Generalized Myasthenia GravisPhase 3NIMBLENCT05070858
A Study to Test How Safe Pozelimab and Cemdisiran Combination Therapy and Cemdisiran Alone Are and How Well They Work in Adult Patients With Generalized Myasthenia Gravis
A Phase 3 study testing Pozelimab + Cemdisiran, Cemdisiran and Pozelimab in people with Generalized Myasthenia Gravis, run by Regeneron Pharmaceuticals at 116 sites in 19 countries.
Trial summary
This study is researching the experimental drugs called pozelimab and cemdisiran, and cemdisiran monotherapy. The study is focused on patients with generalized Myasthenia Gravis (gMG). 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?
- Pozelimab + Cemdisiran, Cemdisiran and Pozelimab
- Type of treatment
- Injection or infusion
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 288 participants
- Where
- 116 sitesin 19 countries
- Study dates
- 14 Dec 2021to 11 Nov 2028
- Phase
- Phase 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 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Male or female participants ≥18 years of age at screening (or ≥ legal age of adulthood based on local regulations, whichever is older)
- Participant with documented diagnosis of Myasthenia Gravis (MG) based on medical history and supported by previous evaluations as described in the protocol
- Documented prior history of positive serologic test or a positive result during screening of Anti-acetylcholine Receptor (AChR) antibodies or anti-Lipoprotein Receptor-related Protein 4 (LRP4) antibodies
- Myasthenia Gravis Foundation of America (MGFA) Clinical Classification Class II to IVa at screening
- Myasthenia Gravis-Activities of Daily Living (MG-ADL) score ≥6 at screening. Ocular items should not contribute more than 50% of MG-ADL total score as described in the protocol
- Currently receiving an acetylcholinesterase inhibitor or documented reason for not using acetylcholinesterase inhibitor therapy per investigator
Show all 10Show fewer
- Currently receiving an Immunosuppressive Therapy (IST) for MG, or documented reason why the participant is not taking an IST per investigator
- If currently receiving an IST, not anticipated to have IST dosage changed before randomization or during Double-Blind Treatment Period (DBTP)
- Willing and able to comply with clinic visits and study-related procedures, including completion of the primary series of the meningococcal vaccinations required per protocol
- For the optional PK sub-study: Must have a Body Mass Index (BMI) ≥ 18.5 kg/m^2 and ≤ 30 kg/m^2 at screening
Who cannot join
- Participants with antibody profile that is only positive for Muscle-Specific tyrosine Kinase (MuSK) (MuSK positivity is based on a documented prior history of positive serologic test for antibodies to MuSK or a positive result during screening
- History of thymectomy within 12 months prior to screening or planned during the study
- History of malignant thymoma (patients with stage 1 may be enrolled), or history of cancer within the past 5 years, except for adequately treated basal cell skin cancer, squamous cell skin cancer, or in situ cervical cancer
- Myasthenic crisis or MGFA Class V within 1 month of screening
- Not meeting meningococcal vaccination requirements and, at a minimum, documentation of quadrivalent meningococcal vaccination within 5 years prior to randomization and serotype B vaccine (when available) within 3 years prior to randomization as described in the protocol
- Known contraindication to meningococcal vaccines (group ACWY conjugate and group B vaccines) as described in the protocol
Show all 10Show fewer
- Participants who require antibiotics for meningococcal prophylaxis and have a contraindication, warning, or precaution precluding the use of penicillin class and penicillin-alternative antibiotics planned to be used for prophylaxis, or a history of intolerance leading to the discontinuation of these antibiotics
- Positive hepatitis B surface antigen or hepatitis C virus Ribonucleic Acid (RNA) during screening. NOTE: Cases with unclear interpretation should be discussed with the medical monitor
- History of Human Immunodeficiency Virus (HIV) infection or a positive test at screening per local requirements
- NOTE: Other protocol-defined Inclusion/ Exclusion Criteria apply
Trial locations and contacts
116 sites in 19 countries.
