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NCT Number: NCT06298552

A Phase 3 Study to Evaluate the Efficacy and Safety of Efgartigimod IV in Patients With Acetylcholine Receptor Binding Antibody Seronegative Generalized Myasthenia Gravis

The primary purpose of this study is to measure the efficacy and safety of efgartigimod IV compared to placebo in participants with Acetylcholine Receptor Binding Antibody (AChR-Ab) seronegative Generalized Myasthenia Gravis (gMG). The study consists of a Part A where participants will be randomized to receive either efgartigimod IV or placebo IV and a Part B where participants completing part A will receive open-label efgartigimod IV. Participants will be in the study for up to (approximately) 2.5 years.

Active, Not Recruiting

This study is active but is not currently recruiting participants.

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Key information

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • The participant is at least 18 years of age and the local legal age of consent for clinical studies when signing the ICF.
  • The participant is capable of providing signed informed consent and following with protocol requirements.
  • The participant agrees to use contraceptive measures consistent with local regulations and the women of child-bearing potential (WOCBP) must have a negative serum pregnancy test result at screening and a negative urine pregnancy test result at baseline before receiving the study drug.
  • The participant has no known weakness in infancy and later develop fatigable weakness after aged 16 years and diagnosed with acquired gMG of both of the following:
  • History of abnormal neuromuscular transmission demonstrated by single fiber electromyography or repetitive nerve stimulation (RNS) or is anti-muscle-specific kinase antibodies (MuSK-Ab) seropositive
  • Either a history of positive edrophonium chloride test OR a demonstrated improvement in MG signs with treatments such as oral acetylcholinesterase (AChE) inhibitors, plasma exchange (PLEX), immunoabsorption, or intravenous immunoglobulin (IVIg)/ subcutaneous immunoglobulin (SCIg) treatment
  • The participant is receiving a stable dose of MG therapy before screening that includes acetylcholinesterase (AChE) inhibitors, steroids, or nonsteroidal immunosuppressive therapies (NSISTs) in combination or alone.

Exclusion criteria

  • Known autoimmune disease or any medical condition that would interfere with an accurate assessment of clinical symptoms of gMG or puts the participant at undue risk
  • History of malignancy, cancer, unless considered cured by adequate treatment with no evidence of recurrence for ≥3 years. Adequately treated participants with the following cancers can be included at any time: Basal cell or squamous cell skin cancer, Carcinoma in situ of the cervix, Carcinoma in situ of the breast, Incidental histological findings of prostate cancer
  • Clinically significant active infection that is not sufficiently resolved in the investigator's opinion or positive serum test at screening for active infection with any of the following: Hepatitis B virus (HBV), Hepatitis C virus (HCV), HIV
  • History of or current alcohol, drug, or medication abuse as assessed by the investigator
  • Pregnant or lactating state or intention to become pregnant during the study
  • Live or live-attenuated vaccine received <4 weeks before screening
  • Worsening muscle weakness secondary to concurrent infections or medications
  • Received a thymectomy less than 3 months before screening or thymectomy is planned during the study

The complete list of exclusion criteria can be found in the protocol.

Treatment and study plan

efgartigimod IV

Biological

Intravenous infusion of efgartigimod

Placebo IV

Other

Intravenous infusion of placebo

Primary outcomes

  1. MG-ADL total score change from baseline

    Time frame: Up to 29 days (part A)

    The Myasthenia Gravis Activities of Daily Living (MG- ADL) scale is an 8-item instrument used to assess MG symptoms and their effects on daily activities. The total score ranges from 0 (normal symptoms) to 24 (most severe symptoms)

Secondary outcomes

  1. QMG total score change from baseline

    Time frame: Up to 8 weeks (part A) + 2 years (part B)

    The Quantitative myasthenia gravis (QMG) includes 13 items that measure endurance or fatigability and accounts for fluctuations in disease state. The total score ranges from 0 (no disease severity) to 39 (highest disease severity)

  2. Proportion of participants who are both MG-ADL and QMG responders in part A

    Time frame: Up to 8 weeks (part A)

  3. Proportion of participants with MSE

    Time frame: Up to 8 weeks (part A) + 2 years (part B)

    Minimal symptom expression (MSE) is defined as an MG-ADL total score of 0 or 1

  4. Proportion of participants who are MG-ADL responders in part A

    Time frame: Up to 8 weeks (part A)

    The Myasthenia Gravis Activities of Daily Living (MG- ADL) scale is an 8-item instrument used to assess MG symptoms and their effects on daily activities. The total score ranges from 0 (normal symptoms) to 24 (most severe symptoms).

  5. Proportion of participants who are QMG responders in part A

    Time frame: Up to 8 weeks (part A)

    The Quantitative myasthenia gravis (QMG) includes 13 items that measure endurance or fatigability and accounts for fluctuations in disease state. The total score ranges from 0 (no disease severity) to 39 (highest disease severity)

  6. Proportion of participants who are early MG-ADL responders in part A

    Time frame: Up to 8 weeks (part A)

    The Myasthenia Gravis Activities of Daily Living (MG- ADL) scale is an 8-item instrument used to assess MG symptoms and their effects on daily activities. The total score ranges from 0 (normal symptoms) to 24 (most severe symptoms).

  7. MG-ADL total score change from baseline over time in part A and part A+B

    Time frame: Up to 8 weeks (part A) + 2 years (part B)

    The Myasthenia Gravis Activities of Daily Living (MG- ADL) scale is an 8-item instrument used to assess MG symptoms and their effects on daily activities. The total score ranges from 0 (normal symptoms) to 24 (most severe symptoms).

  8. MG-QoL15r change from baseline over time in part A and part A+B

    Time frame: Up to 8 weeks (part A) + 2 years (part B)

    The Myasthenia Gravis Quality of Life-15 revised (MG-QoL15r) is a patient-reported instrument that measures the impact of MG symptoms on quality of life. The total scores range from 0 (best outcome) to 30 (worst outcome)

  9. EQ-5D-5L VAS change from baseline over time in part A and part A+B

    Time frame: Up to 8 weeks (part A) + 2 years (part B)

    The EQ-5D-5L is a participant-reported measure of health status developed by the EuroQol Group. The questionnaire comprises 5 dimensions: mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. Current health status is rated on vertical visual analog score (VAS) from 0 to 100, with a score of 0 corresponding to "the worst health you can imagine" and 100 corresponding to "the best health you can imagine."

  10. Incidence of AEs and SAEs in part A and part A+B

    Time frame: Up to 8 weeks (part A) + 2 years (part B)

    AE: adverse event; SAE: serious adverse event

  11. Total IgG concentrations percent changes from baseline over time in part A and part A+B

    Time frame: Up to 8 weeks (part A) + 2 years (part B)

Sponsors and collaborators

Lead sponsor

argenx

Industry

Registry information

Official study title

A Randomized, Double-Blinded, Placebo-Controlled, Phase 3, Parallel-Group Design Study Evaluating the Efficacy and Safety of Efgartigimod IV in Adult Participants With Acetylcholine Receptor Binding Antibody Seronegative Generalized Myasthenia Gravis

Acronym: ADAPT SERON

Important dates

Study start
2024
Primary completion
2025
Study completion
2027
First posted
Mar 7, 2024
Registry last updated
Nov 5, 2025

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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