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Generalized Myasthenia GravisPhase 3NCT03920293

Safety and Efficacy Study of Ravulizumab in Adults With Generalized Myasthenia Gravis

A Phase 3 study testing Ravulizumab in people with Generalized Myasthenia Gravis, run by Alexion Pharmaceuticals, Inc. at 106 sites in 15 countries.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
Search all trials

Trial summary

The primary purpose of this study is to evaluate the safety and efficacy of ravulizumab for the treatment of participants with generalized myasthenia gravis (gMG). Read more about this study

Who is it for?
Any age
Conditions the study is for
Generalized Myasthenia Gravis
What is being tested?
Ravulizumab
Type of treatment
Injection or infusion
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
175 participants
Where
106 sitesin 15 countries
Study dates
12 Mar 2019to 25 May 2023
Phase
Phase 3
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages Any age
  • All sexes
  • No healthy volunteers
  • Child, Adult, Older adult

Who may be able to join

  • Diagnosed with Myasthenia Gravis at least 6 months (180 days) prior to the date of the Screening Visit as confirmed by specific criteria.
  • Myasthenia Gravis Foundation of America Clinical Classification Class II to IV at screening.
  • MG-ADL profile must be ≥ 6 at screening and randomization (Day 1).
  • Vaccinated against meningococcal infections within 3 years prior to, or at the time of, initiating study drug to reduce the risk of meningococcal infection (N meningitidis).

Who cannot join

  • Medical Conditions
  • Any active or untreated thymoma. History of thymic carcinoma or thymic malignancy unless deemed cured by adequate treatment with no evidence of recurrence for ≥ 5 years before screening.
  • History of thymectomy within the 12 months prior to screening.
  • History of N meningitidis infection.
  • Use of the following within the time period specified below:
  • IV immunoglobulin within 4 weeks of randomization
Show all 9Show fewer
  • Use of plasma exchange within 4 weeks of randomization
  • Use of rituximab within 6 months of screening
  • Participants who have received previous treatment with complement inhibitors (for example, eculizumab).

Trial locations and contacts

106 sites in 15 countries.