116 sites in 19 countries
United States19 sites
National Neuromuscular Research Institute
Austin, Texas, 78759
SFM Clinical Research, LLC
Boca Raton, Florida, 33487
Dayton Center for Neurological Disorders
Centerville, Ohio, 45459
University of Cincinnati Gardner Neuroscience Institute
Cincinnati, Ohio, 45219
Colorado Springs Neurological Associates
Colorado Springs, Colorado, 80907-5307
Wayne State University School of Medicine
Detroit, Michigan, 48201
NorthShore University Health System
Glenview, Illinois, 60026-1301
Nerve and Muscle Center of Texas
Houston, Texas, 77030
University of California Irvine
Irvine, California, 92697
University of Southern California
Los Angeles, California, 90033
Diverse Clinical Research
Miami, Florida, 33175
Aqualane Clinical Research
Naples, Florida, 34105
St. Elizabeth's Hospital
O'Fallon, Illinois, 62269
Neurological Services of Orlando
Orlando, Florida, 32806
Penn Medicine University City
Philadelphia, Pennsylvania, 19104
Medsol Clinical Research Center Inc
Port Charlotte, Florida, 33952
Northwest Neurology Ltd. - Clinedge - PPDS
Rolling Meadows, Illinois, 60080
HonorHealth Neurology 2018
Scottsdale, Arizona, 85251
University of South Florida Morsani Center for Advanced Healthcare
Tampa, Florida, 33612
China15 sites
Peking Union Medical College Hospital
Beijing, Beijing Municipality, 100032
The First Hospital of Jilin University
Changchun, Jilin, 130000
Xiangya Hospital Central South University
Changsha, Hunan, 410008
Sichuan Provincial People's Hospital
Chengdu, Sichuan, 610072
Fujian Medical University Union Hospital
Fuzhou, Fujian, 350001
Guangdong Hospital of Traditional Chinese Medicine
Guangdong, Guangdong, 510120
Nanfang Hospital Southern Medical University
Guangzhou, Guangdong, 510120
The First Affiliated Hospital of Guangzhou University of Chinese Medicine
Guangzhou, Guangzhou, 510405
Hainan General Hospital
Haikou, Hainan, 570311
Qilu Hospital of Shandong University (Qingdan)
Qingdao, Shandong, 266035
Huashan Hospital Fudan University
Shanghai, Shanghai Municipality, 201107
The University of Hong Kong-Shenzhen Hospital
Shenzhen, Guangdong, 518053
Tianjin Medical University General Hospital
Tianjin, Tianjin Municipality, 300050
Renmin Hospital of Wuhan University - Hubei Provincial People's Hospital
Wuhan, Hubei, 430060
The Second Affiliated Hospital of the Chinese Peoples' Liberation Army Air Force Medical University
Xi’an, Shanxi, 710032
India14 sites
Bangalore Medical College and Research Institute (BMCRI) - Victoria Hospital
Bangalore, 560002
Postgraduate Institute of Medical Education & Research
Chandigarh, 160012
Government General Hospital, Guntur
Guntur, Andhra Pradesh, 522001
City Neuro Centre, Hyderabad
Hyderabad, Telangana, 500034
Apex Hospital
Jaipur, Rajasthan, 302017
Amrita Institute of Medical Sciences and Research Centre (AIMS)
Kochi, Kerala, 682041
Polakulath Narayanan Renai Medicity Multi Specialty Hospital, Kochi
Kochi, Punjab, 141008
Christian Medical College & Hospital
Ludhiana, Punjab, 141008
All India Institute of Medical Sciences New Delhi
New Delhi, National Capital Territory of Delhi, 110029
Nizam's Institute of Medical Sciences (NIMS)
Panjagutta, Hyderabad, 500082
Seth G.S. Medical College & K.E.M. Hospital, Mumbai
Parel, Mumbai, 400012
Deenanath Mangeshkar Hospital and Research Centre
Pune, Maharashtra, 411004
Institute of Neurosciences
Surat, Gujarat, 395001
Kasturba Medical College (KMC)
Udupi, Karnataka, 576104
Japan12 sites
Medical Hospital of Tokyo Medical and Dental University
Bunkyo, Tokyo, 113-8519
Chiba University Hospital
Chiba, 260-8677
Okinawa National Hospital
Ginowan-Shi, Okinawa, 901-2214
Hiroshima City Hiroshima Citiz
