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RecruitingInterventionalPhase 3

Efficacy and Safety of Nipocalimab vs Efgartigimod for Patients With Generalized Myasthenia Gravis in a Randomized, Open-label, Phase 3b, Interventional Trial Including Within Class Switching From Efgartigimod to Nipocalimab

NCT ID: NCT07217587Sponsor: Janssen Research & Development, LLCLast updated: 2026-06-05

Summary

The purpose of this study is to assess how well nipocalimab works when compared to efgartigimod in participants with generalized myasthenia gravis (a condition in which body's immune system mistakenly attacks and damages the connection between nerves and muscles causing muscle weakness).

Arms & interventions

  • DrugNipocalimab

    Nipocalimab will be administered intravenously.

  • DrugEfgartigimod

    Efgartigimod will be administered intravenously.

Outcome measures

Primary

  • Arms 1 and 2: Averaged Mean Percent Change from Baseline in Total Immunoglobulin G (IgG) Levels Over Weeks 8, 10 and 12

    Average mean percent change from baseline in total IgG levels over Weeks 8 , 10 and 12 will be reported.

    Time frame: Baseline, Weeks 8, 10 and 12

Secondary

  • Arms 1 and 2: Averaged Mean Change from Baseline in Myasthenia Gravis-Activities of Daily Living (MG-ADL) Total Score Over Weeks 8, 10 and 12

    Time frame: Baseline, Weeks 8, 10 and 12

  • Arms 1 and 2: Mean Percent Change from Baseline in Total IgG Between Arm 1 at EoT and Arm 2 at EoC Based on Clinical Evaluation

    Time frame: Baseline, EoT (for Arm 1) and EoC (Arm 2) up to Week 12

  • Arms 1 and 2: Mean Percent Change from Baseline in MG-ADL Total Score Between Arm 1 at EoT and Arm 2 at EoC Based on Clinical Evaluation

    Time frame: Baseline, EoT (for Arm 1) and EoC (Arm 2) up to Week 12

  • Arms 1 and 2: Mean Percent Change from Baseline in Total IgG Levels at Week 8

    Time frame: Baseline and Week 8

  • Arms 1 and 2: Mean Change from Baseline in MG-ADL Total Score at Week 8

    Time frame: Baseline and Week 8

  • Arms 1 and 2: Averaged Mean Change from Baseline in Quantitative Myasthenia Gravis (QMG) Total Score Over Weeks 8 and 12

    Time frame: Baseline, Weeks 8 and 12

  • Arms 1 and 2: Mean Percent Change from Baseline in QMG Total Score Between Arm 1 at EoT and Arm 2 at EoC Based on Clinical Evaluation

    Time frame: Baseline, EoT (for Arm 1) and EoC (Arm 2) up to Week 12

  • Arms 1 and 2: Mean Change from Baseline in QMG Total Score at Week 8

    Time frame: Baseline and Week 8

  • Arms 1 and 2: Percentage of Participants Maintaining >= 2-Point Improvement in MG-ADL Total Score for At Least 6 Weeks During Randomized Treatment Phase

    Time frame: Baseline up to Week 12

  • Arms 1 and 2: Percentage of Participants Maintaining >= 2-Point Improvement in MG-ADL Total Score for At Least 8 Weeks During Randomized Treatment Phase

    Time frame: Baseline up to Week 12

  • Arms 1 and 2: Percentage of Participants Maintaining >= 2-Point Improvement in MG-ADL Total Score for 50% of Postbaseline Observations

    Time frame: Baseline, Week 2 up to Week 12

  • Arms 1 and 2: Percentage of Participants Maintaining >= 2-Point Improvement in MG-ADL Total Score for 75% of Postbaseline Observations

    Time frame: Baseline, Week 2 up to Week 12

  • Arms 1 and 2: Percentage of Participants with MG-ADL Total Score of 0 or 1 at Week 12

