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A Study to Investigate the Long-term Safety, Tolerability, and Efficacy of Rozanolixizumab in Adult Patients With Generalized Myasthenia Gravis

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: NCT04124965
Recruitment Status : Completed
First Posted : October 14, 2019
Results First Posted : August 21, 2023
Last Update Posted : September 5, 2023
Sponsor:
Information provided by (Responsible Party):
UCB Pharma ( UCB Biopharma SRL )

Study Type Interventional
Study Design Allocation: Randomized;   Intervention Model: Single Group Assignment;   Masking: None (Open Label);   Primary Purpose: Treatment
Condition Generalized Myasthenia Gravis
Intervention Drug: Rozanolixizumab
Enrollment 71
Recruitment Details The study started to enroll study participants in Oct 2019 and concluded in Sep 2021.
Pre-assignment Details Participant Flow refers to the Randomized Set.
Arm/Group Title Rozanolixizumab ~7 mg/kg Rozanolixizumab ~10 mg/kg
Hide Arm/Group Description Participants received rozanolixizumab equivalent to approximately 7 milligrams/kilogram (mg/kg), subcutaneously on a weekly basis over a 52-week Treatment Period. After 52-week Treatment Period, participants were followed up for 8 weeks (up to Week 60). Participants received rozanolixizumab equivalent to approximately 10 mg/kg, subcutaneously on a weekly basis over a 52-week Treatment Period. After 52-week Treatment Period, participants were followed up for 8 weeks (up to Week 60).
Period Title: Overall Study
Started 35 36
Safety Set [1] 35 35
Completed 5 3
Not Completed 30 33
Reason Not Completed
Adverse event, non-fatal             3             1
Withdrawal by Subject             1             1
Rolled Over To MG0007 Study             25             28
Pregnancy             1             0
Sponsor and participant decision             0             1
Personal surgery             0             1
Physician Decision             0             1
[1]
Received at least 1 dose of investigational medicinal product
Arm/Group Title Rozanolixizumab ~7 mg/kg Rozanolixizumab ~10 mg/kg Total
Hide Arm/Group Description Participants received rozanolixizumab equivalent to approximately 7 mg/kg, subcutaneously on a weekly basis over a 52-week Treatment Period. After 52-week Treatment Period, participants were followed up for 8 weeks (up to Week 60). Participants received rozanolixizumab equivalent to approximately 10 mg/kg, subcutaneously on a weekly basis over a 52-week Treatment Period. After 52-week Treatment Period, participants were followed up for 8 weeks (up to Week 60). Total of all reporting groups
Overall Number of Baseline Participants 35 36 71
Hide Baseline Analysis Population Description
Baseline Characteristics refer to the Randomized Set (RS) which consisted of all study participants who were randomized, using the treatment assigned instead of the actual treatment received.
Age, Categorical  
Measure Type: Count of Participants
Unit of measure:  Participants
Number Analyzed 35 participants 36 participants 71 participants
<=18 years
0
   0.0%
0
   0.0%
0
   0.0%
Between 18 and 65 years
29
  82.9%
26
  72.2%
55
  77.5%
>=65 years
6
  17.1%
10
  27.8%
16
  22.5%
Age, Continuous  
Mean (Standard Deviation)
Unit of measure:  Years
Number Analyzed 35 participants 36 participants 71 participants
50.6  (14.2) 53.7  (17.2) 52.2  (15.8)
Sex: Female, Male  
Measure Type: Count of Participants
Unit of measure:  Participants
Number Analyzed 35 participants 36 participants 71 participants
Female
19
  54.3%
19
  52.8%
38
  53.5%
Male
16
  45.7%
17
  47.2%
33
  46.5%
Race/Ethnicity, Customized  
Measure Type: Count of Participants
Unit of measure:  Participants
Number Analyzed 35 participants 36 participants 71 participants
Asian
4
  11.4%
4
  11.1%
8
  11.3%
Black
2
   5.7%
3
   8.3%
5
   7.0%
White
17
  48.6%
19
  52.8%
36
  50.7%
Missing
12
  34.3%
10
  27.8%
22
  31.0%
Race/Ethnicity, Customized  
Measure Type: Count of Participants
Unit of measure:  Participants
Number Analyzed 35 participants 36 participants 71 participants
Hispanic or Latino
4
  11.4%
2
   5.6%
6
   8.5%
Not Hispanic or Latino
19
  54.3%
25
  69.4%
44
  62.0%
Missing
12
  34.3%
9
  25.0%
21
  29.6%
1.Primary Outcome
Title Percentage of Participants With Treatment-emergent Adverse Events (TEAEs)
Hide Description A TEAE is defined as an AE starting on or after the time of first administration of investigational medicinal product (IMP) or any unresolved event already present before the first administration of IMP that worsened in intensity following exposure to IMP, up to 8 weeks after the last dose of IMP in study participants who discontinued the study or IMP.