Hiroshima, 730-8518
Saitama Medical University, Saitama Medical Center
Kawagoe, Saitama, 350-8550
Kobe City Medical Center General Hospital
Kobe, Hyōgo, 650-0047
Kochi Medical School Hospital
Nankoku, Kochi, 783-8505
Japanese Red Cross Osaka Hospital
Osaka, 543-8555
Okinawa Prefectural Nanbu Medical Center and Children's Medical Center
Shimajiri, Okinawa, 901-1193
Tokyo Medical University Hospital
Shinjuku, Tokyo, 160-0023
Nihon University Itabashi Hospital
tabashi City, Tokyo, 173-8610
Yamaguchi University Hospital
Ube, Yamaguchi, 755-8505
Germany6 sites
Charite - Universitatsmedizin Berlin
Berlin, 10117
University Hospital Essen
Essen, North Rhine-Westphalia, 45127
Universitatsklinikum Jena
Jena, 07747
Universitatsklinikum Leipzig
Leipzig, Saxony, 04103
Friedrich Baur Institute
München, Bavaria, 80336
Universitatsklinikum Munster
Münster, North Rhine-Westphalia, 48149
Poland6 sites
Gdanski Uniwersytet Medyczny
Gdansk, Pomeranian Voivodeship, 80-952
Centrum Neurologii Klinicznej, Krakowska Akademia Neurologii
Krakow, Lesser Poland Voivodeship, 31-505
Clinical Research Center Spolka z Ograniczona Odpowiedzialnoscia Medic-R Sp.k
Poznan, Greater Poland Voivodeship, 61-731
NZOZ Neuro-kard
Poznan, Greater Poland Voivodeship, 61-853
NeuroProtect
Warsaw, Mazovian, 01-684
Uniwersyteckie Centrum Kliniczne WUM, Centralny Szpital Kliniczny
Warsaw, Mosavian, 02-097
Brazil5 sites
Jordy Sinapse Medicina LTDA
Itapevi, São Paulo, 06655-250
IMV Pesquisa Neurologica
Porto Alegre, Rio Grande do Sul, 90110-000
Faculdade de Medicina Do ABC
Santo André, São Paulo, 09060-870
Pseg Centro de Pesquisa Clinica S.A
São Paulo, 04038-002
Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo
São Paulo, 05403-010
Georgia5 sites
Israeli-Georgian Medical Research Clinic Healthycore, LTD
Tbilisi, 0112
LTD New Hospitals
Tbilisi, 0114
Pineo Medical Ecosystem
Tbilisi, 0114
LTD National Center of Urology Named after L. Managadze
Tbilisi, 0144
Multiprofile Clinic Consilium Medulla
Tbilisi, 0186
Italy5 sites
Azienda Ospedaliera Papa Giovanni XXIII
Bergamo, 24127
Fondazione IRCCS Di Rilievo Nazionale Istituto Nazionale Neurologico Carlo Besta
Milan, Lombardy, 20133
Azienda Ospedaliero Universitaria Pisana
Pisa, Tuscany, 56126
Universita' Degli Studi di Roma La Sapienza
Roma, 00161
Azienda Ospedaliera Sant'andrea
Rome, Lazio, 00189
Taiwan5 sites
Chang Gung Memorial Foundation Kaohsiung Branch
Kaohsiung City, 833
China Medical University
Taichung, 40447
National Cheng Kung University Hospital
Tainan, 701
Shin Kong Wu Ho Su Memorial Hospital
Taipei, 111
Chang Gung Memorial Hospital at Linkou
Taoyuan, 333
Denmark4 sites
Aalborg Universitetshospital
Aalborg, North Denmark, 09000
Aarhus University Hospital
Aarhus N, 8200
Rigshospitalet, Copenhagen
Copenhagen, 2100
Odense Universitetshospital
Odense, 05000
France4 sites
CHU Bicetre
Le Kremlin-Bicêtre, 94275
Centre Hospitalier Regional Universitaire (CHRU) de Nancy
Nancy, 54035
Centre Hospitalier Universitaire de Nice
Nice, Alpes Maritimes, 6002
Hopital de la Pitie Salpetriere
Paris, 75013
Turkey (Türkiye)4 sites
Dokuz Eylul University Medical Faculty
Izmir, 35340
Kocaeli University Hospital
Izmit, Van, 41380
Ondokuz Mayis Universitesi Tip Fakultesi Hastanesi
Samsun, 55239
Karadeniz Technical University Farabi Hospital
Trabzon, 61080
Canada3 sites
University of Alberta
Edmonton, Alberta, T6G 2X8
London Health Sciences Centre
London, Ontario, N6A 5A5
Toronto General Hospital
Toronto, Ontario, M5G2C4
Belgium2 sites
Universitair Ziekenhuis Antwerpen
Edegem, Antwerp, 2650
AZ Sint-Lucas
Ghent, Oost-Vlaanderen, 9000
South Korea2 sites
Kyungpook National University Chilgok Hospital
Daegu, 41404
