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Generalized Myasthenia GravisPhase 2/3ADAPT JrNCT04833894

Evaluating the Pharmacokinetics, Pharmacodynamics, and Safety of Efgartigimod Administered Intravenously in Children With Generalized Myasthenia Gravis

A Phase 2/3 study testing Efgartigimod IV in people with Generalized Myasthenia Gravis, run by argenx at 25 sites in 12 countries.

Active, not recruiting

Under way, not looking for participants. Everyone needed has enrolled. The study is still running.

Official record
Search all trials

Trial summary

The purpose of this trial is to investigate the PK, PD, safety, and activity of efgartigimod IV in children and adolescents aged from 2 to less than 18 years of age with gMG. Trial details include: The maximum trial duration for each individual participant will be approximately 28 weeks The treatment duration will be… Read more about this study

Who is it for?
Ages 2 to 18 years
Conditions the study is for
Generalized Myasthenia Gravis
What is being tested?
Efgartigimod IV
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
15 participants
Where
25 sitesin 12 countries
Study dates
26 Oct 2021to Mar 2027
Phase
Phase 2/3
Are there results?
Not yet: the study is under way

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 2 to 18 years
  • All sexes
  • No healthy volunteers
  • Child, Adult

Who may be able to join

  • Ability of the participant and/or his/her legally authorized representative to understand the requirements of the trial and provide written informed consent/assent, if applicable (including consent/assent for the use and disclosure of research-related health information), willingness and ability to comply with the trial protocol procedures (including attending the required trial visits).
  • Male or female participants between 2 to less than 18 years of age at the time of providing informed consent/assent. Age groups are enrolled in a staggered fashion respectively: 6 participants in the 12 to less than 18 years of age group followed by 6 participants in the 2 to less than 12 years of age group at the time of providing informed consent/assent.
  • Diagnosed with Generalized Myasthenia Gravis (gMG) with confirmed documentation
  • Meeting the clinical criteria as defined by the Myasthenia Gravis Foundation of America (MGFA) class II, III, and IVa.
  • Eligible participants should have an unsatisfactory response (efficacy and/or safety) to immunosuppressants, steroids or acetylcholinesterase (AChE) inhibitors and should be on stable concomitant gMG therapy of adequate duration before screening.
  • Positive serologic test for acetylcholine receptor (anti-AChR) antibodies at screening (for younger participants (<15kg) historical values can be used).
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  • Contraceptive use should be consistent with local regulations regarding the methods of contraception for those participating in clinical trials. A subject is of childbearing potential if, in the opinion of the investigator, he/she is biologically capable of having children and is sexually active.
  • Male participants: Male participants must agree to not donate sperm from of providing informed consent/assent until they have completed the trial.
  • Female participants: Female adolescents of childbearing potential must have a negative serum pregnancy test at screening and a negative urine pregnancy test at baseline before investigational medicinal product (IMP) can be administered.

Who cannot join

  • Participants with MGFA class I, IVb, and V.
  • Female adolescents of childbearing potential: Pregnancy or lactation, or the participant intends to become pregnant during the trial or within 90 days after the last dose of IMP.
  • Has any of the following medical conditions:
  • Clinically significant uncontrolled active or chronic bacterial, viral, or fungal infection at screening.
  • Any other known autoimmune disease that, in the opinion of the investigator, would interfere with an accurate assessment of clinical symptoms of myasthenia gravis or put the participant at undue risk.
  • History of malignancy unless deemed cured by adequate treatment with no evidence of recurrence for ≥3 years before the first administration of 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
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  • Clinical evidence of other significant serious diseases, or have had a recent major surgery, or who have any other condition that, in the opinion of the investigator, could confound the results of the trial or put the participant at undue risk
  • Worsening muscle weakness secondary to concurrent infections or medications (aminoglycosides, fluoro-quinolones, beta-blockers, etc).
  • A documented lack of clinical response to plasma exchange (PLEX).
  • Received a live or live-attenuated vaccine fewer than 28 days before screening. Receiving an inactivated, subunit, polysaccharide, or conjugate vaccine any time before screening is not exclusionary.
  • Received a thymectomy <3 months before screening or 1 is planned to be performed during the trial period.
  • The following results from these diagnostic assessments will be considered exclusionary:
  • Positive serum test at screening for an active viral infection with any of the following conditions: Hepatitis B virus (HBV) that is indicative of an acute or chronic infection; Hepatitis C virus (HCV) based on HCV antibody assay; Positive HIV serology at screening; Positive nasopharyngeal swab polymerase chain reaction (PCR) test for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) at screening.
  • Using the following prior or concomitant therapies: Use of an investigational product within 3 months or 5 half-lives (whichever is longer) before the first dose of IMP, Use of any monoclonal antibody within the 6 months before the first dose of IMP, Use of intravenous immunoglobulin (IVIg), administered subcutaneously or intramuscularly, or PLEX within 4 weeks before screening.
  • Total immunoglobulin (IgG) levels <6 g/L below the lower limit of normal (LLN) according to the reference ranges of the central laboratory for participant by sex and age at screening.
  • A known hypersensitivity reaction to efgartigimod or any of its excipients.
  • Current participation in another interventional clinical trial or previous participation in an efgartigimod trial with at least 1 dose of IMP received.
  • History (within 12 months of screening) of current alcohol, drug, or medication abuse as assessed by the investigator.

