Efficacy and Safety Study of Efgartigimod in Adults With Post-COVID-19 POTS (POTS)
The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. |
ClinicalTrials.gov Identifier: NCT05633407 |
Recruitment Status :
Completed
First Posted : December 1, 2022
Last Update Posted : May 7, 2024
|
- Study Details
- Tabular View
- No Results Posted
- Disclaimer
- How to Read a Study Record
Condition or disease | Intervention/treatment | Phase |
---|---|---|
Postural Orthostatic Tachycardia Syndrome | Drug: Efgartigimod Drug: Placebo | Phase 2 |
Study Type : | Interventional (Clinical Trial) |
Actual Enrollment : | 53 participants |
Allocation: | Randomized |
Intervention Model: | Parallel Assignment |
Masking: | Triple (Participant, Care Provider, Investigator) |
Primary Purpose: | Treatment |
Official Title: | A Phase 2 Randomized, Double-blinded, Placebo-controlled Study to Evaluate the Efficacy and Safety of Efgartigimod IV in Adult Patients With Post-COVID-19 Postural Orthostatic Tachycardia Syndrome (POTS) |
Actual Study Start Date : | September 23, 2022 |
Actual Primary Completion Date : | April 18, 2024 |
Actual Study Completion Date : | April 18, 2024 |
Arm | Intervention/treatment |
---|---|
Experimental: Efgartigimod
Receive efgartigimod IV 10mg/kg during weekly infusions during a treatment period of 24 weeks
|
Drug: Efgartigimod
Efgartigimod IV 10 mg/kg infusion qw for 24 weeks. Participants will be randomized to receive efgartigimod IV 10 mg/kg or matching placebo in a 2:1 ratio, respectively |
Placebo Comparator: Placebo
Receive a matching placebo during weekly infusions during a treatment period of 24 weeks
|
Drug: Placebo
Receive a matching placebo during weekly infusions during a treatment period of 24 weeks. Participants will be randomized to receive efgartigimod IV 10 mg/kg or matching placebo in a 2:1 ratio, respectively |
- Evaluate the efficacy of efgartigimod in reducing the severity of post-COVID-19 POTS symptoms [ Time Frame: Outcome measure is assessed at baseline and week 24. ]Change from baseline to week 24 in the Composite Autonomic Symptom Score 31 (COMPASS 31).
- Evaluate the efficacy of efgartigimod in reducing the severity of post-COVID-19 POTS symptoms [ Time Frame: Outcome measure is assessed at baseline and week 24. ]Change from baseline to week 24 in the Malmo POTS Symptom Score (MaPS).
- Evaluate the safety and tolerability of efgartigimod in patients with post-COVID-19 POTS [ Time Frame: Up to 31 weeks ]Incidence and severity of adverse events (AEs), incidence of serious adverse events (SAEs), changes in laboratory test results, vital sign measurements, and electrocardiogram (ECG) results.
- Evaluate the efficacy of efgartigimod on patient global assessment of disease activity and fatigue [ Time Frame: Change from baseline to week 24 ]Change from baseline to week 24 in the Patient Global Impression of Severity (PGI-S)
- Evaluate the efficacy of efgartigimod on patient global assessment of disease activity and fatigue [ Time Frame: Change from baseline to week 24 ]Change from baseline to week 24 in the Patient Global Impression of Change (PGI-C)
- Evaluate the efficacy of efgartigimod on patient global assessment of disease activity and fatigue [ Time Frame: Change from baseline to week 24 ]Change from baseline to week 24 in the Patient-Reported Outcomes Measurement Information System (PROMIS) Fatigue Short Form 8a
- Evaluate the efficacy of efgartigimod on patient global assessment of disease activity and fatigue [ Time Frame: Change from baseline to week 24 ]Change from baseline to week 24 in the PROMIS Cognitive Function Short Form 6a
- Assess the pharmacodynamic (PD) effect of efgartigimod [ Time Frame: From Baseline to week 24 ]Absolute values, changes from baseline, and percent reduction from baseline in total IgG levels
- Assess the pharmacokinetic (PK) profile of efgartigimod [ Time Frame: From Baseline to week 24 ]Efgartigimod serum concentration-time profile
- Assess the immunogenicity of efgartigimod [ Time Frame: From Baseline to week 24 ]Incidence and prevalence of antidrug antibodies (ADA) against efgartigimod
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.
Ages Eligible for Study: | 18 Years and older (Adult, Older Adult) |
Sexes Eligible for Study: | All |
Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Reached the age of consent when signing the informed consent form
- Capable of providing signed informed consent and complying with protocol requirements
-
Diagnosed with new-onset POTS post-COVID-19 established by the following:
- History of COVID-19 based on a previous positive test result from either laboratory-confirmed COVID-19 test (eg, a PCR test) or non-laboratory-confirmed COVID-19 test (eg, rapid antigen test); this positive result may be either documented or patient-reported
- Tilt table or orthostatic vital sign measurements during screening consistent with consensus criteria: sustained HR increase of ≥30 bpm within 10 min of standing or head up tilt (≥40 bpm for individuals aged 18 to 19 years) and/or HR reaching >120 bpm within 10 min; absence of sustained 20 mmHg decrease in systolic blood pressure (SBP)
- Ongoing symptoms of POTS confirmed by the investigator with at least 3 symptoms in each of the following areas lasting longer than 12 weeks after either diagnosis of COVID-19 or after hospital discharge for COVID-19:
i. Vasomotor symptoms: fatigue, orthostatic intolerance, brain fog, exertional dyspnea, difficulty with concentration, venous pooling, and exercise intolerance ii. Sympathetic over-compensation symptoms: palpitation, heat intolerance, nausea with or without vomiting, insomnia, anxiety, lack of appetite, chest pain, and diaphoresis
- COMPASS 31 ≥35 at screening
-
Agree to use contraceptives consistent with local regulations regarding the methods of contraception for those participating in clinical studies and the following:
Male participants: No male contraception is required Female participants of childbearing potential must have a negative serum pregnancy test at screening and a negative urine pregnancy test at baseline before receiving IMP. Contraceptive requirements.