    Time frame: Week 12

  • Arm 3: Mean Percent Change in Total IgG from Switch Day 1 to Switch Week 12

    Time frame: Switch Day 1 to Switch Week 12

  • Arm 3: Mean Change in MG-ADL Total Score from Switch Day 1 to Switch Week 12

    Time frame: Switch Day 1 to Switch Week 12

  • Arm 3: Percentage of Participants with >= 2-Point Improvement in MG-ADL Total Score at Switch Week 12

    Time frame: At Switch Week 12

  • Arm 3: Percentage of Participants Maintaining >= 2-Point Improvement in MG-ADL Total Score for At Least 6 Weeks During Treatment Phase

    Time frame: Switch Day 1 up to Switch Week 12

  • Arm 3: Percentage of Participants with MG-ADL Total Score of 0 or 1 at Switch Week 12

    Time frame: At Switch Week 12

  • Arms 1 and 2: Number of Participants with Adverse Events (AEs), Serious Adverse Events (SAEs) and Adverse Events of Special Interest (AESIs)

    Time frame: Up to Week 20

  • Arm 3: Number of Participants with AEs, SAEs and AESIs

    Time frame: Up to Switch Week 20

Eligibility criteria

Sex: AllAge: 18 Years to 74 YearsHealthy volunteers: No
Inclusion criteria: For all arms: * Medically stable on the basis of physical examination, medical history, vital signs, clinical laboratory tests, and 12-lead electrocardiogram (ECG) performed at screening * Diagnosis of myasthenia gravis (MG) with generalized muscle weakness meeting the clinical criteria for generalized MG (gMG) as defined by the Myasthenia gravis foundation of America (MGFA) clinical classification class II a/b, III a/b, or IV a/b at screening and positive for acetylcholine receptor (AChR) antibodies * Myasthenia Gravis-Activities of Daily Living (MG-ADL) score of greater than or equal to (\>=) 5 with less than (\<) 50% of symptoms coming from ocular MG-ADL sub-scores at study screening and baseline (Day 1) visits Criteria specific to Arms 1 and 2 only: \- Has suboptimal response to current stable therapy for gMG according to the investigator or has discontinued corticosteroids and/or immunosuppressants/immunomodulators including eculizumab or other novel approved immune agents at least 4 weeks prior to baseline due to intolerance or lack of efficacy Criteria specific to Arm 3: \- Treatment with efgartigimod IV or subcutaneous (SC) for \>=1 cycle, and the final cycle is consistent with product information Exclusion criteria: * Any confirmed or suspected clinical immunodeficiency syndrome not related to treatment of his/her gMG, or has a family history of congenital or hereditary immunodeficiency unless confirmed absent in the participant * Had a thymectomy within 1 year prior to baseline, or thymectomy is planned during the study * Currently has a malignancy or has a history of malignancy within 3 years before baseline Criteria specific to Arms 1 and 2 only: \- Has received treatment for MG with an FcRn-targeting therapy Criteria specific to Arm 3 only: \- Is currently taking IgG monoclonal antibody therapeutics, or Fc-conjugated therapeutic agents, including factor or enzyme replacement, with the exception of efgartigimod

Study locations (11)

Neurology Center of North Orange County

Fullerton, California, 92835

Recruiting

The Neurology Group

Pomona, California, 91767

Recruiting

Advanced Neurology of Colorado

Fort Collins, Colorado, 80528

Recruiting

University of Connecticut

Farmington, Connecticut, 06030

Recruiting

SFM Clinical Research LLC

Boca Raton, Florida, 33487

Recruiting

HSHS St. Elizabeth's Hospital

O'Fallon, Illinois, 62269

Recruiting

Josephson Wallack Munshower Neurology, PC

Indianapolis, Indiana, 46256

Recruiting

Henry Ford Hospital

Detroit, Michigan, 48202

Recruiting

Velocity Clinical Research, Inc.

Raleigh, North Carolina, 27607 6010

Recruiting

Atrium Health Wake Forest Baptist

Winston-Salem, North Carolina, 27157

Recruiting

Texas Neurology

Dallas, Texas, 75206

Recruiting