A Study to Evaluate the Efficacy and Safety of IGIV-C in Symptomatic Subjects With Generalized Myasthenia Gravis



Status:Completed
Conditions:Neurology
Therapuetic Areas:Neurology
Healthy:No
Age Range:18 - 85
Updated:3/7/2019
Start Date:August 2015
End Date:January 2018

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A Multi-center, Randomized, Double-blind, Placebo-controlled Study to Evaluate the Efficacy and Safety of Immune Globulin (Human), 10% Caprylate/Chromatography Purified (IGIV-C) in Symptomatic Subjects With Generalized Myasthenia Gravis

The primary objective is to evaluate whether IGIV-C improves MG symptoms as compared to
placebo in subjects with MG.

The primary objective is to evaluate the efficacy of IGIV-C in subjects with generalized
myasthenia gravis (MG) on standard of care treatment at study entry in terms of improvement
in MG symptoms as measured by the mean change in Quantitative Myasthenia Gravis (QMG) score
from Baseline (Week 0) to Week 24 as compared to placebo.

The safety objective of this study is to evaluate the safety and tolerability of IGIV-C
loading dose of 2 g/kg followed by 7 maintenance dosages of 1 g/kg every 3 weeks through Week
21 in subjects with MG.

Inclusion Criteria:

- Anti-acetylcholine receptor (AChR) antibody positive

- Confirmed diagnosis of generalized myasthenia gravis (MG).

- Myasthenia Gravis Foundation of America (MGFA) classification of Class II, III, or IVa
inclusive at Screening.

- QMG >= 10 at Screening. Note: Subjects who only have a history of ocular MG may not
enroll.

- Receiving standard of care MG treatment at a stable dose consisting of any one of the
following for the time intervals delineated below (time intervals apply to medications
and maintenance of stable dose level):

1. Cholinesterase inhibitor (pyridostigmine or equivalent) for at least 2 weeks
prior to Screening and no immunosuppressants

2. Cholinesterase inhibitor (pyridostigmine or equivalent) for at least 2 weeks
prior to Screening AND/OR only one of the following:

1. Prednisone (up to 60 mg/day or equivalent) for at least 2 months prior to
Screening, OR

2. Azathioprine for at least 6 months prior to Screening, OR

3. Mycophenolate mofetil for at least 6 months prior to Screening, OR

4. Methotrexate for at least 6 months prior to Screening, OR

5. Cyclosporine or tacrolimus for at least 3 months prior to Screening

3. Cholinesterase inhibitor (pyridostigmine or equivalent) for at least 2 weeks
prior to Screening AND/OR prednisone (up to 60 mg/day or equivalent) for at least
one month prior to Screening and only one of the following:

1. Azathioprine for at least 6 months prior to Screening, OR

2. Mycophenolate mofetil for at least 6 months prior to Screening, OR

3. Methotrexate for at least 6 months prior to Screening, OR

4. Cyclosporine or tacrolimus for at least 3 months prior to Screening

Exclusion Criteria:

- Have received cyclophosphamide or any other immunosuppressive agent apart from the
ones allowed per inclusion criteria within the past 6 months

- Any change in MG treatment regimen between Screening (Week -3, Visit 0) and Baseline
(Week 0, Visit 1)

- Greater than two point change in QMG score, increased or decreased, between Screening
(Week -3, Visit 0) and Baseline (Week 0, Visit 1)

- Any episode of myasthenic crisis in the one month prior to Screening

- Evidence of malignancy within the past 5 years (non-melanoma skin cancer, carcinoma in
situ of cervix is allowed) or thymoma potentially requiring surgical intervention
during the course of the trial (intent to perform thymectomy)

- Thymectomy within the preceding 6 months

- Rituximab, belimumab, eculizumab or any monoclonal antibody used for immunomodulation
within the past 12 months

- Have received immune globulin (Ig) treatment given by intravenous (IV), subcutaneous,
or intramuscular route within the last 3 months

- Current known hyperviscosity or hypercoagulable state

- Currently receiving anti-coagulation therapy (vitamin K antagonists, nonvitamin K
antagonist oral anticoagulants [e.g., dabigatran etexilate, rivaroxaban, edoxaban, and
apixaban], parenteral anticoagulants [e.g., fondaparinux]). Note that oral
anti-platelet agents are allowed (e.g., aspirin, clopidogrel, ticlodipine)

- Documented diagnosis of thrombotic complications to polyclonal intravenous
immunoglobulin (IVIg) therapy in the past

- History of recent (within the last year) myocardial infarction or stroke

- Uncontrolled congestive heart failure; embolism; or historically documented (within
the last year) electrocardiogram (ECG) changes indicative of myocardial ischemia or
atrial fibrillation

- History of chronic alcoholism or illicit drug abuse (addiction) in the 12 months
preceding the Screening/Week -3 (Visit 0)

- Plasma exchange (PLEX) performed within the last 3 months

- Renal impairment (i.e., serum creatinine exceeds more than 1.5 times the upper limit
of normal [ULN] for the expected normal range for the testing laboratory).

- Hemoglobin levels less than 9 g per dL
We found this trial at
16
sites
4202 E Fowler Ave
Tampa, Florida 33620
(813) 974-2011
University of South Florida The University of South Florida is a high-impact, global research university...
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425 University Blvd.
Indianapolis, Indiana 46202
(317) 274-4591
Indiana University INDIANA UNIVERSITY is a major multi-campus public research institution, grounded in the liberal...
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Indianapolis, IN
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5090 N 40th St # 250
Phoenix, Arizona 85018
Principal Investigator: Todd Levine
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1120 15th Street
Augusta, Georgia 30912
(706) 721-0211
Georgia Regents University Georgia Regents University, home of the Medical College of Georgia, is one...
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Augusta, GA
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Burlington, Vermont 05405
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Burlington, VT
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410 W 10th Ave
Columbus, Ohio 43210
(614) 293-8652
The Ohio State University, Wexner Medical Center Located in Columbus, The Ohio State University Wexner...
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Columbus, OH
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Houston, TX
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Jacksonville, Florida 32209
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Jacksonville, FL
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Kansas City, KS
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Leuven, 3001
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Leuven,
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333 Cedar St
New Haven, Connecticut 06504
(203) 432-4771
Principal Investigator: Richard Nowak
Yale University School of Medicine Founded in 1810, the Yale School of Medicine is a...
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New Haven, CT
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630 W 168th St
New York, New York
212-305-2862
Columbia University Medical Center Situated on a 20-acre campus in Northern Manhattan and accounting for...
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New York, NY
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Newark, New Jersey 07103
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Newark, NJ
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Orange, California 92868
Principal Investigator: Tahseen Mozaffar
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111 S 11th St
Philadelphia, Pennsylvania 19107
(215) 955-6000
Thomas Jefferson University Hospital Our hospitals in Center City Philadelphia share a 13-acre campus with...
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Philadelphia, PA
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1959 NE Pacific St
Seattle, Washington 98195
(206) 598-3300
University of Washington Medical Center University of Washington Medical Center is one of the nation's...
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Seattle, WA
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