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NCT06456580PHASE3Recruiting

A Study of Telitacicept for the Treatment of Generalized Myasthenia Gravis (UPSTREAM MG)

Vor Biopharma

Start Date

7/17/2024

Completion Date

1/1/2029

Summary

The purpose of this study is to evaluate the efficacy and safety of telitacicept in the treatment of generalized myasthenia gravis.

Detailed Description

Myasthenia gravis (MG) is an autoimmune disease in which autoantibodies disrupt the postsynaptic membrane, impairing nerve-to-muscle signal transmission. The predominant manifestation is muscle weakness, which typically worsens with repeated muscle exertion, such that function is usually the best in the morning with more pronounced weakness at the end of the day. A major challenge in MG is the lack of therapies that effectively treat the disease. Telitacicept is a fully human TACI-Fc fusion protein that targets B-lymphocyte stimulator (BLyS) and A proliferating-inducing ligand (APRIL), neutralizing their interactions with receptors on B cells. The blockage of BLyS and APRIL interaction with their respective cell membrane receptors (transmembrane activator and CAML interactor \[TACI\], B-cell maturation antigen, and BLyS receptors) by telitacicept can inhibit B-cell proliferation and maturation. This suppression at the proximal portion of the immune response could alleviate autoimmune symptoms. This is a randomized, double-blind, placebo-controlled Phase 3 study with an open-label extension (OLE) to evaluate the efficacy and safety of telitacicept in a global patient population with gMG. The total duration of the study is variable but will include an approximately 4-week screening period, a 24-week double-blind treatment period (Week 0 through Week 24), a 48-week OLE (Week 24 through Week 72), followed by an extended OLE period (E-OLE), and an 8-week end-of-study follow-up period. The E-OLE is variable duration, defined as the period after the 48-week OLE period until telitacicept is approved for MG in the country or the further development in the indication is concluded.

Eligibility Criteria

Age Range: 18 years to No maximum

Key Inclusion Criteria: 1. Male or female patient aged ≥18 years at screening. 2. Patients have prior confirmed diagnosis of gMG with generalized muscle weakness (typical pattern of weakness meeting the clinical criteria for diagnosis of MG as defined by the Myasthenia Gravis Foundation of America (MGFA) clinical classification II-IV. 3. Patients have positive antibodies against AChR or MuSK at screening. 4. MG-ADL score ≥6 points at screening and baseline with ocular-related score \<50% of the total score. 5. QMG score ≥8 points, and ≥ 4 items score at least 2 points at screening and baseline. Key Exclusion Criteria: 1. Patients have been diagnosed with any other autoimmune disease which can potentially pose a safety or efficacy confounding risk. 2. Patients having acute or chronic infection. 3. Patients having thymoma within 5 years or received thymectomy ≤6 months prior to screening. Patients with thymoma diagnosed 3-5 years prior to screening may be eligible if thymoma was at a localized stage and definitively treated with complete surgical resection. 4. Patients having current or history of primary immunodeficiency. 5. Patients having history of malignancy within the last 5 years. 6. Patient having prior or continuing diagnosis of serious cardiovascular, liver, kidney, respiratory system, endocrine or hematologic disease.

Interventions

BIOLOGICAL

Telitacicept

DRUG

Placebo

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Conditions

Generalized Myasthenia Gravis

Locations

HonorHealth Neurology - Bob Bové Neuroscience Institute

Scottsdale, Arizona 85258

United States

University of Southern California

Los Angeles, California 90033

United States

University of California Irvine

Orange, California 92868

United States

University of California San Francisco (UCSF)

San Francisco, California 94143

United States

SFM Clinical Research

Boca Raton, Florida 33487

United States

Allied Biomedical Research Institute (ABRI)

Miami, Florida 33155

United States

Medsol Clinical Research Center

Port Charlotte, Florida 33952

United States

University of South Florida Health (USF Health)