Trial locations and contacts

25 sites in 12 countries.

25 sites in 12 countries

United States3 sites
  • University of North Carolina at Chapel Hill

    Chapel Hill, North Carolina, 27599

  • University of Virginia (UVA) Health - Developmental Pediatrics Clinic

    Charlottesville, Virginia, 22903

  • Ann and Robert H Lurie Children's Hospital of Chicago - Main Hospital

    Chicago, Illinois, 60611

Other trials in United States

Italy3 sites
  • Azienda Ospedaliera Universitaria Policlinico Consorziale Di Bari

    Bari, 70124

  • Azienda Ospedaliero Universitaria A. Meyer

    Florence, 50139

  • Ospedale Giannina Gaslini

    Genova, 16147

Other trials in Italy

Poland3 sites
  • Uniwersyteckie Centrum Kliniczne

    Gdansk, Woj. Pomorskie, 80-952

  • Wielospecjalistyczna Poradnia Lekarska Synapsis

    Katowice, Woj. Slaskie, 40-123

  • Centralny Szpital Kliniczny - Uniwersyteckie Centrum Kliniczne WUM

    Warsaw, 02-097

Other trials in Poland

United Kingdom3 sites
  • Great Ormand Street Hospital for Children NHS Foundation Trust - Great Ormond Street Hospital

    London, WC1N 3JH

  • Manchester University NHS Foundation Trust - Royal Manchester Children's Hospital

    Manchester, M13 9WL

  • Oxford University Hospitals NHS Foundation Trust - John Radcliffe Hospital Children's Hospital

    Oxford, OX3 9DU

Other trials in United Kingdom

Canada2 sites
  • Alberta Childrens Hospital

    Calgary, T3B 6A8

  • British Columbia Children's Hospital

    Vancouver, V6H 3N1

Other trials in Canada

France2 sites
  • AP-HM - Hopital de la Timone

    Marseille, 13385

  • Assistance Publique Hopitaux de Paris (AP-HP) - Hopital Necker-Enfants Malades

    Paris, 75015

Other trials in France

Georgia2 sites
  • Vian - M. Iashvili Children's Central Hospital

    Tbilisi, 121

  • Tbilisi State Medical University - Givi Zhvania Pediatric Academic Clinic

    Tbilisi, 159

Other trials in Georgia

Germany2 sites
  • Charite Universitaetsmedizin Berlin - Campus Virchow-Klinikum - Sozialpadiatrisches Zentrum

    Berlin, 13353

  • Universitätsklinikum Essen

    Essen, 45147

Other trials in Germany

Spain2 sites
  • Hospital Sant Joan de Deu

    Esplugues de Llobregat, 08950

  • Hospital Universitari i Politecnic La Fe de Valencia

    Valencia, 46026

Other trials in Spain

Austria1 site
  • Medizinische Universitat Wien

    Vienna, 1090

Other trials in Austria

Belgium1 site
  • Universitair Ziekenhuis Antwerpen

    Antwerp, 2650

Other trials in Belgium

Netherlands1 site
  • Leids Universitair Medisch Centrum

    Leiden, 2333 ZA

Other trials in Netherlands

About this study

Official title: Open-label Uncontrolled Trial to Evaluate Pharmacokinetics, Pharmacodynamics, Safety, and Activity of Efgartigimod in Children From 2 to Less Than 18 Years of Age With Generalized Myasthenia Gravis

The purpose of this trial is to investigate the PK, PD, safety, and activity of efgartigimod IV in children and adolescents aged from 2 to less than 18 years of age with gMG.

Trial details include:

  • The maximum trial duration for each individual participant will be approximately 28 weeks
  • The treatment duration will be 8 weeks for the dose-confirmatory part (Part A) and 18 weeks for the treatment response-confirmatory part (Part B)
Being tested
Efgartigimod IV
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 IVBiological

    Intravenous infusion of Efgartigimod

Study groups in NCT04833894
Study groupRoleWhat they receive
EfgartigimodExperimentalPatients receiving efgartigimod intravenous (IV) treatment
Receives: Biological: Efgartigimod IV

What is being measured

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

  1. Efgartigimod concentrations as input for compartmental, model-driven analysis to determine (age and size dependency of) Clearance (CL)

    Blood samples will be collected from each participant for measurement of serum concentrations of efgartigimod

    Measured: up to 26 weeks

  2. Efgartigimod concentrations as input for compartmental, model-driven analysis to determine (age and size dependency of) Volume of Distribution (Vd)

    Blood samples will be collected from each participant for measurement of serum concentrations of efgartigimod

