A Phase 3, Randomized, Double-Blind, Placebo-Controlled Study With an Open-label Extension Period to Evaluate the Efficacy and Safety of Telitacicept in Patients With Generalized Myasthenia Gravis
Summary
The purpose of this study is to evaluate the efficacy and safety of telitacicept in the treatment of generalized myasthenia gravis.
Detailed description
Myasthenia gravis (MG) is an autoimmune disease in which autoantibodies disrupt the postsynaptic membrane, impairing nerve-to-muscle signal transmission. The predominant manifestation is muscle weakness, which typically worsens with repeated muscle exertion, such that function is usually the best in the morning with more pronounced weakness at the end of the day. A major challenge in MG is the lack of therapies that effectively treat the disease. Telitacicept is a fully human TACI-Fc fusion protein that targets B-lymphocyte stimulator (BLyS) and A proliferating-inducing ligand (APRIL), neutralizing their interactions with receptors on B cells. The blockage of BLyS and APRIL interaction with their respective cell membrane receptors (transmembrane activator and CAML interactor \[TACI\], B-cell maturation antigen, and BLyS receptors) by telitacicept can inhibit B-cell proliferation and maturation. This suppression at the proximal portion of the immune response could alleviate autoimmune symptoms. This is a randomized, double-blind, placebo-controlled Phase 3 study with an open-label extension (OLE) to evaluate the efficacy and safety of telitacicept in a global patient population with gMG. The total duration of the study is variable but will include an approximately 4-week screening period, a 24-week double-blind treatment period (Week 0 through Week 24), a 48-week OLE (Week 24 through Week 72), followed by an extended OLE period (E-OLE), and an 8-week end-of-study follow-up period. The E-OLE is variable duration, defined as the period after the 48-week OLE period until telitacicept is approved for MG in the country or the further development in the indication is concluded.
Arms & interventions
- BiologicalTelitacicept
Subcutaneous injection
- DrugPlacebo
Subcutaneous injection
Outcome measures
Primary
Change from baseline in Myasthenia Gravis-Activities of Daily Living (MG-ADL) score at Week 24
The MG-ADL is an 8-item patient-reported outcome measure assessing MG symptoms and their effects on daily activities. Each item in the scale is scored on a 0 to 3 (0=normal, 3=severe disease) point scale. The total score is the sum of all individual item scores ranging from 0 to 24. Higher scores indicate more severe disability due to MG. A decrease from Baseline score indicates improvement.
Time frame: Week 24
Secondary
Change from baseline in Quantitative Myasthenia Gravis (QMG) score at Week 24
Time frame: Week 24
Change from baseline in MG Quality of Life scale (MG-QOL15r) at Week 24
Time frame: Week 24
Proportion of patients with a decrease of ≥2 points from baseline in Myasthenia Gravis-Activities of Daily Living (MG-ADL) score at Week 24
Time frame: Week 24
Proportion of patients with a decrease of ≥3 points from baseline in Quantitative Myasthenia Gravis (QMG) score at Week 24
Time frame: Week 24
Proportion of patients who achieved minimal symptomatic expression (MSE, defined as having MG-ADL score of 0 or 1) at Week 24
Time frame: Week 24
Eligibility criteria
Study locations (26)
HonorHealth Neurology - Bob Bové Neuroscience Institute
Scottsdale, Arizona, 85258
University of Southern California
Los Angeles, California, 90033
University of California Irvine
Orange, California, 92868
University of California San Francisco (UCSF)
San Francisco, California, 94143
SFM Clinical Research
Boca Raton, Florida, 33487
Allied Biomedical Research Institute (ABRI)
Miami, Florida, 33155
Medsol Clinical Research Center
Port Charlotte, Florida, 33952
University of South Florida Health (USF Health)
Tampa, Florida, 33613
Wellstar MCG Health Medical Center
Augusta, Georgia, 30912
Hospital Sisters Health System Medical
O'Fallon, Illinois, 62269
University of Kansas Medical Center
Kansas City, Kansas, 66160
University of Kentucky
Lexington, Kentucky, 40506
University of Louisville Physicians
Louisville, Kentucky, 40202
Neurology Center of New England
Foxborough, Massachusetts, 02035
Michigan State University Clinical Center
East Lansing, Michigan, 48824
Trinity Health - Grand Rapids Hospital
Grand Rapids, Michigan, 49503
UM Health Care - Neurology and Sleep Disorders Clinic
Columbia, Missouri, 65212
Hospital for Special Surgery
New York, New York, 10021
Mount Sinai Health System
New York, New York, 10029
Montefiore Medical Center
The Bronx, New York, 10467
University of North Carolina Hospitals - Neurology Clinic
Chapel Hill, North Carolina, 27517
University of Cincinnati Health Physicians - Clifton
Cincinnati, Ohio, 45219
Empower Clinical Research
Tigard, Oregon, 97223
University of Texas Southwestern Medical Center
Dallas, Texas, 75390
Houston Methodist Neurological Institute
Houston, Texas, 77030
Center for Neurological Disorders, S.C. - Greenfield - Gamma Therapeutic Center
Greenfield, Wisconsin, 53228