Time Frame From Baseline until End of Study (up to Week 60)
Hide Outcome Measure Data
Hide Analysis Population Description
The Safety Set (SS) consisted of all randomized study participants who received at least 1 dose of IMP in this study. This endpoint was planned to be analyzed using the SS by most recent dose received i.e. the most recent dose received at or before the AE onset. Participants who switched doses were counted in both rozanolixizumab (RLZ) doses.
Arm/Group Title Rozanolixizumab ~7 mg/kg Rozanolixizumab ~10 mg/kg
Hide Arm/Group Description:
Participants received rozanolixizumab equivalent to approximately 7 mg/kg, subcutaneously on a weekly basis over a 52-week Treatment Period. After 52-week Treatment Period, participants were followed up for 8 weeks (up to Week 60).
Participants received rozanolixizumab equivalent to approximately 10 mg/kg, subcutaneously on a weekly basis over a 52-week Treatment Period. After 52-week Treatment Period, participants were followed up for 8 weeks (up to Week 60).
Overall Number of Participants Analyzed 50 42
Measure Type: Number
Unit of Measure: percentage of participants
76.0 78.6
2.Primary Outcome
Title Percentage of Participants With Treatment-emergent Adverse Events (TEAEs) Leading to Permanent Withdrawal of Study Medication
Hide Description A TEAE is defined as an AE starting on or after the time of first administration of IMP or any unresolved event already present before the first administration of IMP that worsened in intensity following exposure to IMP, up to 8 weeks after the last dose of IMP in study participants who discontinued the study or IMP.
Time Frame From Baseline until End of Study (up to Week 60)
Hide Outcome Measure Data
Hide Analysis Population Description
The Safety Set consisted of all randomized study participants who received at least 1 dose of IMP in this study. This endpoint was planned to be analyzed using the SS by most recent dose received i.e. the most recent dose received at or before the AE onset. Participants who switched doses were counted in both rozanolixizumab doses.
Arm/Group Title Rozanolixizumab ~7 mg/kg Rozanolixizumab ~10 mg/kg
Hide Arm/Group Description:
Participants received rozanolixizumab equivalent to approximately 7 mg/kg, subcutaneously on a weekly basis over a 52-week Treatment Period. After 52-week Treatment Period, participants were followed up for 8 weeks (up to Week 60).
Participants received rozanolixizumab equivalent to approximately 10 mg/kg, subcutaneously on a weekly basis over a 52-week Treatment Period. After 52-week Treatment Period, participants were followed up for 8 weeks (up to Week 60).
Overall Number of Participants Analyzed 50 42
Measure Type: Number
Unit of Measure: percentage of participants
6.0 0
3.Secondary Outcome
Title Change From Baseline in Myasthenia Gravis-Activities of Daily Living (MG-ADL) Total Score at Each Scheduled Assessment During Treatment and Observation Periods
Hide Description The Myasthenia Gravis Activities of Daily Living (MG-ADL) is an 8-item patient-reported outcome (PRO) instrument developed on the basis of the Quantitative Myasthenia Gravis (QMG). The MG-ADL targeted symptoms and disability across ocular, bulbar, respiratory, and axial symptoms. The total MG-ADL score was obtained by summing the responses to each individual item (8 items; Grades: 0, 1, 2, 3), where 0 represents no symptoms or impaired performance and 3 represents the most severe symptoms or impaired performance. The total score ranges from 0 to 24, with a higher score indicating more disability. A positive change indicates worsening and a negative change indicates improvement.
