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OpenTrials
Active, Not Recruiting

NCT Number: NCT07025330

A Study of Efgartigimod in Patients With IgG4-Related Disease

The goal of this clinical trial is to learn if efgartigimod can treat IgG4-related disease in adults. The main questions it aims to answer are:

In patients with IgG4-related disease, does treatment with efgartigimod reduce the volume of the:

* lacrimal gland(s) and/or * salivary gland(s) and/or * pancreas

Participants will:

* Receive efgartigimod once weekly for up to 12 weeks * Visit the clinic every one to six weeks for checkups and tests * Be asked to complete questionnaires to see how they feel on efgartigimod

Active, Not Recruiting

This study is active but is not currently recruiting participants.

Key information

Age range

18 year–90 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Phase 2

Primary location

Stanford University

Palo Alto, California, 94304-2210, United States

Who can participate

Healthy volunteers accepted: No

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

Key Inclusion Criteria:

  • Have a clinical diagnosis of IgG4-related disease that requires treatment in the opinion of the investigator
  • Meet the 2019 ACR/EULAR Classification Criteria for IgG4-Related Disease
  • Have a serum IgG4 concentration greater than or equal to 2 times the upper limit of normal at Screening
  • Have involvement of the lacrimal gland(s), salivary gland(s), and/or pancreas
  • If lacrimal and/or salivary glands are involved, it must be symptomatic, including but not limited to discomfort, pain, dryness, headache, or vision changes
  • If the pancreas is involved, it must be asymptomatic, diffuse enlargement without signs or symptoms of obstruction or evidence of major organ dysfunction in the opinion of the investigator
  • Have a prior inadequate response to, or intolerance of, glucocorticoids, or who have experienced recurrent symptoms after previous treatment with glucocorticoids
  • Are not receiving current treatment with immunosuppressive medications
  • All women must test negative for pregnancy and agree to use a reliable method of birth control

Key Exclusion Criteria:

  • Any exclusion criteria listed in the 2019 ACR/EULAR Classification Criteria for IgG4-Related Disease
  • Prior treatment with an FcRn inhibitor
  • Have conventional synthetic disease-modifying antirheumatic drug (csDMARD) or immunosuppressive use as follows:
  • Treatment with glucocorticoids within 28 days prior to Baseline or planned treatment during the study
  • Treatment with csDMARDs including but not limited to hydroxychloroquine, methotrexate, leflunomide, or sulfasalazine within 28 days prior to Baseline or planned treatment during the study
  • Treatment with cytotoxic or immunosuppressive drugs including but not limited to cyclophosphamide, mycophenolic acid, azathioprine, cyclosporine, sirolimus, or tacrolimus within 28 days prior to Baseline or planned treatment during the study
  • Treatment with a janus kinase (JAK) inhibitor including but not limited to tofacitinib, baricitinib, upadacitinib, or filgotinib within 28 days prior to Baseline or planned treatment during the study
  • Treatment with a Bruton's tyrosine kinase (BTK) inhibitor including but not limited to ibrutinib, zanubrutinib, acalabrutinib, pirtobrutinib, or rilzabrutinib within 28 days prior to Baseline or planned treatment during the study
  • Have biologic disease-modifying antirheumatic drug (bDMARD) use as follows:
  • Treatment with etanercept, adalimumab, or anakinra within 28 days before Baseline or planned treatment during the study
  • Treatment with infliximab, certolizumab pegol, golimumab, abatacept, or tocilizumab within 56 days before Baseline or planned treatment during the study
  • Treatment with a B cell depleting agent including but not limited to rituximab, ocrelizumab, obinutuzumab, ofatumumab, inebilizumab, ianalumab, or obexelimab ≤ 6 months prior to Baseline
  • Patients who received B-cell targeted therapy > 6 and ≤ 12 months prior to Baseline must have a B-cell count that is within the laboratory reference range at Screening
  • Treatment with a BAFF antagonist including but not limited to belimumab or tabalumab within 6 months before Baseline or planned treatment during the study
  • Treatment with an IL-17 antagonist including but not limited to secukinumab, ixekizumab, or brodalumab within 6 months before Baseline or planned treatment during the study
  • Prior treatment with other bDMARDs may be allowed at the discretion of the investigator
  • A history of, or current, inflammatory or autoimmune disease (that could affect the interpretation of safety or efficacy outcomes) other than IgG4-related disease
  • Evidence of active tuberculosis, HIV, or hepatitis B or C infection
  • History of cancer except for skin basal or squamous cell carcinoma, cervical dysplasia or carcinoma in situ that has been treated and is considered cured > 1 year prior to Baseline, prostate cancer considered cured for > 5 years with a normal prostate specific antigen, or colon cancer considered cured > 5 years

