Generalized Myasthenia GravisPhase 3ADAPTSC+NCT04818671
Evaluating the Long-Term Safety and Tolerability of Efgartigimod PH20 SC Administered Subcutaneously in Patients With Generalized Myasthenia Gravis
A Phase 3 study testing efgartigimod PH20 SC in people with Generalized Myasthenia Gravis, run by argenx at 47 sites in 12 countries.
Trial summary
The purpose of this study is to evaluate the long-term safety and tolerability of efgartigimod PH20 SC 1000 mg, and the clinical efficacy, PD, pharmacokinetics (PK), immunogenicity, impact on the quality of life (QoL) of the participants, treatment satisfaction, and administration method preference, and the… Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Generalized Myasthenia Gravis
- What is being tested?
- efgartigimod PH20 SC
- Type of treatment
- Injection or infusion
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 184 participants
- Where
- 47 sitesin 12 countries
- Study dates
- 26 Apr 2021to 31 Dec 2024
- 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 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Must be capable of giving signed informed consent, which includes compliance with the requirements and restrictions listed in the informed consent form (ICF) and in this protocol.
- Previously participated in antecedent studies ARGX-113-2001 or ARGX-113-1705 and are eligible for roll over.
- Contraceptive use by men and women should be consistent with local regulations regarding the methods of contraception for those participating in clinical studies and:
- Women of Child bearing potential (WOCBP) must have a negative urine pregnancy test at baseline before investigational medicinal product (IMP) can be administered.
Who cannot join
- The participant was discontinued early from studies ARGX-113-2001 or ARGX-113-1705, unless the reason for discontinuation from study ARGX-113-1705 was to roll over into study ARGX-113-2002.
- Participants who, in the investigator's judgment, are not benefiting from efgartigimod IV in study ARGX-113-1705 Part B are not eligible for roll over into ARGX-113-2002.
- Are pregnant or lactating, or intend to become pregnant during the study or within 90 days after the last dose of investigational medicinal product (IMP)
- Has any of the following medical conditions:
- Clinically significant uncontrolled chronic bacterial, viral, or fungal infection at roll-over
- Any other known autoimmune disease that, in the opinion of the investigator, would interfere with accurate assessment of clinical symptoms of myasthenia gravis or put the participant at undue risk
Show all 15Show fewer
- History of malignancy unless deemed cured by adequate treatment with no evidence of reoccurrence for ≥3 years before the first administration of investigational medicinal product (IMP).
- Participants with the following cancers can be included at any time:
- adequately treated basal cell or squamous cell skin cancer
- carcinoma in situ of the cervix
- carcinoma in situ of the breast
- incidental histological findings of prostate cancer (TNM classification of malignant tumors stage T1a or T1b)
- Clinical evidence of other significant serious diseases, or the participant has had a recent major surgery, or who have any other condition that, in the opinion of the investigator, could confound the results of the study or put the participant at undue risk
- Received a live-attenuated vaccine within 28 days prior to study entry or plan to receive a live-attenuated vaccine during the study
- A known hypersensitivity reaction to efgartigimod, rHuPH20, or any of its excipients
Trial locations and contacts
47 sites in 12 countries.