Time Frame Baseline, Weeks 5, 7, 9, 13, 17, 21, 25, 29, 33, 37, 41, 45, 49, 52 and 60
Hide Outcome Measure Data
Hide Analysis Population Description
The Safety Set consisted of all randomized study participants who received at least 1 dose of IMP in this study. Here, number analyzed signifies those participants who were evaluable at specified time points.
Arm/Group Title Rozanolixizumab ~7 mg/kg Rozanolixizumab ~10 mg/kg
Hide Arm/Group Description:
Participants received rozanolixizumab equivalent to approximately 7 mg/kg, subcutaneously on a weekly basis over a 52-week Treatment Period. After 52-week Treatment Period, participants were followed up for 8 weeks (up to Week 60).
Participants received rozanolixizumab equivalent to approximately 10 mg/kg, subcutaneously on a weekly basis over a 52-week Treatment Period. After 52-week Treatment Period, participants were followed up for 8 weeks (up to Week 60).
Overall Number of Participants Analyzed 35 35
Mean (Standard Deviation)
Unit of Measure: units on a scale
Week 5 Number Analyzed 34 participants 34 participants
-2.7  (3.3) -3.2  (3.8)
Week 7 Number Analyzed 35 participants 32 participants
-2.7  (3.8) -3.7  (3.4)
Week 9 Number Analyzed 29 participants 31 participants
-2.8  (3.4) -3.4  (3.7)
Week 13 Number Analyzed 30 participants 30 participants
-3.1  (3.4) -3.9  (4.0)
Week 17 Number Analyzed 25 participants 29 participants
-2.8  (3.3) -4.0  (3.9)
Week 21 Number Analyzed 20 participants 24 participants
-3.0  (3.4) -4.1  (4.3)
Week 25 Number Analyzed 18 participants 17 participants
-2.7  (3.0) -3.7  (4.7)
Week 29 Number Analyzed 13 participants 14 participants
-2.8  (2.1) -3.6  (4.3)
Week 33 Number Analyzed 10 participants 12 participants
-3.0  (2.8) -3.5  (4.5)
Week 37 Number Analyzed 7 participants 10 participants
-3.9  (2.5) -3.6  (3.6)
Week 41 Number Analyzed 6 participants 6 participants
-2.8  (2.1) -1.8  (1.0)
Week 45 Number Analyzed 4 participants 7 participants
-3.8  (2.4) -2.1  (1.1)
Week 49 Number Analyzed 5 participants 6 participants
-2.4  (1.1) -0.5  (3.7)
Week 52 Number Analyzed 5 participants 3 participants
-2.6  (1.3) -2.0 [1]   (NA)
Week 60 Number Analyzed 7 participants 7 participants
-0.3  (2.1) -1.3  (3.9)
[1]
NA signifies that as pre-specified in the Statistical Analysis Plan, Standard Deviation was only calculated if there were a minimum of 4 participants.
4.Secondary Outcome
Title Change From Baseline in Myasthenia Gravis-Composite (MG-C) Total Score at Each Scheduled Assessment During Treatment and Observation Periods
Hide Description MG-C scale is a validated assessment and scale tests 10 items with individual items being weighted differently. The items included ptosis/upward gaze (range: 0 [>45 second] - 3 [Immediate]), double vision on lateral gaze (range: 0 [>45 second] - 4 [Immediate]), eye closure (range: 0 [Normal] - 2 [severe weakness]), talking (range: 0 [Normal] - 6 [difficult to understand speech]), chewing (range: 0 [Normal] - 6 [gastric tube]), swallowing (range: 0 [Normal] - 6 [gastric tube]), breathing (range: 0 [Normal] - 9 [ventilator dependence]), neck flexion (range: 0 [Normal] - 4 [severe weakness]), shoulder abduction (range: 0 [Normal] - 5 [severe weakness]) and hip flexion (range: 0 [Normal] - 5 [severe weakness]), lower scores= lower disease activity. Total MG-C score was obtained by summing responses to each individual item and score ranges from 0 to 50, with lower scores indicating lower disease activity. A positive change indicates worsening and a negative change indicates improvement.
