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Completed

NCT Number: NCT03315130

Safety and Efficacy Study of RA101495 in Subjects With Generalized Myasthenia Gravis

The purpose of the study is to evaluate the safety and efficacy of RA101495 in patients with generalized Myasthenia Gravis (gMG). Subjects will be randomized in a 1:1:1 ratio to receive daily SC doses of 0.1 mg/kg RA101495, 0.3 mg/kg RA101495, or matching placebo for 12 weeks.

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Key information

Age range

18 year–85 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Phase 2

Primary location

University of Alberta Hospital, Edmonton, Alberta, Canada

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Who can participate

Healthy volunteers accepted: No

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

Inclusion criteria

  • Diagnosis of gMG [Myasthenia Gravis Foundation of America (MGFA) Class II-IVa] at Screening
  • Positive serology for acetylcholine receptor (AChR) autoantibodies
  • QMG score ≥ 12 at Screening and Randomization
  • No change in corticosteroid dose for at least 30 days prior to Randomization or anticipated to occur during the 12-week Treatment Period
  • No change in immunosuppressive therapy, including dose, for at least 30 days prior to Randomization or anticipated to occur during the 12-week Treatment Period

Exclusion criteria

  • Thymectomy within 6 months prior to Randomization or scheduled to occur during the 12 week Treatment Period
  • History of meningococcal disease
  • Current or recent systemic infection within 2 weeks prior to Randomization or infection requiring intravenous (IV) antibiotics within 4 weeks prior to Randomization

Treatment and study plan

zilucoplan (RA101495)

Drug

Daily subcutaneous (SC) injection

Placebo

Drug

Daily subcutaneous (SC) injection

Primary outcomes

  1. Main Portion: Change From Baseline to Week 12 in Quantitative Myasthenia Gravis (QMG) Score

    Time frame: From Baseline to Week 12

    The QMG is a standardized and validated quantitative strength scoring system that was developed specifically for myasthenia gravis (MG). The scale consists of 13 individual assessments, each scored on a 0-3 point scale (i.e., 0=none, 1=mild, 2=moderate, and 3=severe). The total score is the sum of the individual scores with a range of 0-39. Higher scores are representative of more severe impairment.

Secondary outcomes

  1. Main Portion: Change From Baseline to Week 12 in the Myasthenia Gravis - Activities of Daily Living (MG-ADL) Scale

    Time frame: From Baseline to Week 12

    The MG-ADL is a brief 8-item survey designed to evaluate MG symptom severity. The scale consists of 8 items each scored on a 0-3 point scale (i.e., 0=none, 1=mild, 2=moderate, and 3=severe). The total score is the sum of the 8 individual scores with range of 0-24. Higher scores are associated with more severe symptoms of MG.

  2. Main Portion: Change From Baseline to Week 12 in the Myasthenia Gravis - Quality of Life 15r (MG-QOL15r) Survey

    Time frame: From Baseline to Week 12

    The MG-QOL15r is a 15-item survey that was designed to assess quality of life in participants with MG. The survey consisted of 15 questions and the corresponding responses were each scored on a 0-2 point scale (0=Not much at all, 1=Somewhat, 2=Very Much). The total score is the sum of the 15 individual item scores with a range of 0-30. Higher scores indicate more severe impact of the disease on aspects of the participant's life.

  3. Main Portion: Change From Baseline to Week 12 in the MG Composite Scale Total Score

    Time frame: From Baseline to Week 12

    The MG Composite is a 10-item scale that has been used to measure the clinical status of participants with MG, in order to evaluate treatment response. It consists of 10 items which included ptosis (score range=0 to 3), double vision on lateral gaze left/right/both (score range=0 to 4), eye closure (score range=0 to 2), talking (score range=0 to 6), chewing (score range=0 to 6), swallowing (score range=0 to 6), breathing (score range=0 to 9), neck flexion or extension (score range=0 to 4), shoulder abduction (score range=0 to 5) and hip flexion (score range= 0 to 5). The total score is the sum of the 10 individual scores with a range of 0-50. Higher scores in the MG Composite indicate more severe impairment due to the disease.