47 sites in 12 countries
United States13 sites
Investigator Site 46 - US0010111
Amherst, New York, 14226
Investigator Site 43 - US0010066
Austin, Texas, 78759
Investigator Site 45 - US0010108
Boca Raton, Florida, 33428
Investigator site 6 - US0010032
Carlsbad, California, 92011
Investigator Site 38 - US0010003
Chapel Hill, North Carolina, 27514
Investigator Site 42 - US0010019
Cleveland, Ohio, 44195
Investigator site 7 - US0010008
Cordova, Tennessee, 38018
Investigator Site 44 - US0010077
Durham, North Carolina, 27710
Investigator Site 41 - US0010015
Kansas City, Kansas, 66160
Investigator Site 47 - US0010021
Palo Alto, California, 94304
Investigator site 4 - US0010110
Port Charlotte, Florida, 33952
Investigator Site 40 - US0010009
San Antonio, Texas, 78229
Investigator Site 39 - US0010006
Tampa, Florida, 41076
Japan8 sites
Investigator site 12 - JP0810002
Chiba, Chiba-Shi, 260-8677
Investigator site 8 - JP0810004
Hanamaki, Iwate, 025-0082
Investigator site 14 - JP0810007
Osaka, 565-0871
Investigator Site 28- JP0810059
Ōta-ku, Tokyo, 143-8541
Investigator Site 36 - JP0810055
Sapporo, Hokkaido, 063-0005
Investigator Site 27 - JP0810008
Sapporo, 060 8542
Investigator site 13 - JP0810005
Sendai, 983-8520
Investigator site 15 - JP0810009
Tokyo, 160-0023
Poland6 sites
Investigator site 17 - PL0480001
Gdansk, 80-952
Investigator site 19 - PL0480007
Katowice, 40-123
Investigator site 22 - PL0480065
Krakow, 31-426
Investigator site 18 - PL0480005
Krakow, 31-505
Investigator site 20 - PL0480018
Lublin, 20-093
Investigator site 21 - PL0480022
Warsaw, 02-097
Georgia5 sites
Investigator Site 32 - GEO9950004
Tbilisi, K'alak'i T'bilisi, 0160
Investigator Site 33 - GEO9950016
Tbilisi, K'alak'i T'bilisi, 016
Investigator site 2 - GEO9950002
Tbilisi, 0112
Investigator Site 1 - GEO9950001
Tbilisi, 0114
Investigator site 3 - GEO9950003
Tbilisi, 0114
Italy3 sites
Investigator site 11 - IT0390003
Milan, 20133
Investigator Site 34 - IT0390007
Naples, 80138
Investigator Site 35 - IT0390008
Roma, 00189
Spain3 sites
Investigator Site 37 - ES0340021
Barcelona, 08035
Investigator Site 31 - ES0340038
Barcelona, 08041
Investigator site 23 - ES0340039
Valencia, 46026
Germany2 sites
Investigator Site 25 - DE490006
Berlin, 10117
Investigator Site 26 - DE490009
Münster, 48149
Hungary2 sites
Investigator site 10 - HU0360013
Budapest, 1082
Investigator site 9 - HU0360012
Budapest, 1204
Russia2 sites
Investigator Site 29- RU0070002
Novosibirsk, 630087
Investigator Site 30 - RU0070014
Saint Petersburg, 194354
About this study
Official title: A Long-Term, Single-Arm, Open-label, Multicenter Phase 3 Study to Evaluate the Safety and Tolerability of Multiple Subcutaneous Injections of Efgartigimod PH20 SC in Patients With Generalized Myasthenia Gravis
The purpose of this study is to evaluate the long-term safety and tolerability of efgartigimod PH20 SC 1000 mg, and the clinical efficacy, PD, pharmacokinetics (PK), immunogenicity, impact on the quality of life (QoL) of the participants, treatment satisfaction, and administration method preference, and the feasibility of self- and caregiver-supported administration of the SC injection.
Treatment duration: 3-week treatment periods, repeated as needed with at least 28 days in between treatment periods
Health measurements: total levels of immunoglobulin G (IgG), Acetylcholine receptor binding autoantibodies (AChR-Ab) levels, Myasthenia Gravis Activities of Daly Living (MG-ADL).
- Conditions
- Generalized Myasthenia Gravis
- Being tested
- efgartigimod PH20 SC
- Medical subject headings
- Myasthenia Gravis
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
efgartigimod PH20 SCBiological
Subcutaneous injection with efgartigimod PH20 SC
| Study group | Role | What they receive |
|---|---|---|
| efgartigimod PH20 SC | Experimental | Patients receiving efgartigimod PH20 subcutaneous (SC) treatment Receives: Biological: efgartigimod PH20 SC |
What is being measured
The primary outcome is the main question the study is designed to answer.
Number of AEs, SAEs and AESIs
Adverse events, Serious Adverse event and Adverse events of special interest. Adverse events in the 'Infections and infestations' SOC were defined as AESIs because efgartigimod causes a transient reduction in total IgG levels.
Measured: Up to 3.5 years
Secondary outcomes (12)
MG-ADL Total Score Changes From Baseline
The Myasthenia Gravis Activities of Daily Living (MG-ADL) is an 8-item patient-reported scale that assesses MG symptoms and their effects on daily activities. It evaluates a participant's capacity to perform different activities in their daily life. The total score ranges from 0 to 24 with higher scores indicating more impairment.
Measured: Up to week 4 of the first cycle
Percent Change in Total IgG Levels From Baseline
IgG: immunoglobulin G
Measured: Up to week 4 of the first cycle
Percent Change in AChR-Ab From Baseline in AChR-Ab Seropositive Participants
AchR-Ab: anti-acetylcholine receptor antibodies.