- Body mass index (BMI) <35 kg/m2
Exclusion Criteria:
- Diagnosis of or receiving treatment for the following conditions before COVID-19: peripheral neuropathy, POTS, myalgic encephalomyelitis encephalitis/chronic fatigue syndrome, Ehlers Danlos syndrome confirmed by genetic testing, autonomic neuropathy, multiple sclerosis, stroke, spinal cord injury, or any known lesions in the central nervous system by imaging or neurological exam
- History of or currently being treated for clinically significant ongoing cardiac arrythmia, heart failure, myocarditis, pulmonary embolism requiring anticoagulation, pulmonary fibrosis, or critical illness-related polyneuropathy or myopathy
- Known autoimmune disease that, in the investigator's judgment, would interfere with an accurate assessment of clinical symptoms of post-COVID-19 POTS or puts the participant at undue risk
- Known HIV disease or common variable immunodeficiency
-
History of malignancy unless considered cured by adequate treatment with no evidence of recurrence for ≥3 years before the first administration of IMP. Adequately-treated participants with the following cancers may 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 finding of prostate cancer (TNM stage T1a or T1b)
- Clinically significant uncontrolled active or chronic bacterial, viral, or fungal infection or positive SARS-CoV-2 PCR test at screening
-
Positive serum test at screening for an active infection with any of the following:
- Hepatitis B virus (HBV) that is indicative of an acute or chronic infection, unless associated with a negative HB surface antigen (HBsAg) or negative HBV DNA test
- Hepatitis C virus (HCV) based on HCV antibody assay unless a negative RNA test is available
- HIV
- A medical condition that could confound the results of the study or put the participant at undue risk in the investigator's judgment
- Clinically significant disease, recent major surgery (within 3 months of screening), or intends to have surgery during the study; or any other condition that in the opinion of the investigator could confound the results of the study or put the participant at undue risk
- Total IgG <4 g/L at screening
- Received within 12 weeks or 5 half-lives (whichever is longer) before screening an investigational product
- Received within 12 weeks before screening either intravenous immunoglobulin (Ig) IV or SC or plasmapheresis/plasma exchange (PLEX)
- Received a live or live-attenuated vaccine less than 4 weeks before screening
- Known hypersensitivity to IMP or 1 of its excipients
- Previously participated in an efgartigimod clinical study and received at least 1 dose of IMP
- Currently participating in another interventional clinical study
- History (within 12 months of screening) of or current alcohol, drug, or medication abuse
- Pregnant or lactating or intends to become pregnant during the study
- Unwilling to remain on a stable regimen of medications during the study
- Unwilling to avoid initiation of new physical rehabilitation or other physician-prescribed exercise programs during the 24-week treatment period
To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT05633407
United States, California | |
University of California, San Diego Sulpizio Cardiovascular Center | |
La Jolla, California, United States, 92037 | |
Stanford Movement Disorder Center | |
Palo Alto, California, United States, 94304 | |
United States, Illinois | |
Northshore University Health System | |
Glenview, Illinois, United States, 60026 | |
United States, Maryland | |
Johns Hopkins University | |
Baltimore, Maryland, United States, 21224 | |
United States, Massachusetts | |
Harvard Medical School, Brigham and Women's Hospital | |
Boston, Massachusetts, United States, 02115 | |
United States, Ohio | |
Case Western Reserve University | |
Cleveland, Ohio, United States, 44106 | |
United States, Tennessee | |
Vandetbilt University Medical Center / Clinical Research Center | |
Nashville, Tennessee, United States, 37232 | |
United States, Texas | |
Apex Trials Croup, LLC | |
Fort Worth, Texas, United States, 76132 | |
Texas Institute of Cardiology | |
McKinney, Texas, United States, 75071 | |
Pioneer Clinical Research | |
Rosharon, Texas, United States, 77583 | |
United States, Utah | |
Metrodora Institute | |
West Valley City, Utah, United States, 84119 |
Responsible Party: | argenx |
ClinicalTrials.gov Identifier: | NCT05633407 |
Other Study ID Numbers: |
ARGX-113-2104 |
First Posted: | December 1, 2022 Key Record Dates |
Last Update Posted: | May 7, 2024 |
Last Verified: | May 2024 |
Individual Participant Data (IPD) Sharing Statement: | |
Plan to Share IPD: | No |
Studies a U.S. FDA-regulated Drug Product: | Yes |
Studies a U.S. FDA-regulated Device Product: | No |
POTS Long COVID Postural Orthostatic Tachycardia Syndrome efgartigimod |
Postural Orthostatic Tachycardia Syndrome Tachycardia Syndrome Disease Pathologic Processes Arrhythmias, Cardiac Heart Diseases |
Cardiovascular Diseases Cardiac Conduction System Disease Orthostatic Intolerance Primary Dysautonomias Autonomic Nervous System Diseases Nervous System Diseases |