106 sites in 15 countries

United States49 sites
  • Research Site

    Ann Arbor, Michigan, 48109

  • Research Site

    Aurora, Colorado, 80045

  • Research Site

    Austin, Texas, 78756

  • Research Site

    Baltimore, Maryland, 21287

  • Research Site

    Boston, Massachusetts, 02116

  • Research Site

    Burlington, Massachusetts, 01805

  • Research Site

    Burlington, Vermont, 05401

  • Research Site

    Chapel Hill, North Carolina, 27599

  • Research Site

    Charleston, South Carolina, 29425

  • Research Site

    Charlotte, North Carolina, 28207

  • Research Site

    Chicago, Illinois, 60637

  • Research Site

    Cincinnati, Ohio, 45219

  • Research Site

    Cleveland, Ohio, 44195

  • Research Site

    Colorado Springs, Colorado, 80907

  • Research Site

    Columbia, Missouri, 65201

  • Research Site

    Columbus, Ohio, 43221

  • Research Site

    Dallas, Texas, 75206

  • Research Site

    Durham, North Carolina, 27710

  • Research Site

    East Lansing, Michigan, 48824

  • Research Site

    Fairfield, Connecticut, 06824

  • Research Site

    Fort Collins, Colorado, 80528

  • Research Site

    Grand Rapids, Michigan, 49525

  • Research Site

    Great Neck, New York, 11021

  • Research Site

    Hershey, Pennsylvania, 17033

  • Research Site

    Houston, Texas, 77030

  • Research Site

    Indianapolis, Indiana, 46202

  • Research Site

    Irvine, California, 92617

  • Research Site

    Jacksonville, Florida, 32209

  • Research Site

    Kansas City, Kansas, 66160

  • Research Site

    Las Vegas, Nevada, 89104

  • Research Site

    Las Vegas, Nevada, 89145

  • Research Site

    Lexington, Kentucky, 40503

  • Research Site

    Loma Linda, California, 92354

  • Research Site

    Morgantown, West Virginia, 26506

  • Research Site

    New York, New York, 10021

  • Research Site

    North Charleston, South Carolina, 29406

  • Research Site

    Palo Alto, California, 94304

  • Research Site

    Philadelphia, Pennsylvania, 19104

  • Research Site

    Phoenix, Arizona, 85013

  • Research Site

    Phoenix, Arizona, 85018

  • Research Site

    Phoenix, Arizona, 85028

  • Research Site

    Pittsburgh, Pennsylvania, 15212

  • Research Site

    Richmond, Virginia, 23298

  • Research Site

    Rolling Meadows, Illinois, 60008

  • Research Site

    Round Rock, Texas, 78681

  • Research Site

    San Francisco, California, 94115

  • Research Site

    Sylmar, California, 91342

  • Research Site

    Tampa, Florida, 33612

  • Research Site

    Washington D.C., District of Columbia, 20007

Other trials in United States

Japan14 sites
  • Research Site

    Bunkyō City, 113-8655

  • Research Site

    Chiba, 260-0877

  • Research Site

    Fukuoka, 812-8582

  • Research Site

    Hanamaki-shi, 025-0075

  • Research Site

    Kawagoe-shi, 350-8550

  • Research Site

    Moriguchi-shi, 570-8507

  • Research Site

    Nagoya, 466-8560

  • Research Site

    Niigata, 951-8585

  • Research Site

    Osaka, 565-0871

  • Research Site

    Sapporo, 060-8543

  • Research Site

    Sapporo, 063-0005

  • Research Site

    Sendai, 983-0045

  • Research Site

    Shinjuku-ku, 160-8582

  • Research Site

    Ube-shi, 755-8505

Other trials in Japan

Germany6 sites
  • Research Site

    Berlin, 10117

  • Research Site

    Essen, 45147

  • Research Site

    Hamburg, 20246

  • Research Site

    Leipzig, 04103

  • Research Site

    Münster, 48149

  • Research Site

    Würzburg, 97070

Other trials in Germany

Italy6 sites
  • Research Site

    Bergamo, 24127

  • Research Site

    Bologna, 40139

  • Research Site

    Milan, 20133

  • Research Site

    Naples, 80131

  • Research Site

    Roma, 00168

  • Research Site

    Rome, 00189

Other trials in Italy

South Korea6 sites
  • Research Site

    Daegu, 41404

  • Research Site

    Seoul, 02841

  • Research Site

    Seoul, 03722

  • Research Site

    Seoul, 06351

  • Research Site

    Seoul, 143-729

  • Research Site

    Yangsan, 50612

Other trials in South Korea

Canada4 sites
  • Research Site

    Edmonton, Alberta, T6G 2G3

  • Research Site

    London, Ontario, N6A 5A5

  • Research Site

    Montreal, Quebec, H3A 2B4

  • Research Site

    Toronto, Ontario, M5G 2C4

Other trials in Canada

France4 sites
  • Research Site

    Garches, 92380

  • Research Site

    Lille, 59037

  • Research Site

    Marseille, 13005

  • Research Site

    Nice, 6000

Other trials in France

Spain4 sites
  • Research Site

    Barcelona, 08025

  • Research Site

    L'Hospitalet de Llobregat, 08907

  • Research Site

    Madrid, 28040

  • Research Site

    Murcia, 30120

Other trials in Spain

Czechia3 sites
  • Research Site

    Brno, 625 00

  • Research Site

    Ostrava, 708 52

  • Research Site

    Prague, 12800

Other trials in Czechia

Denmark3 sites
  • Research Site

    Aalborg, 9100

  • Research Site

    Arhus C, 8000

  • Research Site

    Copenhagen, 2100

Other trials in Denmark

Israel2 sites
  • Research Site

    Haifa, 3109601

  • Research Site

    Tel Aviv, 6423906

Other trials in Israel

Netherlands2 sites
  • Research Site

    Amsterdam, 1105 AZ

  • Research Site

    Leiden, 2333 ZA

Other trials in Netherlands

Austria1 site
  • Research Site

    Vienna, 1090

Other trials in Austria

Portugal1 site
  • Research Site

    Porto, 4099-001

Other trials in Portugal

Switzerland1 site
  • Research Site

    Zurich, 8091

Other trials in Switzerland

About this study

Official title: A Phase 3, Randomized, Double-Blind, Placebo-Controlled, Multicenter Study to Evaluate the Safety and Efficacy of Ravulizumab in Complement-Inhibitor-Naïve Adult Patients With Generalized Myasthenia Gravis

The primary purpose of this study is to evaluate the safety and efficacy of ravulizumab for the treatment of participants with generalized myasthenia gravis (gMG).