Measured: Up to week 4 of the first cycle
Efgartigimod Serum Concentrations
Measured: Up to week 4 of the first cycle
Incidence of ADAs Against Efgartigimod Over Time
ADA: Anti-drug antibodies.
Measured: Up to 3.5 years
Incidence of NAbs Against Efgartigimod Over Time
NAbs: neutralizing antibodies
Measured: Up to 3.5 years
Incidence of Antibodies Against rHuPH20 Over Time
Measured: Up to 3.5 years
Incidence of NAbs Against rHuPH20 Over Time
NAbs: neutralizing antibodies
Measured: Up to 3.5 years
Changes in Total MG-QoL15r From Baseline
Myasthenia Gravis Quality of Life 15 item scale revised (MG-QoL 15r) scores range from 0 to 30 with a higher score representing more severe symptoms.
Measured: Up to week 4 of the first cycle
Changes in EQ-5D-5L VAS Score From Baseline
EuroQoL 5 Dimensions 5-Level (EQ-5D-5L) visual analog scale (VAS) scores range from 0 to 100 with a higher score representing better health.
Measured: Up to week 4 of the first cycle
Percent of Participants or Caregivers by Number of Training Visits Needed to be Competent to Start Self- or Caregiver-Supported Administration
Measured: Up to 3.5 years
Percent of Self- or Caregiver-supported Study Drug Administration Among All Study Treatment Visits at Home
Measured: Up to 3.5 years
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted26 Mar 2021
- Study start26 Apr 2021
- Primary completion31 Dec 2024
- Study completion31 Dec 2024
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Publications (1)Papers the sponsor has linked to this study.
- Other trials for Generalized Myasthenia GravisStudies of the same condition, open and under way.
- More trials run by argenxThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
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
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Enrolment
- 184 participants (actual)
Sponsor and investigators
- Lead sponsor
- argenx
- Sponsor type
- Industry (pharma, biotech, devices)
- Responsible party
- Sponsor
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT04818671
- Sponsor's protocol ID
- ARGX-113-2002
- Acronym
- ADAPTSC+
- Status last verified
- Jan 2026
- First submitted
- 11 Mar 2021
- Last updated
- 22 Jan 2026
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- Yes
- FDA-regulated drug
- Yes
- FDA-regulated device
- No
- Individual data sharing
- Undecided
Publications
Meisel A, Antozzi C, Bhavaraju-Sanka R, De Bleecker JL, Huang WY, Jimenez RH, Verhamme FM, Jiang M, Liu L, Korobko D, Kostera-Pruszczyk A, Utsugisawa K, Verschuuren JJGM, Vu T, Wiendl H, Howard JF Jr. Long-term safety, tolerability, and efficacy of subcutaneous efgartigimod PH20 in generalized myasthenia gravis: final results from a phase 3 open-label extension study (ADAPT-SC+). Front Neurol. 2026 Aug 21;17:1876344. doi: 10.3389/fneur.2026.1876344. eCollection 2026.
PubMed 42699831
Study at a glance
From the registry record, last updated by the sponsor on 22 Jan 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Long-Term, Single-Arm, Open-label, Multicenter Phase 3 Study to Evaluate the Safety and Tolerability of Multiple Subcutaneous Injections of Efgartigimod PH20 SC in Patients With Generalized Myasthenia Gravis
- ClinicalTrials.gov ID
- NCT04818671
- Acronym / sponsor ID
- ADAPTSC+ / ARGX-113-2002
- Conditions
- Generalized Myasthenia Gravis
- Phase
- Phase 3
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 184 participants (actual)
- Lead sponsor
- argenxIndustry (pharma, biotech, devices)
- Study start
- 26 Apr 2021 (actual)
- Primary completion
- 31 Dec 2024 (actual)
- Study completion
- 31 Dec 2024 (actual)
- First posted
- 26 Mar 2021 (actual)
- Results
- Posted 22 Jan 2026
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The purpose of this study is to evaluate the long-term safety and tolerability of efgartigimod PH20 SC 1000 mg, and the clinical efficacy, PD, pharmacokinetics (PK), immunogenicity, impact on the quality of life (QoL) of the participants, treatment satisfaction, and administration method preference, and the feasibility of self- and caregiver-supported administration of the SC injection.
Treatment duration: 3-week treatment periods, repeated as needed with at least 28 days in between treatment periods
Health measurements: total levels of immunoglobulin G (IgG), Acetylcholine receptor binding autoantibodies (AChR-Ab) levels, Myasthenia Gravis Activities of Daly Living (MG-ADL).
