A Randomized, Double-blind, Placebo-controlled Phase III Study to Evaluate the Efficacy, Safety, and Tolerability of Remibrutinib in Patients With Generalized Myasthenia Gravis, Followed by an Open-label Extension Phase
Summary
A study to evaluate the efficacy, safety and tolerability of Remibrutinib versus placebo in adult patients with Generalized Myasthenia Gravis who are on stable, standard-of-care (SOC) treatment.
Detailed description
This study is a randomized, double-blind, placebo-controlled, multicenter, Phase III study, to evaluate the efficacy, safety and tolerability of remibrutinib in gMG patients who are on stable SOC treatment. Approximately 180 eligible participants will be randomized in a ratio of 1:1, to receive either remibrutinib or matching placebo. The study consists of a Core Part (6-months double-blind treatment) and an Extension Part (up to 60-month open-label treatment).
Arms & interventions
- DrugRemibrutinib (Blinded)
Remibrutinib (Blinded) active treatment
- OtherPlacebo
Placebo
- DrugRemibrutinib (Open Label)
Remibrutinib (Open Label) active treatment
Outcome measures
Primary
Change from baseline to Month 6 in Myasthenia Gravis Activity of Daily Living (MG-ADL) total score
The MG-ADL is a categorical 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 (total score 0 to 24).
Time frame: Baseline to Month 6
Secondary
Change from baseline to Month 6 in Quantitative Myasthenia Gravis (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 Myasthenia Gravis Activity of Daily Living (MG-ADL) scale total score without rescue medication and/or strongly confounding prohibited medication
Time frame: Baseline to Month 6
Proportion of participants achieving Minimal Symptom Expression (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: Month 6
Change from baseline to Month 6 in Myasthenia Gravis Composite score (MGC) total score
Time frame: Baseline to Month 6
Change from baseline to Month 6 in revised Myasthenia Gravis 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 week 4
Change from baseline to Month 6 in EuroQol-5 Dimensions-5 Level (EQ-5D-5L)
Time frame: Baseline to Month 6
Proportion of participants achieving a reduction from baseline of ≥ 3 points in MGC total score at Month 6
Time frame: Baseline to Month 6
Change from baseline in MG-ADL total score
Time frame: Baseline to Month 66
Proportion of participants achieving a reduction from core part in oral corticosteroids (OCS) dose till the end of extension part
Time frame: Baseline to month 66
Incidence of adverse events
Time frame: Month 7 to month 66
Eligibility criteria
Study locations (24)
Neuromuscular Research Center
Phoenix, Arizona, 85013
Honor Health Research Institute
Scottsdale, Arizona, 85258
Fullerton Neuro and Headache Ctr
Fullerton, California, 92835
University Of Southern California
Los Angeles, California, 90033
Univ Cali Irvine ALS Neuromuscular
Orange, California, 92868
California Pacific Medical Center
Sacramento, California, 94115
Medstar Washington Hospital Center
Washington D.C., District of Columbia, 20010-2975
SFM Clinical Research LLC
Boca Raton, Florida, 33487
Homestead Assoc In Research Inc
Homestead, Florida, 33033
Neurology Associates PA
Maitland, Florida, 32751
AdventHealth
Orlando, Florida, 32804
Neurological Services of Orlando PA
Orlando, Florida, 32806
University of Chicago Medical Centr
Chicago, Illinois, 60637
Mid Atlantic Epilepsy and Sleep Ctr
Bethesda, Maryland, 20817-1807
Neuromuscular Diagnostic Center
Boston, Massachusetts, 02114
Michigan State University-Department of Neurology
East Lansing, Michigan, 48824
Dent Neurological Institute
Buffalo, New York, 14209
Univ of Cincinnati Medical Center
Cincinnati, Ohio, 45219
Cleveland Clinic Foundation
Cleveland, Ohio, 44195
University of Pittsburgh Medical Center
Pittsburgh, Pennsylvania, 15213
Houston Methodist Hospital
Houston, Texas, 77030
UT Health Science Center
Houston, Texas, 77030
University of WA Division of Cardio
Seattle, Washington, 98195
Center for Neurological Disorders G
Greenfield, Wisconsin, 53228-1321