Samsung Medical Center
Seoul, 06351
Spain2 sites
Hospital de la Santa Creu i Sant Pau
Barcelona, 08041
Hospital Universitari i Politecnic La Fe
Valencia, 46026
United Kingdom2 sites
University Hospital Birmingham
Birmingham, B15 2TH
Sheffield Teaching Hospital NHS Foundation Trust
Sheffield, South Yorkshire, 511 9NE
About this study
Official title: Efficacy and Safety of Pozelimab and Cemdisiran Combination Therapy and Cemdisiran Monotherapy in Patients With Symptomatic Generalized Myasthenia Gravis
This study is researching the experimental drugs called pozelimab and cemdisiran, and cemdisiran monotherapy. The study is focused on patients with generalized Myasthenia Gravis (gMG). Myasthenia gravis is a disease that causes weakness and fatigue in muscles in the body because the nerves and muscles are not communicating properly.
The aim of the study is to see how effective pozelimab and cemdisiran are when used in combination and when pozelimab and cemdisiran are used alone for patients with gMG.
Read more
The study is looking at several other research questions, including:
- What side effects may happen from taking the study drugs
- How the study drugs work inside the body
- How much of the study drugs are in the blood at different times
- Whether the body makes antibodies against pozelimab and cemdisiran (which could make the drugs less effective or could lead to side effects)
Read the detailed description
DBTP- Double Blind Treatment Period (24 weeks) ETP - Extension Treatment Period (28 weeks) OLTP- Open Label Treatment Period (68 weeks) FUP-Off treatment Follow Up Period (52 weeks)
- Conditions
- Generalized Myasthenia Gravis
- Being tested
- Pozelimab + Cemdisiran, Cemdisiran, Placebo, Pozelimab
- Medical subject headings
- Myasthenia Gravis
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Pozelimab + CemdisiranDrug
Subcutaneous administration as described in the protocol
CemdisiranDrug
Also called ALN-CC5
SC administration as described in the protocol
PlaceboOther
SC administration as described in the protocol
PozelimabDrug
Also called REGN3918
SC administration as described in the protocol
| Study group | Role | What they receive |
|---|---|---|
| Group 1 | Experimental | Placebo in DBTP; Re-randomized to Combination or Cemdisiran in ETP. Participants who received combination therapy during ETP and have not yet reached OLTP be reallocated to cemdisiran at the start of OLTP. In OLTP, participants on combination therapy who have not reached week 108 will switch to cemdisiran, while those who have reached week 108 will continue combination therapy Receives: Drug: Pozelimab + Cemdisiran; Drug: Cemdisiran; Other: Placebo |
| Group 2 | Experimental | Combination regimen in DBTP and ETP. Participants who have not yet reached OLTP will be reallocated to cemdisiran at the start of OLTP. Participants who are in OLTP and have not reached week 108 will switch to cemdisiran, while those who have reached week 108 will continue combination therapy. Receives: Drug: Pozelimab + Cemdisiran; Drug: Cemdisiran |
| Group 3 | Experimental | Cemdisiran throughout the study Receives: Drug: Cemdisiran |
| Group 4 | Experimental | Pozelimab monotherapy in DBTP followed by combination in ETP. Participants who have not yet reached OLTP will be reallocated to cemdisiran at the start of OLTP. Participants who are in OLTP and have not reached week 108 will switch to cemdisiran, while those who have reached week 108 will continue combination therapy. Receives: Drug: Pozelimab + Cemdisiran; Drug: Cemdisiran; Drug: Pozelimab |
What is being measured
The primary outcome is the main question the study is designed to answer.
