A Randomized, Double-blind, Placebo-controlled Phase III Study to Evaluate the Efficacy, Safety, and Tolerability of Iptacopan in Patients With Generalized Myasthenia Gravis, Followed by an Open-label Extension Phase
Summary
The study is a randomized, double-blind, placebo-controlled, multicenter, Phase III study, to evaluate efficacy, safety and tolerability of iptacopan in patients with AChR+ gMG who are on stable SOC treatment. Participants who meet the eligibility criteria will be randomized in a ratio of 1:1, to receive either iptacopan or matching placebo, for 6 months (180 days) while continuing on a stable SOC treatment. The randomization will be stratified based on region.
Detailed description
The study consists of a 6-month double-blind treatment period for the primary efficacy and safety analysis followed by a maximum duration of 60 month open label extension period. A safety follow up assessment will be performed, one 7 days after the last administration of study treatment and one 30 days after the last administration of study treatment for all participants.
Arms & interventions
- DrugIptacopan
Hard gelatin capsule
- OtherMatching Placebo
Hard gelatin capsule
Outcome measures
Primary
Change from baseline to Month 6 in Myasthenia Gravis Activity of Daily Living (MG-ADL) total score
The MG-ADL is an 8 item interviewer led patient reporting scale that assesses MG symptoms and their effects on daily activities. MG-ADL is composed of items related to patient's assessment of functional disability secondary to ocular (2 items), bulbar (3 items), respiratory (1 item), and gross motor or limb (2 items) impairment related to effects from MG. Each item is assessed on a 4-points scale where a score 0 represents normal function and a score 3 represents loss of ability to perform that function. The scores ranges from 0 to 24, with a higher score indicating more disability.
Time frame: Baseline to Month 6
Secondary
Change from baseline to Month 6 in Quantitative MG (QMG) total score
Time frame: Baseline to Month 6
Proportion of participants with ≥ 5 points reduction from baseline to Month 6 of QMG total score without rescue medication and/or strongly confounding prohibited medication
Time frame: Baseline to Month 6
Proportion of participants with ≥ 3 points reduction from baseline to Month 6 of MG-ADL total score without rescue medication and/or strongly confounding prohibited medication
Time frame: Baseline to Month 6
Proportion of participants achieving MSE at Month 6, defined as MG-ADL score of 0 or 1 at Month 6 without rescue therapy and/or strongly confounding prohibited medication
Time frame: Baseline to Month 6
Change from baseline to Month 6 in Myasthenia Gravis Composite (MGC) total score
Time frame: Baseline to Month 6
Change from baseline to Month 6 in revised MG Quality of Life Questionnaire (MG-QOL15r) survey score
Time frame: Baseline to Month 6
Incidence of adverse events
Time frame: Baseline to Month 6
Proportion of time during which participants showed a reduction of ≥ 2 points in MG-ADL total score that was maintained up to Month 6
Time frame: Baseline to Month 6
Proportion of early MG-ADL responders during treatment (early responders with first MG-ADL improvement from baseline of ≥ 2 points occurring by week 4)
Time frame: Baseline to Month 6
Change from baseline to Month 6 in EuroQol-5 Dimensions-5 Level (EQ-5D-5L)
Time frame: Baseline to Month 6
Proportion of participants with a reduction of ≥ 3 points from baseline to Month 6 in MGC total score
Time frame: Baseline to month 6
Change from baseline in MG-ADL total score
Time frame: Baseline to Month 66 (end of extension phase)
Proportion of participants achieving a reduction in oral corticosteroids (OCS) dose compared to Core Part that was maintained up to end of Extension Part
Time frame: Month 6 (end of core phase) to Month 30 (end of extension phase)
Incidence of adverse events
Time frame: Baseline to Month 30 (end of extension phase)
Eligibility criteria
Study locations (21)
Honor Health Research Institute
Scottsdale, Arizona, 85258
Fullerton Neuro and Headache Ctr
Fullerton, California, 92835
SC3 Research Pasadena
Pasadena, California, 91105
California Pacific Medical Center
Sacramento, California, 94115
Neurology Offices Of South Florida
Boca Raton, Florida, 33428
Superior Associates in Research LLC
Hialeah, Florida, 33012
Augusta University Georgia
Augusta, Georgia, 30912
Hawaii Pacific Neuroscience LLC
Honolulu, Hawaii, 96817
University of Chicago Medical Centr
Chicago, Illinois, 60637
Prairie Heart Institute
Springfield, Illinois, 62769
Mid Atlantic Epilepsy and Sleep Ctr
Bethesda, Maryland, 20817-1807
Massachusetts General Hospital
Boston, Massachusetts, 02114
Henry Ford Health System
Detroit, Michigan, 48202
Duke University Medical Center
Durham, North Carolina, 27710
Neuroscience Research Ctr
Canton, Ohio, 44718
Ohio State University Medical Center
Columbus, Ohio, 43210
Penn Presbyterian Medical Center
Philadelphia, Pennsylvania, 19104
Vanderbilt University Medical CenterX
Nashville, Tennessee, 37221
Nerve and Muscle Center of Texas
Houston, Texas, 77030
Central TX Neuro Consultants P A
Round Rock, Texas, 78681
Center for Neurological Disorders G
Greenfield, Wisconsin, 53228-1321