Time Frame Baseline, Weeks 5, 7, 9, 13, 17, 21, 25, 29, 33, 37, 41, 45, 49, 52 and 60
Hide Outcome Measure Data
Hide Analysis Population Description
The Safety Set consisted of all randomized study participants who received at least 1 dose of IMP in this study. Here, number analyzed signifies those participants who were evaluable at specified time points.
Arm/Group Title Rozanolixizumab ~7 mg/kg Rozanolixizumab ~10 mg/kg
Hide Arm/Group Description:
Participants received rozanolixizumab equivalent to approximately 7 mg/kg, subcutaneously on a weekly basis over a 52-week Treatment Period. After 52-week Treatment Period, participants were followed up for 8 weeks (up to Week 60).
Participants received rozanolixizumab equivalent to approximately 10 mg/kg, subcutaneously on a weekly basis over a 52-week Treatment Period. After 52-week Treatment Period, participants were followed up for 8 weeks (up to Week 60).
Overall Number of Participants Analyzed 35 35
Mean (Standard Deviation)
Unit of Measure: units on a scale
Week 5 Number Analyzed 34 participants 35 participants
-4.7  (5.5) -5.5  (7.3)
Week 7 Number Analyzed 35 participants 33 participants
-5.0  (5.7) -7.1  (7.4)
Week 9 Number Analyzed 29 participants 30 participants
-5.0  (5.3) -6.0  (7.4)
Week 13 Number Analyzed 30 participants 30 participants
-4.8  (5.5) -7.0  (7.8)
Week 17 Number Analyzed 25 participants 29 participants
-4.4  (5.7) -5.5  (8.6)
Week 21 Number Analyzed 20 participants 24 participants
-5.3  (6.9) -7.3  (8.1)
Week 25 Number Analyzed 18 participants 17 participants
-6.1  (5.8) -8.8  (7.7)
Week 29 Number Analyzed 13 participants 14 participants
-5.1  (5.5) -9.1  (9.2)
Week 33 Number Analyzed 9 participants 12 participants
-4.6  (5.1) -8.4  (8.6)
Week 37 Number Analyzed 7 participants 10 participants
-6.3  (6.8) -8.6  (6.9)
Week 41 Number Analyzed 6 participants 6 participants
-6.0  (7.1) -6.5  (5.8)
Week 45 Number Analyzed 4 participants 7 participants
-4.0  (6.2) -5.3  (4.9)
Week 49 Number Analyzed 5 participants 6 participants
-1.4  (3.8) -0.8  (9.2)
Week 52 Number Analyzed 5 participants 2 participants
-3.8  (3.1) NA [1]   (NA)
Week 60 Number Analyzed 7 participants 7 participants
1.7  (3.7) -2.3  (8.5)
[1]
NA signifies that as pre-specified in the Statistical Analysis Plan, mean was only calculated if there were a minimum of 3 participants and standard deviation was only calculated if there were a minimum of 4 participants.
5.Secondary Outcome
Title Change From Baseline in Quantitative Myasthenia Gravis (QMG) Total Score at Each Scheduled Assessment During Treatment and Observation Periods
Hide Description The QMG is a validated assessment and the scale tested 13 items, including ocular and facial involvement, swallowing, speech, limb strength, and forced vital capacity. The total QMG score was obtained by summing the responses to each individual item (13 items; Responses: None=0, Mild=1, Moderate=2, Severe=3) and the score ranges from 0 to 39, with lower scores indicating lower disease activity. A positive change indicates worsening and a negative change indicates improvement.
Time Frame Baseline, Weeks 5, 7, 9, 13, 17, 21, 25, 29, 33, 37, 41, 45, 49, 52 and 60
Hide Outcome Measure Data
Hide Analysis Population Description
The Safety Set consisted of all randomized study participants who received at least 1 dose of IMP in this study. Here, number analyzed signifies those participants who were evaluable at specified time points.
Arm/Group Title Rozanolixizumab ~7 mg/kg Rozanolixizumab ~10 mg/kg
Hide Arm/Group Description:
Participants received rozanolixizumab equivalent to approximately 7 mg/kg, subcutaneously on a weekly basis over a 52-week Treatment Period. After 52-week Treatment Period, participants were followed up for 8 weeks (up to Week 60).