Change in Myasthenia Gravis-Activities of Daily Living (MG-ADL) total score
The total MG-ADL score ranges from 0 to 24 points, with higher scores indicating greater functional impairment and disability
Measured: From baseline to week 24
Secondary outcomes (27)
Change from baseline in Quantitative Myasthenia Gravis (QMG) score
QMG total scores range from 0 to 39, with higher scores representing greater impairment
Measured: Week 24
Achievement of a ≥3-point reduction (improvement) in MG-ADL total score
Measured: From baseline to week 24
Achievement of a ≥5-point reduction (improvement) in QMG total score
Measured: From baseline to week 24
Achievement of a consistent response on the MG-ADL
A participant with a ≥2-point reduction (improvement) in MG-ADL total score on 2 or more consecutive assessments spanning 4 or more weeks during the DBTP
Measured: From baseline to week 24
Achievement of Minimal Symptom Expression (MSE)
Score of 0 to 1 on the MG-ADL
Measured: Week 24
Change from baseline in the Myasthenia Gravis Composite (MGC) total score
MGC score ranges from 0 to 50, with higher score indicating higher impairment
Measured: Week 24
Change from baseline in Myasthenia Gravis Quality of Life (MG-QOL15r) total score
Total score ranges from 0 to 30 points; a higher score represents greater impairment
Measured: Week 24
Achievement of a ≥2-, 4-, 5-, 6-, 7-, 8-, 9-, or 10-point reduction on MG-ADL total score
Measured: From baseline to week 24
Achievement of a ≥3-, 4-, 6-, 7-, 8-, 9-, or 10-point reduction on QMG
Measured: From baseline to week 24
Incidence and severity of Treatment-Emergent Adverse Events (TEAEs) in participants treated with pozelimab + cemdisiran combination therapy, cemdisiran monotherapy or placebo
Measured: Through week 24
Incidence and severity of Serious Adverse Events (SAEs) in participants treated with pozelimab + cemdisiran combination therapy, cemdisiran monotherapy or placebo
Measured: Through week 24
Incidence and severity of Adverse Events of Special Interest (AESIs) in participants treated with pozelimab + cemdisiran combination therapy, cemdisiran monotherapy or placebo
Measured: Through week 24
Concentrations of total pozelimab in serum
Measured: Through study duration, approximately 172 weeks
Concentrations of total Complement component 5 (C5) in plasma
Measured: Through study duration, approximately 172 weeks
Concentrations of cemdisiran and its metabolites in plasma
Measured: Through study duration, approximately 172 weeks
Incidence of treatment-emergent Anti-Drug Antibodies (ADAs) to pozelimab over time
Measured: Through study duration, approximately 172 weeks
Incidence of treatment-emergent ADAs to cemdisiran over time
Measured: Through study duration, approximately 172 weeks
Change in total complement hemolysis activity assay (CH50) over time
Measured: Through study duration, approximately 172 weeks
Percent change in CH50 over time
Measured: Through study duration, approximately 172 weeks
Concentrations of cemdisiran and its metabolite in plasma
During the OLTP for the optional PK sub-study
Measured: At week 60 and up to week 120
Concentrations of total C5 in plasma
During the OLTP for the optional PK sub-study
Measured: At week 60 and up to week 120
Incidence of TEAEs
During the OLTP for the optional PK sub-study
Measured: Through week 144
Severity of TEAEs
During the OLTP for the optional PK sub-study
Measured: Through week 144
Incidence of SAEs
During the OLTP for the optional PK sub-study
Measured: Through week 144
