiting

UCSF Benioff Children's Hospital

San Francisco, California, 94158

Recruiting

Children's Hospital Colorado

Aurora, Colorado, 80045

Recruiting

University of South Florida Morsani Center for Advanced Healthcare

Tampa, Florida, 33613

Recruiting

University of Kansas Medical Center

Lawrence, Kansas, 66045

Completed

C.S. Mott Children's Hospital

Ann Arbor, Michigan, 48109

Recruiting

Penn State Milton S Hershey Medical Ctr

Hershey, Pennsylvania, 17033

Recruiting

Childrens Hospital Of Philadelphia

Philadelphia, Pennsylvania, 19106

Recruiting

University of Pittsburgh Medical Center

Pittsburgh, Pennsylvania, 15224

Terminated