Participants received rozanolixizumab equivalent to approximately 10 mg/kg, subcutaneously on a weekly basis over a 52-week Treatment Period. After 52-week Treatment Period, participants were followed up for 8 weeks (up to Week 60).
Overall Number of Participants Analyzed 35 35
Mean (Standard Deviation)
Unit of Measure: units on a scale
Week 5 Number Analyzed 34 participants 34 participants
-2.9  (4.7) -4.5  (4.4)
Week 7 Number Analyzed 35 participants 32 participants
-3.3  (4.4) -5.2  (4.3)
Week 9 Number Analyzed 28 participants 30 participants
-3.3  (3.8) -4.7  (4.3)
Week 13 Number Analyzed 30 participants 29 participants
-2.6  (4.2) -5.5  (4.4)
Week 17 Number Analyzed 25 participants 28 participants
-3.1  (4.9) -4.2  (4.4)
Week 21 Number Analyzed 20 participants 23 participants
-4.0  (4.7) -5.1  (4.9)
Week 25 Number Analyzed 18 participants 16 participants
-5.1  (4.6) -5.7  (5.5)
Week 29 Number Analyzed 13 participants 13 participants
-5.4  (3.6) -5.5  (6.3)
Week 33 Number Analyzed 10 participants 11 participants
-4.9  (4.8) -6.2  (5.7)
Week 37 Number Analyzed 7 participants 9 participants
-5.3  (3.9) -6.8  (5.9)
Week 41 Number Analyzed 6 participants 5 participants
-5.7  (4.3) -4.0  (3.1)
Week 45 Number Analyzed 4 participants 6 participants
-5.3  (2.8) -4.0  (3.5)
Week 49 Number Analyzed 5 participants 5 participants
-3.8  (0.8) -1.8  (1.8)
Week 52 Number Analyzed 5 participants 2 participants
-4.6  (2.9) NA [1]   (NA)
Week 60 Number Analyzed 7 participants 6 participants
-0.9  (2.4) -1.8  (5.1)
[1]
NA signifies that as pre-specified in the Statistical Analysis Plan, mean was only calculated if there were a minimum of 3 participants and standard deviation was only calculated if there were a minimum of 4 participants.
6.Secondary Outcome
Title Percentage of Participants Using Rescue Medication (Intravenous Infusion of Immunoglobulin G (IVIg) or Plasma Exchange (PEX))
Hide Description Rescue therapy consisted of IVIg or PEX. Study participants who experienced disease worsening (eg, an increase of 2 points on the MG-ADL or 3 points on the QMG scale between 2 consecutive visits) may be considered for rescue therapy at the discretion of the Investigator.
Time Frame From Baseline until End of Study (up to Week 60)
Hide Outcome Measure Data
Hide Analysis Population Description
The Safety Set consisted of all randomized study participants who received at least 1 dose of IMP in this study.
Arm/Group Title Rozanolixizumab ~7 mg/kg Rozanolixizumab ~10 mg/kg
Hide Arm/Group Description:
Participants received rozanolixizumab equivalent to approximately 7 mg/kg, subcutaneously on a weekly basis over a 52-week Treatment Period. After 52-week Treatment Period, participants were followed up for 8 weeks (up to Week 60).
Participants received rozanolixizumab equivalent to approximately 10 mg/kg, subcutaneously on a weekly basis over a 52-week Treatment Period. After 52-week Treatment Period, participants were followed up for 8 weeks (up to Week 60).
Overall Number of Participants Analyzed 35 35
Measure Type: Number
Unit of Measure: percentage of participants
11.4 0
Time Frame From Baseline until End of Study (up to Week 60)
Adverse Event Reporting Description TEAEs are reported in the safety section. TEAEs were planned to be analyzed using the SS by most recent dose received i.e. the most recent dose received at or before the AE onset. Participants who switched doses were counted in both RLZ doses.
 
Arm/Group Title Rozanolixizumab ~7 mg/kg Rozanolixizumab ~10 mg/kg
Hide Arm/Group Description Participants received rozanolixizumab equivalent to approximately 7 mg/kg, subcutaneously on a weekly basis over a 52-week Treatment Period. After 52-week Treatment Period, participants were followed up for 8 weeks (up to Week 60). Participants received rozanolixizumab equivalent to approximately 10 mg/kg, subcutaneously on a weekly basis over a 52-week Treatment Period. After 52-week Treatment Period, participants were followed up for 8 weeks (up to Week 60).