Treatment and study plan

Efgartigimod

Drug

efgartigimod 1000 mg subcutaneous injection given once weekly

Other names: efgartigimod alfa and hyaluronidase-qvfc

Primary outcomes

  1. Change in volume on FDG-PET/MRI of lacrimal gland(s) and/or

    Time frame: From Baseline to Week 12

  2. Change in volume on FDG-PET/MRI of salivary gland(s) and/or

    Time frame: From Baseline to Week 12

    Salivary glands include parotid glands, submandibular glands, sublingual glands

  3. Change in volume of pancreas on FDG-PET/MRI

    Time frame: From Baseline to Week 12

Secondary outcomes

  1. Change in FDG avidity (SUVmax) of lacrimal glands on PET

    Time frame: Baseline to Week 12

  2. Change in FDG avidity (SUVmean) of lacrimal glands on PET

    Time frame: Baseline to Week 12

  3. Change in FDG avidity (total gland glycolysis) of lacrimal glands on PET

    Time frame: Baseline to Week 12

    Total gland glycolysis is SUVmean x gland volume

  4. Change in FDG avidity (SUVmax) of salivary glands on PET

    Time frame: Baseline to Week 12

  5. Change in FDG avidity (SUVmean) of salivary glands on PET

    Time frame: Baseline to Week 12

  6. Change in FDG avidity (total gland glycolysis) of salivary glands on PET

    Time frame: Baseline to Week 12

    Total gland glycolysis is SUVmean x gland volume

  7. Change in FDG avidity (SUVmax) of pancreas on PET

    Time frame: Baseline to Week 12

  8. Change in FDG avidity (SUVmean) of pancreas on PET

    Time frame: Baseline to Week 12

  9. Change in FDG avidity (total pancreatic glycolysis) of pancreas on PET

    Time frame: Baseline to Week 12

    Total pancreatic glycolysis is SUVmean x pancreatic volume

  10. Change in exchange transfer (K^trans) of lacrimal glands on MRI

    Time frame: From Baseline to Week 12

  11. Change in apparent diffusion coefficient (ADC) of lacrimal glands on MRI

    Time frame: From Baseline to Week 12

  12. Change in microvascular volume fraction (f) of lacrimal glands on MRI

    Time frame: From Baseline to Week 12

  13. Change in exchange transfer (K^trans) of salivary glands on MRI

    Time frame: From Baseline to Week 12

  14. Change in apparent diffusion coefficient (ADC) of salivary glands on MRI

    Time frame: From Baseline to Week 12

  15. Change in microvascular volume fraction (f) of salivary glands on MRI

    Time frame: From Baseline to Week 12

  16. Change in apparent diffusion coefficient (ADC) of pancreas on MRI

    Time frame: From Baseline to Week 12

  17. Change in T1 mapping of pancreas on MRI

    Time frame: From Baseline to Week 12

  18. Change in T2 mapping of pancreas on MRI

    Time frame: From Baseline to Week 12

  19. Change in extracellular volume (ECV) of pancreas on MRI

    Time frame: From Baseline to Week 12

  20. Change in microvascular perfusion fraction of pancreas on MRI

    Time frame: From Baseline to Week 12

  21. Change in serum IgG4 level

    Time frame: From Baseline to Week 12

  22. Change in serum IgG level

    Time frame: From Baseline to Week 12

  23. Change in serum IgE level

    Time frame: From Baseline to Week 12

  24. Change in plasmablast count

    Time frame: From Baseline to Week 12

  25. Change in absolute regulatory B cell count

    Time frame: From Baseline to Week 12

  26. Change in IgG4-RD Responder Index

    Time frame: From Baseline to Week 12

  27. Change in physician global assessment of disease

    Time frame: From Baseline to Week 12

    Symptoms rated on a 100 mm VAS. Score range: 0 to 100, higher scores correspond to worse disease state.

  28. Change in patient global assessment of disease

    Time frame: From Baseline to Week 12

    Symptoms rated on a 100 mm VAS. Score range: 0 to 100, higher scores correspond to worse disease state.

  29. Change in patient global assessment of ocular symptoms

    Time frame: From Baseline to Week 12

    Symptoms rated on a 100 mm VAS. Score range: 0 to 100, higher scores correspond to worse disease state.

  30. Change in patient global assessment of salivary symptoms

    Time frame: From Baseline to Week 12

    Symptoms rated on a 100 mm VAS. Score range: 0 to 100, higher scores correspond to worse disease state.

  31. Change in FACIT-F fatigue score

    Time frame: From Baseline to Week 12

    Total score range: 0-52, lower scores correspond with more fatigue.

  32. Change in C3 laboratory assessment

    Time frame: From Baseline to Week 12

  33. Change in C4 laboratory assessment

    Time frame: From Baseline to Week 12

  34. Change in total IgG laboratory assessment

    Time frame: From Baseline to Week 12

  35. Change in ESR laboratory assessment

    Time frame: From Baseline to Week 12

  36. Change in CRP laboratory assessment

    Time frame: From Baseline to Week 12

  37. Number of participants with safety endpoints of interest

    Time frame: From Screening to end of follow-up at Week 18

    Safety endpoints of interest include hypogammaglobulinemia, severe infection requiring hospitalization or IV antibiotics, and mortality

Sponsors and collaborators

Lead sponsor

Stanford University

Other

Registry information

Official study title

A Phase IIa, Single-Site, Open-Label Study of Efgartigimod in Patients With IgG4-Related Disease

Important dates

Study start
2025
Primary completion
2028
Study completion
2028
First posted
Jun 17, 2025
Registry last updated
Jul 23, 2026

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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