  4. Main Portion: Percentage of Participants With >= 3-point Reduction in QMG Total Score at Week 12

    Time frame: Week 12

    The QMG is a standardized and validated quantitative strength scoring system that was developed specifically for MG. The scale consists of 13 individual assessments, each scored on a 0-3 point scale (i.e., 0=none, 1=mild, 2=moderate, and 3=severe). The total score is the sum of the individual scores with a range of 0-39. Higher scores are representative of more severe impairment.

  5. Main Portion: Percentage of Participants Who Required Rescue Therapy Over the 12-week Treatment Period

    Time frame: Up to Week 12

    Percentage of participants who used at least 1 dose of rescue medication were reported.

  6. Main Portion: Number of Participants With Adverse Events (AEs) and Serious Adverse Events (SAEs)

    Time frame: From Baseline to Week 12

    An adverse event (AE) is any untoward medical occurrence in a participant or clinical investigation participant administered a pharmaceutical product, which does not necessarily have a causal relationship with this treatment. An AE could therefore be any unfavorable and unintended sign, symptom, or disease temporally associated with the use of a medicinal (investigational) product, whether or not related to the medicinal (investigational) product. A serious adverse event (SAE) is any untoward medical occurrence that at any dose resulted in death, life-threatening, significant or persistent disability/incapacity, congenital anomaly/birth defect, important medical event, initial inpatient hospitalization or prolongation of hospitalization.

  7. Main Portion: Change From Baseline in Sheep Red Blood Cell (sRBC) Lysis Assay at Week 12 (Pre-dose)

    Time frame: Baseline and Week 12 (Pre-dose)

    A BioTek ELx800 automated microplate reader is used to measure the optical density at 415 nanometer (nm) of human plasma samples to calculate the percent lysis of sheep erythrocytes that has occurred as a result of total complement activity. The measure of complement activity is determined by the degree of hemolysis of the erythrocytes.

  8. Main Portion: Change From Baseline in C5 Levels at Week 12 (Pre-dose)

    Time frame: Baseline and Week 12 (Pre-dose)

    Blood samples were collected from participants to assess Complement Component 5C levels.

  9. Main Portion: Plasma Concentration of RA101495 and Its Major Metabolites

    Time frame: 1, 3 and 6 hours postdose on Day 1; Pre-dose on Week 1, 2, 4, 8 and 12

    RA102758 and RA103488 are the metabolites of RA101495.

  10. Main Portion: Maximum Plasma Concentration (Cmax) on Day 1

    Time frame: Pre-dose, 1, 3 and 6 hours postdose on Day 1

    Cmax is defined as the maximum observed plasma concentration.

  11. Main Portion: Time Corresponding to Cmax (Tmax) on Day 1

    Time frame: Pre-dose, 1, 3 and 6 hours postdose on Day 1

    Tmax is defined as the time to observe maximum plasma concentration.

  12. Main Portion: Metabolites (RA102758 and RA103488) to Parent Ratio

    Time frame: Pre-dose, 1, 3 and 6 hours postdose on Day 1; Pre-dose on Week 1, 2, 4, 8 and 12

    RA102758 and RA103488 are the metabolites of RA101495.

Sponsors and collaborators

Lead sponsor

Ra Pharmaceuticals

Industry

Registry information

Official study title

A Phase 2, Multicenter, Randomized, Double-Blind, Placebo-Controlled Study to Evaluate the Safety, Tolerability, and Preliminary Efficacy of RA101495 in Subjects With Generalized Myasthenia Gravis

Important dates

Study start
2017
Primary completion
2018
Study completion
2020
First posted
Oct 19, 2017
Registry last updated
Jul 27, 2022

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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