Tampa, Florida 33613

United States

Wellstar MCG Health Medical Center

Augusta, Georgia 30912

United States

Hospital Sisters Health System Medical

O'Fallon, Illinois 62269

United States

University of Kansas Medical Center

Kansas City, Kansas 66160

United States

University of Kentucky

Lexington, Kentucky 40506

United States

University of Louisville Physicians

Louisville, Kentucky 40202

United States

Neurology Center of New England

Foxborough, Massachusetts 02035

United States

Michigan State University Clinical Center

East Lansing, Michigan 48824

United States

Trinity Health - Grand Rapids Hospital

Grand Rapids, Michigan 49503

United States

UM Health Care - Neurology and Sleep Disorders Clinic

Columbia, Missouri 65212

United States

Hospital for Special Surgery

New York, New York 10021

United States

Mount Sinai Health System

New York, New York 10029

United States

Montefiore Medical Center

The Bronx, New York 10467

United States

University of North Carolina Hospitals - Neurology Clinic

Chapel Hill, North Carolina 27517

United States

University of Cincinnati Health Physicians - Clifton

Cincinnati, Ohio 45219

United States

Empower Clinical Research

Tigard, Oregon 97223

United States

University of Texas Southwestern Medical Center

Dallas, Texas 75390

United States

Houston Methodist Neurological Institute

Houston, Texas 77030

United States

Center for Neurological Disorders, S.C. - Greenfield - Gamma Therapeutic Center

Greenfield, Wisconsin 53228

United States

STAT Research S.A.

Ciudad Autónoma de Buenos Aires, Buenos Aires C1023AAB

Argentina

Hospital Italiano de Buenos Aires

Ciudad Autónoma de Buenos Aires, Buenos Aires C1199ABB

Argentina

Hospital General de Agudos José María Ramos Mejía

Ciudad Autónoma de Buenos Aires, Buenos Aires C1221ADC

Argentina

Fundación Scherbovsky

Mendoza, Mendoza Province M5500AXR

Argentina

INECO Neurociencias Oroño

Rosario, Santa Fe Province S2000TP

Argentina

Concord Repatriation General Hospital

Concord, New South Wales 2139

Australia

Townsville University Hospital

Douglas, Queensland 4814

Australia

Gold Coast University Hospital

Southport, Queensland 4215

Australia

Universitair Ziekenhuis (UZ) Leuven - Campus Gasthuisberg

Leuven, Flemish Brabant 3000

Belgium

Centre Hospitalier Régional de la Citadelle

Liège, Liège 4000

Belgium

Instituto de Neurologia de Curitiba

Curitiba, Paraná 81210-310

Brazil

Hospital São Lucas da PUCRS

Porto Alegre, Rio Grande do Sul 90619-900

Brazil

Universidade Estadual de Campinas

Campinas, São Paulo 13083-888

Brazil

Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto

Ribeirão Preto, São Paulo 14051-140

Brazil

Pseg Centro de Pesquisa Clinica

São Paulo, São Paulo 04038-002

Brazil

University Hospital - London Health Sciences Centre

London, Ontario N6C 2R5

Canada

Toronto General Hospital

Toronto, Ontario M5G 2C4

Canada

AnHui Provincial Hospital

Hefei, Anhui 230000

China

Beijing Hospital

Beijing, Beijing Municipality 100730

China

The First Affiliated Hospital of Chongqing Medical University

Chongqing, Chongqing Municipality 400010

China

Fujian Medical University Union Hospital

Fuzhou, Fujian 350000

China

The Second Hospital & Clinical Medical School. Lan Zhou University

Lanzhou, Gansu 730000

China

The First Affiliated Hospital, Sun Yat-Sen University

Guangzhou, Guangdong 510080

China

Affiliated Hospital of ZunYi Medical University

Zunyi, Guizhou 563000

China

TongJi Medical College of HUST

Wuhan, Hubei 430030

China

XiangYa Hospital of Central South University

Changsha, Hunan 410000

China

Jilin University China-Japan Union Hospital

Changchun, Jilin 130000

China

The Second Affiliated Hospital of PLA Air Force Military Medical University

Xi'an, Shaanxi 710000

China

Xi'An GaoXin Hospital

Xi'an, Shaanxi 710000

China

QiLU Hospital of ShanDong University

Jinan, Shangdong 250000

China

The 960th Hospital of the Joint Service Support Force of the Chinese People's Liberation Army

Jinan, Shangdong 250031

China

The First People's Hospital of JiNing Medical University

Jining, Shangdong 272000

China

Huashan Hospital of the ShangHai FuDan University Medical College

Shanghai, Shanghai Municipality 201100

China

First Hospital of ShanXi Medical University

Taiyuan, Shanxi 030000

China

NingBo Medical Center LiHuiLi Hospital

Ningbo, Zhejiang 315100

China

The 1 School of Medicine, School of Information and Engineering. The 1 Affiliated Hospital of WMU.

Wenzhou, Zhejiang 325000

China

Fakultni Nemocnice Ostrava

Ostrava-Poruba, Moravian-Silesian 708 54

Czechia

MINKSneuro s.r.o. - MUDr. Eduard Minks Ph.D.