Being tested
Ravulizumab, Placebo
Medical subject headings
Myasthenia Gravis

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • RavulizumabBiological

    Also called ALXN1210, Ultomiris

    Concentrated sterile, preservative-free aqueous solution (10 milligrams [mg]/milliliter [mL]) in single-use, 30-mL vial for intravenous (IV) infusion. Single loading dose on Day 1, followed by regular maintenance dosing beginning on Day 15, based on weight.

  • PlaceboDrug

    Matching, sterile, preservative-free aqueous solution in single-use, 30-mL vial for IV infusion. Single loading dose on Day 1, followed by regular maintenance dosing beginning on Day 15, based on weight.

Study groups in NCT03920293
Study groupRoleWhat they receive
RavulizumabExperimentalParticipants will receive ravulizumab for the duration of the study.
Receives: Biological: Ravulizumab
PlaceboPlacebo comparatorParticipants will receive placebo during the 26-week randomized-controlled period of the study, after which they will enter the open-label extension period of the study and receive ravulizumab.
Receives: Drug: Placebo

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Change From Baseline In Myasthenia Gravis-Activities Of Daily Living (MG-ADL) Total Score At Week 26

    The MG-ADL is an 8-point questionnaire that focused on relevant symptoms and functional performance of activities of daily living in participants with MG. The 8 items of the MGADL questionnaire were derived from symptom-based components of the original 13-item QMG scale to assess disability secondary to ocular (2 items), bulbar (3 items), respiratory (1 item), and gross motor or limb (2 items) impairment related to effects from MG. In this functional status instrument, each response was graded 0 (normal) to 3 (most severe). The range of total MG-ADL score was 0 to 24. A decrease in score indicated improvement. Estimates were based on Mixed Effect Repeated Measures (MMRM) that included treatment group, stratification factor region, and MG-ADL total score at baseline, study visit, and study visit by treatment group interaction.

    Measured: Baseline, Week 26

Secondary outcomes (5)
  1. Change From Baseline In The Quantitative Myasthenia Gravis (QMG) Total Score At Week 26

    The QMG scoring system consisted of 13 items: ocular (2 items), facial (1 item), bulbar (2 items), gross motor (6 items), axial (1 item), and respiratory (1 item); each graded 0 to 3, with 3 being the most severe. The range of total QMG score is 0 to 39. The QMG scoring system was considered to be an objective evaluation of therapy for MG and was based on quantitative testing of sentinel muscle groups. A decrease in score indicated improvement. Estimates were based on MMRM that included treatment group, stratification factor region, and QMG total score at baseline, study visit, and study visit by treatment group interaction.

    Measured: Baseline, Week 26

  2. Percentage of Participants With a Quantitative Myasthenia Gravis (QMG) Total Score Reduction of at Least 5 Points At Week 26

    The QMG scoring system consisted of 13 items: ocular (2 items), facial (1 item), bulbar (2 items), gross motor (6 items), axial (1 item), and respiratory (1 item); each graded 0 to 3, with 3 being the most severe. The range of total QMG score is 0 to 39. A decrease in score indicated improvement. Percentage of participants with a ≥5-point reduction in the QMG total score are reported. Estimates were based on a generalized linear mixed model (GLMM) that included treatment group, stratification factor region and QMG total score at baseline, study visit and study visit by treatment group interaction.

    Measured: Week 26

  3. Change From Baseline In the Revised 15 Component Myasthenia Gravis Quality of Life (MG-QOL15r) At Week 26

    The revised Myasthenia Gravis Qualify of Life 15-item scale (MG-QOL15r) is a health-related QoL evaluative instrument specific to participants with MG. The MG-QOL15r was designed to provide information about participants' perception of impairment and disability, determine the degree to which disease manifestations are tolerated, and to be administered and interpreted easily. Each item was graded on a scale of 0 to 2, with 2 being the most severe. The range of MG-QOL15r score is 0 to 30. Higher scores indicated greater extent of and dissatisfaction with MG-related dysfunction. Estimates are based on MMRM that included treatment group, stratification factor region and MG-QOL15r score at baseline, study visit and study visit by treatment group interaction.