Severity of SAEs
During the OLTP for the optional PK sub-study
Measured: Through week 144
Incidence of AESIs
During the OLTP for the optional PK sub-study
Measured: Through week 144
Severity of AESIs
During the OLTP for the optional PK sub-study
Measured: Through week 144
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted7 Oct 2021
- Study start14 Dec 2021
- Primary completion8 Jul 2025
- Study completion11 Nov 2028 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- 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 Regeneron PharmaceuticalsThe 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
- Randomised
- Intervention model
- Parallel groups
- Masking
- Quadruple blind
- Who is masked
- Participant, Care provider, Investigator, Outcomes assessor
- Enrolment
- 288 participants (actual)
Sponsor and investigators
- Lead sponsor
- Regeneron Pharmaceuticals
- Sponsor type
- Industry (pharma, biotech, devices)
- Responsible party
- Sponsor
- Investigators
- Clinical Trial Management, Study director, Regeneron Pharmaceuticals
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT05070858
- Sponsor's protocol ID
- R3918-MG-2018
- Other IDs
- 2020-003272-41, 2023-508842-17-00, 2023
- Acronym
- NIMBLE
- Status last verified
- Oct 2026
- First submitted
- 27 Sep 2021
- Last updated
- 28 Oct 2026
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- Yes
- FDA-regulated device
- No
- Individual data sharing
- Yes: All Individual Patient Data (IPD) that underlie publicly available results will be considered for sharing
Publications
Vu T, Habib AA, Jacob S, Mantegazza R, Murai H, Vissing J, Shaibani A, Levine T, Hussain Y, Meisel A, Adamczak-Ratajczak A, Ilkowski J, Sgobbi P, Guerreiro A, Luo S, Pavani R, Chaudhari U, Jalali N, DeVeaux M, Moore W, Meagher KA, Burczynski ME, Kokate S, Sherman S, Pawaskar D, Singh N, Souttou A, Sirulnik A, Perlee L, Yancopoulos GD, Howard JF Jr; NIMBLE Trial Investigators. Efficacy and safety of cemdisiran siRNA in myasthenia gravis (NIMBLE): a double-blind, randomised, placebo-controlled, phase 3 trial. Lancet. 2026 May 2;407(10540):1712-1725. doi: 10.1016/S0140-6736(26)00690-2. Epub 2026 Apr 21.
PubMed 42030965
Study at a glance
From the registry record, last updated by the sponsor on 28 Oct 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Efficacy and Safety of Pozelimab and Cemdisiran Combination Therapy and Cemdisiran Monotherapy in Patients With Symptomatic Generalized Myasthenia Gravis
- ClinicalTrials.gov ID
- NCT05070858
- Acronym / sponsor ID
- NIMBLE / R3918-MG-2018
- Conditions
- Generalized Myasthenia Gravis
- Phase
- Phase 3
- Study type
- Interventional
- Recruitment status
- Active, not recruiting
- Enrolment
- 288 participants (actual)
- Lead sponsor
- Regeneron PharmaceuticalsIndustry (pharma, biotech, devices)
- Study start
- 14 Dec 2021 (actual)
- Primary completion
- 8 Jul 2025 (actual)
- Study completion
- 11 Nov 2028 (estimated)
- First posted
- 7 Oct 2021 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This study is researching the experimental drugs called pozelimab and cemdisiran, and cemdisiran monotherapy. The study is focused on patients with generalized Myasthenia Gravis (gMG). Myasthenia gravis is a disease that causes weakness and fatigue in muscles in the body because the nerves and muscles are not communicating properly.
The aim of the study is to see how effective pozelimab and cemdisiran are when used in combination and when pozelimab and cemdisiran are used alone for patients with gMG.
