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Phase 2 N=322 Randomized Quadruple-blind Treatment

A Study to Assess the Safety and Efficacy of a Subcutaneous Formulation of Efgartigimod in Adults With Chronic Inflammatory Demyelinating Polyneuropathy (CIDP, an Autoimmune Disorder That Affects the Peripheral Nerves)

Chronic Inflammatory Demyelinating Polyneuropathy (CIDP)

Enrolled (actual)
322
Serious AEs
6.1%
Results posted
Aug 2024
Primary outcome: Primary: Stage A: Percentage of Participants With Confirmed Evidence of Clinical Improvement(ECI) — 66.5 percentage of participants

Study Design & Population

Study type
Interventional
Phase
Phase 2
Interventions
efgartigimod PH20 SC in stage B (Biological); placebo in stage B (Other)
Age
Adult, Older Adult · 18+ yrs
Sex
All
Sponsor
argenx
Primary completion
May 2023

Outcome Measures

OutcomeResultp-value
PRIMARY
Stage A: Percentage of Participants With Confirmed Evidence of Clinical Improvement(ECI)
66.5
PRIMARY
Stage B: Time to First Adjusted INCAT Deterioration Compared to Stage B Baseline
NA; 140.0
SECONDARY
Stage A: Time to Initial Confirmed Evidence of Clinical Improvement (ECI)
22; 43.0; 71.0
SECONDARY
Stage A: Change From Stage A Baseline to Last Assessment in Stage A, in Adjusted INCAT Score
-0.9
SECONDARY
Stage A: Change From Stage A Baseline to Last Assessment in Stage A, in Medical Research Council (MRC) Sum Score
3.8
SECONDARY
Stage A: Change From Stage A Baseline to Last Assessment in Stage A, in I-RODS Disability Scores
7.7
SECONDARY
Stage A: Change From Stage A Baseline to Last Assessment in Stage A, in TUG Score
-4.3
SECONDARY
Stage A: Change From Stage A Baseline to Last Assessment in Stage A, in Mean Grip Strength
12.3; 11.2
SECONDARY
Stage A: Exposure Adjusted Occurrence of Treatment-emergent Adverse Events and Serious Adverse Events
1343.1; 51.2
SECONDARY
Stage A: Pre-dosing Efgartigimod Serum Concentrations Over Time
14.9; 19.6; 19.7; 18.9; 18.4; 19.2
SECONDARY
Stage A: Percent Changes From Stage A Baseline of Serum IgG Levels Over Time
-36.1; -54.6; -63.5; -66.2; -67.9; -67.7
SECONDARY
Stage A: Number of Participants With Binding Antidrug Antibodies (ADA) Towards Efgartigimod or Antibodies (Ab) Against rHuPH20 and Neutralizing Antibodies (NAb) Against Efgartigimod and/or rHuPH20
20; 45; 1; 0
SECONDARY
Stage A: Changes From Stage A Baseline to Last Assessment in Stage A, in EQ-5D-5L Visual Analog Scale (VAS) Over Time
10.7
SECONDARY
Stage B: Time to CIDP Disease Progression
NA; 85
SECONDARY
Stage B: Number of Participants With Improved Functional Level Compared to Stage B Baseline
50; 40
SECONDARY
Stage B: Change From Stage B Baseline to Last Assessment in Stage B, in Adjusted INCAT Score
0.1; 0.9
SECONDARY
Stage B: Change From Stage B Baseline to Last Assessment in Stage B, in MRC Sum Score
-0.3; -3
SECONDARY
Stage B: Change From Stage B Baseline to Last Assessment in Stage B, in 24-item I-RODS Disability Score
0.8; -7.0
SECONDARY
Stage B: Change From Stage B Baseline to Last Assessment in Stage B, in TUG Score
0.8; 1.9
SECONDARY
Stage B: Change From Stage B Baseline to Last Assessment in Stage B, in Mean Grip Strength
2.1; -8.2; 2.0; -6.9
SECONDARY
Stage B: Time to 10% Decrease in the 24-item I-RODS
NA; 111
SECONDARY
Stage B: Exposure Adjusted Occurrence of Treatment-emergent Adverse Events and Serious Adverse Events
347.6; 510.9; 14.1; 19.0
SECONDARY
Stage B: Pre-dosing Efgartigimod Serum Concentrations Over Time
18.4; 0.267; 17.2; NA; 18.1; NA
SECONDARY
Stage B: Percent Changes of Serum IgG Levels Over Time
-68.2; -36.7; -68.2; -10.9; -69.8; -7.1
SECONDARY
Stage B: Number of Participants With Binding Antidrug Antibodies (ADA) Towards Efgartigimod or Antibodies (Ab) Against rHuPH20 and Neutralizing Antibodies (NAb) Against Efgartigimod and/or rHuPH20
2; 64; 52; 32; 0; 13
SECONDARY
Stage B: Changes From Stage B Baseline to Last Assessment in Stage B, in EQ-5D-5L Visual Analog Scale (VAS) Over Time
0.5; -10.2