Study design
- Primary purpose
- Treatment
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Number of arms
- 1
| Arm | Type | Receives |
|---|---|---|
| efgartigimod PH20 SC | Experimental | Biological: efgartigimod PH20 SCPatients receiving efgartigimod PH20 subcutaneous (SC) treatment |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (4 listed)
- Must be capable of giving signed informed consent, which includes compliance with the requirements and restrictions listed in the informed consent form (ICF) and in this protocol.
- Previously participated in antecedent studies ARGX-113-2001 or ARGX-113-1705 and are eligible for roll over.
- Contraceptive use by men and women should be consistent with local regulations regarding the methods of contraception for those participating in clinical studies and:
Key exclusion criteria (15 listed)
- The participant was discontinued early from studies ARGX-113-2001 or ARGX-113-1705, unless the reason for discontinuation from study ARGX-113-1705 was to roll over into study ARGX-113-2002.
- Are pregnant or lactating, or intend to become pregnant during the study or within 90 days after the last dose of investigational medicinal product (IMP)
- Has any of the following medical conditions:
- Received a live-attenuated vaccine within 28 days prior to study entry or plan to receive a live-attenuated vaccine during the study
- A known hypersensitivity reaction to efgartigimod, rHuPH20, or any of its excipients
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| efgartigimod PH20 SCSubcutaneous injection with efgartigimod PH20 SC | Biological | efgartigimod PH20 SC |
Primary outcome
Number of AEs, SAEs and AESIs
Time frame: Up to 3.5 years
Adverse events, Serious Adverse event and Adverse events of special interest. Adverse events in the 'Infections and infestations' SOC were defined as AESIs because efgartigimod causes a transient reduction in total IgG levels.
12 secondary outcomes
MG-ADL Total Score Changes From Baseline
Time frame: Up to week 4 of the first cycle
Percent Change in Total IgG Levels From Baseline
Time frame: Up to week 4 of the first cycle
Percent Change in AChR-Ab From Baseline in AChR-Ab Seropositive Participants
Time frame: Up to week 4 of the first cycle
Efgartigimod Serum Concentrations
Time frame: Up to week 4 of the first cycle
Incidence of ADAs Against Efgartigimod Over Time
Time frame: Up to 3.5 years
Incidence of NAbs Against Efgartigimod Over Time
Time frame: Up to 3.5 years
Incidence of Antibodies Against rHuPH20 Over Time
Time frame: Up to 3.5 years
Incidence of NAbs Against rHuPH20 Over Time
Time frame: Up to 3.5 years
Changes in Total MG-QoL15r From Baseline
Time frame: Up to week 4 of the first cycle
Changes in EQ-5D-5L VAS Score From Baseline
Time frame: Up to week 4 of the first cycle
Percent of Participants or Caregivers by Number of Training Visits Needed to be Competent to Start Self- or Caregiver-Supported Administration
Time frame: Up to 3.5 years
Percent of Self- or Caregiver-supported Study Drug Administration Among All Study Treatment Visits at Home
Time frame: Up to 3.5 years
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 22 Jan 2026.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
- Derived from this study: PubMed 42699831Meisel A, Antozzi C, Bhavaraju-Sanka R, De Bleecker JL, Huang WY, Jimenez RH, Verhamme FM, Jiang M, Liu L, Korobko D, Kostera-Pruszczyk A, Utsugisawa K, Verschuuren JJGM, Vu T, Wiendl H, Howard JF Jr. Long-term safety, tolerability, and efficacy of subcutaneous efgartigimod PH20 in generalized myasthenia gravis: final results from a phase 3 open-label extension study (ADAPT-SC+). Front Neurol. 2026 Aug 21;17:1876344. doi: 10.3389/fneur.2026.1876344. eCollection 2026.
- Individual participant dataSharing planned: Undecided
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
The record lists no contact. Use the official record to reach the sponsor.
47 sites in 12 countries: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 3 study testing efgartigimod PH20 SC in people with Generalized Myasthenia Gravis, run by argenx at 47 sites in 12 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 15 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 22 Jan 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 47 sites in United States, Japan, Poland, Georgia, Italy and 7 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. 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 22 Jan 2026). 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?
Number of AEs, SAEs and AESIs (time frame: Up to 3.5 years). 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 NCT04818671, which also lists 1 linked publication.
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 22 Jan 2026.