The study is looking at several other research questions, including:
- What side effects may happen from taking the study drugs
- How the study drugs work inside the body
- How much of the study drugs are in the blood at different times
- Whether the body makes antibodies against pozelimab and cemdisiran (which could make the drugs less effective or could lead to side effects)
Detailed description
DBTP- Double Blind Treatment Period (24 weeks) ETP - Extension Treatment Period (28 weeks) OLTP- Open Label Treatment Period (68 weeks) FUP-Off treatment Follow Up Period (52 weeks)
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Quadruple blind (participant, care provider, investigator, outcomes assessor)
- Number of arms
- 4
| Arm | Type | Receives |
|---|---|---|
| Group 1 | Experimental | Drug: Pozelimab + Cemdisiran, Drug: Cemdisiran, Other: PlaceboPlacebo in DBTP; Re-randomized to Combination or Cemdisiran in ETP. Participants who received combination therapy during ETP and have not yet reached OLTP be reallocated to cemdisiran at the start of OLTP. In OLTP, participants on combination therapy who have not reached week 108 will switch to cemdisiran, while those who have reached week 108 will continue combination therapy |
| Group 2 | Experimental | Drug: Pozelimab + Cemdisiran, Drug: CemdisiranCombination regimen in DBTP and ETP. Participants who have not yet reached OLTP will be reallocated to cemdisiran at the start of OLTP. Participants who are in OLTP and have not reached week 108 will switch to cemdisiran, while those who have reached week 108 will continue combination therapy. |
| Group 3 | Experimental | Drug: CemdisiranCemdisiran throughout the study |
| Group 4 | Experimental | Drug: Pozelimab + Cemdisiran, Drug: Cemdisiran, Drug: PozelimabPozelimab monotherapy in DBTP followed by combination in ETP. Participants who have not yet reached OLTP will be reallocated to cemdisiran at the start of OLTP. Participants who are in OLTP and have not reached week 108 will switch to cemdisiran, while those who have reached week 108 will continue combination therapy. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (10 listed)
- Male or female participants ≥18 years of age at screening (or ≥ legal age of adulthood based on local regulations, whichever is older)
- Participant with documented diagnosis of Myasthenia Gravis (MG) based on medical history and supported by previous evaluations as described in the protocol
- Documented prior history of positive serologic test or a positive result during screening of Anti-acetylcholine Receptor (AChR) antibodies or anti-Lipoprotein Receptor-related Protein 4 (LRP4) antibodies
- Myasthenia Gravis Foundation of America (MGFA) Clinical Classification Class II to IVa at screening
- Myasthenia Gravis-Activities of Daily Living (MG-ADL) score ≥6 at screening. Ocular items should not contribute more than 50% of MG-ADL total score as described in the protocol
Key exclusion criteria (10 listed)
- Participants with antibody profile that is only positive for Muscle-Specific tyrosine Kinase (MuSK) (MuSK positivity is based on a documented prior history of positive serologic test for antibodies to MuSK or a positive result during screening
- History of thymectomy within 12 months prior to screening or planned during the study
- History of malignant thymoma (patients with stage 1 may be enrolled), or history of cancer within the past 5 years, except for adequately treated basal cell skin cancer, squamous cell skin cancer, or in situ cervical cancer
- Myasthenic crisis or MGFA Class V within 1 month of screening
- Not meeting meningococcal vaccination requirements and, at a minimum, documentation of quadrivalent meningococcal vaccination within 5 years prior to randomization and serotype B vaccine (when available) within 3 years prior to randomization as described in the protocol
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 |
|---|---|---|
| Pozelimab + CemdisiranSubcutaneous administration as described in the protocol | Drug | Group 1, Group 2, Group 4 |
| CemdisiranAlso: ALN-CC5SC administration as described in the protocol | Drug | Group 1, Group 2, Group 3, Group 4 |
| PlaceboSC administration as described in the protocol | Other | Group 1 |
| PozelimabAlso: REGN3918SC administration as described in the protocol | Drug | Group 4 |
Primary outcome
Change in Myasthenia Gravis-Activities of Daily Living (MG-ADL) total score
Time frame: From baseline to week 24
The total MG-ADL score ranges from 0 to 24 points, with higher scores indicating greater functional impairment and disability
27 secondary outcomes