Summary

This is a Phase 2 study to evaluate the safety and efficacy of the subcutaneous formulation of efgartigimod in adults with CIDP.

Eligibility Criteria

Inclusion Criteria

  • Ability to understand the requirements of the trial, provide written informed consent (include consent for the use and disclosure of research-related health information), willingness and ability to comply with the trial protocol procedures (including required trial visits)
  • Male or female patient aged 18 years or older, at the time of signing the informed consent.
  • Diagnosed with probable or definite CIDP according to criteria of the European Federation of Neurological Societies/Peripheral Nerve Society (EFNS/PNS 2010), progressing or relapsing forms.
  • CIDP Disease Activity Status (CDAS) score ≥2 at screening.
  • INCAT score ≥2 at the first run-in visit (for patients entering run-in) or stage A baseline (for treatment-naïve patients with documented evidence for worsening on the total adjusted INCAT disability score within 3 months prior to screening). Patients with an INCAT score of 2 at trial entry must have this score exclusively from the leg disability score; for patients with an INCAT score of ≥3 at trial entry, there are no specific requirements for arm or leg scores.
  • Fulfilling any of the following treatment conditions:
  • Currently treated with pulsed corticosteroids, oral corticosteroids equivalent to prednisolone/prednisone ≤10mg/day, and/or IVIg or SCIg, if this treatment has been started within the last 5 years before screening, and the patient is willing to discontinue this treatment at the first run-in visit; or
  • Without previous treatment (treatment-naive); or
  • Treatment with corticosteroids and/or IVIg or SCIg discontinued at least 6 months prior to screening Note: Patients not treated with monthly or daily corticosteroids, IVIg or SCIg for at least 6 months prior to screening are considered as equal to treatment-naïve patients.
  • Women of childbearing potential who have a negative pregnancy test at screening and a negative urine pregnancy test up to Stage A baseline.
  • Women of childbearing potential must use an acceptable method of contraception from signing the ICF until the date of the last dose of IMP

Exclusion Criteria

  • Pure sensory atypical CIDP (EFNS/PNS definition).
  • Polyneuropathy of other causes, including the following: Multifocal motor neuropathy; Monoclonal gammopathy of uncertain significance with anti-myelin associated, glycoprotein immunoglobulin M (IgM) antibodies; Hereditary demyelinating neuropathy; Polyneuropathy, organomegaly, endocrinopathy, monoclonal protein and skin change syndromes; Lumbosacral radiculoplexus neuropathy; Polyneuropathy most likely due to diabetes mellitus; Polyneuropathy most likely due to systemic illnesses; Drug- or toxin-induced polyneuropathy.
  • Any other disease that could better explain the patient's signs and symptoms.
  • Any history of myelopathy or evidence of central demyelination.
  • Current or past history (within 12 months of screening) of alcohol, drug or medication abuse.
  • Severe psychiatric disorder (such as severe depression, psychosis, bipolar disorder), history of suicide attempt, or current suicidal ideation that in the opinion of the investigator could create undue risk to the patient or could affect adherence with the trial protocol.
  • Patients with clinically significant active or chronic uncontrolled bacterial, viral, or fungal infection at screening, including patients who test positive for an active viral infection at screening with: Active Hepatitis B Virus (HBV): serologic panel test results indicative of an active (acute or chronic) infection; Active Hepatitis C Virus (HCV): serology positive for HCV-Ab; Human Immunodeficiency Virus (HIV) positive serology associated with an Acquired Immune Deficiency Syndrome (AIDS)-defining condition or with a cluster of differentiation 4 (CD4) count ≤200 cells/mm3.
  • Total IgG level 10 mg/day. Note: Patients using IVIg, SCIg, pulsed corticosteroids, and oral daily corticosteroids ≤10 mg/day can be included.

Patients who (intend to) use prohibited medicati

View full record on ClinicalTrials.gov →

Data sourced from ClinicalTrials.gov (NCT04281472). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.

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