All-Cause Mortality
Rozanolixizumab ~7 mg/kg Rozanolixizumab ~10 mg/kg
Affected / at Risk (%) Affected / at Risk (%)
Total   0/50 (0.00%)      0/42 (0.00%)    
Hide Serious Adverse Events
Rozanolixizumab ~7 mg/kg Rozanolixizumab ~10 mg/kg
Affected / at Risk (%) # Events Affected / at Risk (%) # Events
Total   7/50 (14.00%)      2/42 (4.76%)    
Cardiac disorders     
Cardiac failure congestive * 1  1/50 (2.00%)  2 0/42 (0.00%)  0
Pericarditis * 1  0/50 (0.00%)  0 1/42 (2.38%)  1
Eye disorders     
Retinal detachment * 1  1/50 (2.00%)  1 0/42 (0.00%)  0
Investigations     
Biopsy kidney abnormal * 1  1/50 (2.00%)  1 0/42 (0.00%)  0
Musculoskeletal and connective tissue disorders     
Muscular weakness * 1  1/50 (2.00%)  1 0/42 (0.00%)  0
Nervous system disorders     
Myasthenia gravis * 1  3/50 (6.00%)  4 1/42 (2.38%)  1
1
Term from vocabulary, MedDRA 24.0
*
Indicates events were collected by non-systematic assessment
Hide Other (Not Including Serious) Adverse Events
Frequency Threshold for Reporting Other Adverse Events 5%
Rozanolixizumab ~7 mg/kg Rozanolixizumab ~10 mg/kg
Affected / at Risk (%) # Events Affected / at Risk (%) # Events
Total   27/50 (54.00%)      25/42 (59.52%)    
Gastrointestinal disorders     
Diarrhoea * 1  6/50 (12.00%)  11 7/42 (16.67%)  10
Abdominal pain * 1  2/50 (4.00%)  2 2/42 (4.76%)  2
Nausea * 1  4/50 (8.00%)  4 5/42 (11.90%)  8
Vomiting * 1  0/50 (0.00%)  0 4/42 (9.52%)  4
General disorders     
Pyrexia * 1  4/50 (8.00%)  5 3/42 (7.14%)  4
Immune system disorders     
Hypogammaglobulinaemia * 1  2/50 (4.00%)  4 2/42 (4.76%)  2
Infections and infestations     
Nasopharyngitis * 1  2/50 (4.00%)  2 4/42 (9.52%)  4
Urinary tract infection * 1  5/50 (10.00%)  5 2/42 (4.76%)  2
Investigations     
Blood immunoglobulin G decreased * 1  6/50 (12.00%)  12 5/42 (11.90%)  6
Musculoskeletal and connective tissue disorders     
Back pain * 1  2/50 (4.00%)  2 3/42 (7.14%)  3
Nervous system disorders     
Headache * 1  15/50 (30.00%)  55 12/42 (28.57%)  40
Skin and subcutaneous tissue disorders     
Rash * 1  1/50 (2.00%)  1 4/42 (9.52%)  7
Vascular disorders     
Hypertension * 1  3/50 (6.00%)  3 1/42 (2.38%)  1
1
Term from vocabulary, MedDRA 24.0
*
Indicates events were collected by non-systematic assessment
Certain Agreements
Principal Investigators are NOT employed by the organization sponsoring the study.
There IS an agreement between Principal Investigators and the Sponsor (or its agents) that restricts the PI's rights to discuss or publish trial results after the trial is completed.
Results Point of Contact
Layout table for Results Point of Contact information
Name/Title: UCB
Organization: Cares
Phone: 001 844 599 2273
EMail: UCBCares@ucb.com
Layout table for additonal information
Responsible Party: UCB Pharma ( UCB Biopharma SRL )
ClinicalTrials.gov Identifier: NCT04124965    
Other Study ID Numbers: MG0004
2019-000969-21 ( EudraCT Number )
First Submitted: October 11, 2019
First Posted: October 14, 2019
Results First Submitted: July 27, 2023
Results First Posted: August 21, 2023
Last Update Posted: September 5, 2023