Change from baseline in Quantitative Myasthenia Gravis (QMG) score
Time frame: Week 24
Achievement of a ≥3-point reduction (improvement) in MG-ADL total score
Time frame: From baseline to week 24
Achievement of a ≥5-point reduction (improvement) in QMG total score
Time frame: From baseline to week 24
Achievement of a consistent response on the MG-ADL
Time frame: From baseline to week 24
Achievement of Minimal Symptom Expression (MSE)
Time frame: Week 24
Change from baseline in the Myasthenia Gravis Composite (MGC) total score
Time frame: Week 24
Change from baseline in Myasthenia Gravis Quality of Life (MG-QOL15r) total score
Time frame: Week 24
Achievement of a ≥2-, 4-, 5-, 6-, 7-, 8-, 9-, or 10-point reduction on MG-ADL total score
Time frame: From baseline to week 24
Achievement of a ≥3-, 4-, 6-, 7-, 8-, 9-, or 10-point reduction on QMG
Time frame: From baseline to week 24
Incidence and severity of Treatment-Emergent Adverse Events (TEAEs) in participants treated with pozelimab + cemdisiran combination therapy, cemdisiran monotherapy or placebo
Time frame: Through week 24
Incidence and severity of Serious Adverse Events (SAEs) in participants treated with pozelimab + cemdisiran combination therapy, cemdisiran monotherapy or placebo
Time frame: Through week 24
Incidence and severity of Adverse Events of Special Interest (AESIs) in participants treated with pozelimab + cemdisiran combination therapy, cemdisiran monotherapy or placebo
Time frame: Through week 24
Concentrations of total pozelimab in serum
Time frame: Through study duration, approximately 172 weeks
Concentrations of total Complement component 5 (C5) in plasma
Time frame: Through study duration, approximately 172 weeks
Concentrations of cemdisiran and its metabolites in plasma
Time frame: Through study duration, approximately 172 weeks
Incidence of treatment-emergent Anti-Drug Antibodies (ADAs) to pozelimab over time
Time frame: Through study duration, approximately 172 weeks
Incidence of treatment-emergent ADAs to cemdisiran over time
Time frame: Through study duration, approximately 172 weeks
Change in total complement hemolysis activity assay (CH50) over time
Time frame: Through study duration, approximately 172 weeks
Percent change in CH50 over time
Time frame: Through study duration, approximately 172 weeks
Concentrations of cemdisiran and its metabolite in plasma
Time frame: At week 60 and up to week 120
Concentrations of total C5 in plasma
Time frame: At week 60 and up to week 120
Incidence of TEAEs
Time frame: Through week 144
Severity of TEAEs
Time frame: Through week 144
Incidence of SAEs
Time frame: Through week 144
Severity of SAEs
Time frame: Through week 144
Incidence of AESIs
Time frame: Through week 144
Severity of AESIs
Time frame: Through week 144
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 28 Oct 2026.
- Derived from this study: PubMed 42030965Vu T, Habib AA, Jacob S, Mantegazza R, Murai H, Vissing J, Shaibani A, Levine T, Hussain Y, Meisel A, Adamczak-Ratajczak A, Ilkowski J, Sgobbi P, Guerreiro A, Luo S, Pavani R, Chaudhari U, Jalali N, DeVeaux M, Moore W, Meagher KA, Burczynski ME, Kokate S, Sherman S, Pawaskar D, Singh N, Souttou A, Sirulnik A, Perlee L, Yancopoulos GD, Howard JF Jr; NIMBLE Trial Investigators. Efficacy and safety of cemdisiran siRNA in myasthenia gravis (NIMBLE): a double-blind, randomised, placebo-controlled, phase 3 trial. Lancet. 2026 May 2;407(10540):1712-1725. doi: 10.1016/S0140-6736(26)00690-2. Epub 2026 Apr 21.
- Individual participant dataSharing planned: Yes. All Individual Patient Data (IPD) that underlie publicly available results will be considered for sharing
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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.
Clinical Trial Management study director
Regeneron Pharmaceuticals
116 sites in 19 countries: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 3 study testing Pozelimab + Cemdisiran, Cemdisiran and Pozelimab in people with Generalized Myasthenia Gravis, run by Regeneron Pharmaceuticals at 116 sites in 19 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 10 inclusion and 10 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 28 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 116 sites in United States, China, India, Japan, Germany and 14 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?
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?
Change in Myasthenia Gravis-Activities of Daily Living (MG-ADL) total score (time frame: From baseline to week 24). 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 NCT05070858, 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 28 Oct 2026.