    Measured: up to 26 weeks

  3. Total Immunoglobulin G (IgG) levels as input for pharmacokinetics (PK) and pharmacodynamics (PD) modeling analysis

    Total Immunoglobulin G levels will be measured from blood samples

    Measured: up to 26 weeks

  4. Anti-acetylcholine receptors antibodies (AChR-Ab) as input for pharmacokinetics (PK) and pharmacodynamics (PD) modeling analysis

    Total Immunoglobulin G (IgG) levels will be measured from blood samples

    Measured: up to 26 weeks

Secondary outcomes (19)
  1. Incidence and severity of adverse events (AEs), serious adverse events (SAEs) and adverse events of special interest (AESIs)

    Measured: up to 28 weeks

  2. Efgartigimod serum concentrations from blood samples

    Measured: up to 26 weeks

  3. Absolute values of levels of total Immunoglobulin G (IgG) from blood samples

    Measured: up to 26 weeks

  4. Change from baseline of levels of total Immunoglobulin G (IgG) from blood samples

    Measured: up to 26 weeks

  5. Percentage change from baseline of total Immunoglobulin G (IgG) from blood samples

    Measured: up to 26 weeks

  6. Absolute values of anti-acetylcholine receptor antibodies (AChR-Ab) from blood samples

    Measured: up to 26 weeks

  7. Change from baseline of anti-acetylcholine receptor antibodies (AChR-Ab) from blood samples

    Measured: up to 26 weeks

  8. Percentage change from baseline of anti-acetylcholine receptor antibodies (AChR-Ab) from blood samples

    Measured: up to 26 weeks

  9. Incidence of anti-drug antibodies (ADAs) against efgartigimod in serum samples

    Measured: up to 28 weeks

  10. Prevalence of anti-drug antibodies (ADAs) against efgartigimod in serum samples

    Measured: up to 28 weeks

  11. Absolute values of total Myasthenia Gravis Activity of Daily Living (MG-ADL) score. Total score can range from 0 to 24, with higher total scores indicating more impairment.

    Measured: up to 26 weeks

  12. Change from baseline of total Myasthenia Gravis Activity of Daily Living (MG-ADL) score. Total score can range from 0 to 24, with higher total scores indicating more impairment.

    Measured: up to 26 weeks

  13. Absolute values of total Quantitative Myasthenia Gravis Score (QMG score). The total possible score is 39, where higher total scores indicate more severe impairments.

    Measured: up to 26 weeks

  14. Change from baseline of total Myasthenia Gravis Score (QMG score). The total possible score is 39, where higher total scores indicate more severe impairments.

    Measured: up to 26 weeks

  15. Absolute values of total score EuroQoL 5 Dimensions Youth (EQ-5D-Y)

    Description of the participant's health state is done by digits for 5 dimensions combined in a 5-digit number. A unique health state is defined by combining 1 level from each of the 5 dimensions. Each state is referred to in terms of a 5-digit code, whereas code 11111 would indicate no problems in any of the 5 dimensions and 33333 would indicate worst problems in any of the 5 dimensions.

    Measured: up to 26 weeks

  16. Change from baseline of total score EuroQoL 5 Dimensions Youth (EQ-5D-Y)

    Description of the participant's health state is done by digits for 5 dimensions combined in a 5-digit number. A unique health state is defined by combining 1 level from each of the 5 dimensions. Each state is referred to in terms of a 5-digit code, whereas code 11111 would indicate no problems and 33333 would indicate worst problems in any of the 5 dimensions.

    Measured: up to 26 weeks

  17. Values of Neurological Quality of Life (Neuro-QoL) pediatric fatigue questionnaire

    Measured: up to 26 weeks

  18. Change from baseline of Neurological Quality of Life (Neuro-QoL) pediatric fatigue questionnaire

    Measured: up to 26 weeks

  19. Change in protective antibody titers to vaccines received before or during the trial from blood samples

    Measured: up to 28 weeks

Timeline

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

  1. First posted6 Apr 2021
  2. Study start26 Oct 2021
  3. Primary completionMar 2027 (estimated)
  4. Study completionMar 2027 (estimated)

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 2/3
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrolment
15 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04833894
Sponsor's protocol ID
ARGX-113-2006
Other IDs
2024-513854-31-00
Acronym
ADAPT Jr
Status last verified
Feb 2026
First submitted
16 Mar 2021
Last updated
29 Oct 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
Undecided

Questions about this trial

What is this clinical trial studying?

A Phase 2/3 study testing Efgartigimod IV in people with Generalized Myasthenia Gravis, run by argenx at 25 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 9 inclusion and 18 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: under way, not looking for participants, as of the sponsor's last update on 29 Oct 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 25 sites in United States, Italy, Poland, United Kingdom, Canada 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 combined phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

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?

This study is still under way. Results are not available in the source record yet.

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?

Efgartigimod concentrations as input for compartmental, model-driven analysis to determine (age and size dependency of) Clearance (CL) (time frame: up to 26 weeks). The study lists 4 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
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 29 Oct 2026.

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