    Measured: Baseline, Week 26

  4. Change From Baseline in Neurological Quality of Life (Neuro-QoL) Fatigue Score at Week 26

    The Neuro-QOL Fatigue is a reliable and validated brief 19-item survey of fatigue, completed by the participant. Each items was rated on a scale of 1 to 5, with 5 being the most severe. The range of total score is 19 to 95. Higher scores indicated greater fatigue and greater impact of MG on activities. Estimates were based on MMRM that included treatment group, stratification factor region and Neuro-QoL Fatigue score at baseline, study visit, and study visit by treatment group interaction.

    Measured: Baseline, Week 26

  5. Percentage of Participants With a Myasthenia Gravis Activities of Daily Living (MG-ADL) Total Score Reduction of at Least 3 Points At Week 26

    The MG-ADL is an 8-point questionnaire that focused on relevant symptoms and functional performance of activities of daily living in participants with MG. The 8 items of the MGADL questionnaire were derived from symptom-based components of the original 13-item QMG scale to assess disability secondary to ocular (2 items), bulbar (3 items), respiratory (1 item), and gross motor or limb (2 items) impairment related to effects from MG. In this functional status instrument, each response was graded 0 (normal) to 3 (most severe). The range of total MG-ADL score was 0 to 24. A decrease in score indicated improvement. Percentage of participants with a ≥3-point reduction in the MG-ADL total score are reported. Estimates were based on a GLMM that included treatment group, stratification factor region and MG-ADL total score at baseline, study visit and study visit by treatment group interaction.

    Measured: Week 26

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted18 Apr 2019
  2. Study start12 Mar 2019
  3. Primary completion11 May 2021
  4. Study completion25 May 2023

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Triple blind
Who is masked
Participant, Care provider, Investigator
Enrolment
175 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03920293
Sponsor's protocol ID
ALXN1210-MG-306
Other IDs
2018-003243-39, 2018
Status last verified
Apr 2024
First submitted
16 Apr 2019
Last updated
28 May 2024
Data monitoring committee
No
FDA-regulated drug
Yes
FDA-regulated device
No

Publications

  • Vu T, Meisel A, Mantegazza R, Annane D, Katsuno M, Aguzzi R, Enayetallah A, Beasley KN, Rampal N, Howard JF. Terminal Complement Inhibitor Ravulizumab in Generalized Myasthenia Gravis. NEJM Evid. 2022 May;1(5):EVIDoa2100066. doi: 10.1056/EVIDoa2100066. Epub 2022 Apr 26.

    PubMed 38319212
  • Meisel A, Annane D, Vu T, Mantegazza R, Katsuno M, Aguzzi R, Frick G, Gault L, Howard JF Jr; CHAMPION MG Study Group. Long-term efficacy and safety of ravulizumab in adults with anti-acetylcholine receptor antibody-positive generalized myasthenia gravis: results from the phase 3 CHAMPION MG open-label extension. J Neurol. 2023 Aug;270(8):3862-3875. doi: 10.1007/s00415-023-11699-x. Epub 2023 Apr 27.

    PubMed 37103755
  • Vu T, Ortiz S, Katsuno M, Annane D, Mantegazza R, Beasley KN, Aguzzi R, Howard JF Jr. Ravulizumab pharmacokinetics and pharmacodynamics in patients with generalized myasthenia gravis. J Neurol. 2023 Jun;270(6):3129-3137. doi: 10.1007/s00415-023-11617-1. Epub 2023 Mar 9.

    PubMed 36890354
  • Vanoli F, Mantegazza R. Ravulizumab for the treatment of myasthenia gravis. Expert Opin Biol Ther. 2023 Mar;23(3):235-241. doi: 10.1080/14712598.2023.2185131. Epub 2023 Mar 8.

    PubMed 36852670

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing Ravulizumab in people with Generalized Myasthenia Gravis, run by Alexion Pharmaceuticals, Inc. at 106 sites in 15 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 4 inclusion and 9 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 28 May 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 106 sites in United States, Japan, Germany, Italy, South Korea and 10 more countries. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 26 May 2022). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Change From Baseline In Myasthenia Gravis-Activities Of Daily Living (MG-ADL) Total Score At Week 26 (time frame: Baseline, Week 26). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT03920293, which also lists 4 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 28 May 2024; AzTrials last refreshed its copy on 7 Nov 2026.

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