Brno, South Moravian 603 00

Czechia

Fakultni Nemocnice Brno

Brno, South Moravian 625 00

Czechia

Hôpital Pasteur

Nice, Alpes-Maritimes 06001

France

Groupe Hospitalier Pellegrin

Bordeaux, Gironde 33076

France

Multi-profile Clinic "New Hospitals"

Tbilisi, 0114

Georgia

Pineo Medical Ecosystem

Tbilisi, 0114

Georgia

Aversi Clinic - Central Branch

Tbilisi, 0160

Georgia

Simon Khechinashvili University Hospital

Tbilisi, 0179

Georgia

IRCCS Fondazione Casa Sollievo della Sofferenza SG Rotondo

San Giovanni Rotondo, Foggia 71013

Italy

Azienda Ospedaliera di Rilievo Nazionale Antonio Cardarelli

Naples, Napoli 80131

Italy

Azienda Ospedaliera Universitaria - Università degli Studi della Campania Luigi Vanvitelli

Naples, Napoli 80131

Italy

Azienda Ospedaliera Universitaria Federico II

Naples, Napoli 80131

Italy

Fondazione Istituto San Raffaele - G. Giglio Di Cefalu

Cefalù, Palermo 90015

Italy

Istituto Neurologico Casimiro Mondino

Pavia, Pavia 27100

Italy

Fondazione Policlinico Universitario Agostino Gemelli IRCCS

Rome, Rome 00168

Italy

Azienda Ospedaliera - Universitaria Sant' Andrea

Rome, Rome 00189

Italy

National Hospital Organization - Nagoya Medical Center

Nagoya, Aichi-ken 460-0001

Japan

Kyushu University Hospital

Fukuoka, Fukuoka 812-8582

Japan

Sapporo Medical University Hospital

Sapporo, Hokkaido 060-8543

Japan

Hokkaido University Hospital

Sapporo, Hokkaido 060-8648

Japan

Kobe University Hospital

Kobe, Hyōgo 650-0017

Japan

St. Marianna University Hospital

Kawasaki, Kanagawa 216-8511

Japan

Yokohama Medical Center

Yokohama, Kanagawa 245-8575

Japan

National Hospital Organization Utano National Hospital

Kyoto, Kyoto 616-8255

Japan

NHO Sendai Medical Center

Sendai, Miyagi 983-8520

Japan

National Hospital Organization Niigata National Hospital

Kashiwazaki-Shi, Niigata 945-8585

Japan

Okinawa National Hospital

Ginowan-Shi, Okinawa 901-2214

Japan

Nagoya City University Hospital

Suita-shi, Osaka 564-0013

Japan

Seirei Hamamatsu General Hospital

Hamamatsu, Sizuoka [Shizuoka] 430-8558

Japan

Tokushima University Hospital

Tokushima, Tokusima [Tokushima] 770-8503

Japan

Juntendo University Hospital

Bunkyo-ku, Tokyo 113-8431

Japan

Tokyo Medical University Hospital

Shinjuku-ku, Tokyo 160-0023

Japan

Niepubliczny Zakład Opieki Zdrowotnej NEURO - KARD

Poznan, Greater Poland Voivodeship 61-853

Poland

Medicover Integrated Clinical Services (MICS) - Centrum Medyczne Bydgoszcz

Bydgoszcz, Kuyavian-Pomeranian Voivodeship 85-065

Poland

Neurocentrum Bydgoszcz

Bydgoszcz, Kuyavian-Pomeranian Voivodeship 85-796

Poland

Krakowska Akademia Neurologii Sp. z o.o.

Krakow, Lesser Poland Voivodeship 31-505

Poland

Clinirem - Lublin

Lublin, Lublin Voivodeship 20-064

Poland

Centrum Medyczne Hope Clinic

Lublin, Lubusz Voivodeship 20-701

Poland

Twoja Przychodnia Nowosolskie Centrum Medyczne

Nowa Sól, Lubusz Voivodeship 67-100

Poland

Centrum Medyczne Neuroprot

Warsaw, Masovian Voivodeship 01-684

Poland

MTZ Powered by Pratia

Warsaw, Masovian Voivodeship 02-172

Poland

Uniwersyteckie Centrum Kliniczne w Gdańsku

Gdansk, Pomeranian Voivodeship 80-214

Poland

Neurologia Śląska Centrum Medyczne

Katowice, Silesian Voivodeship 40-123

Poland

Hospital General Universitario Dr. Balmis

Alicante, Alicante 03010

Spain

Hospital Universitari Vall d'Hebron

Barcelona, Barcelona 08035

Spain

Hospital Universitari Mútua Terrassa

Terrassa, Barcelona 08221

Spain

Hospital Universitario de Basurto

Bilbao, Biscay 48013

Spain

Hospital Universitari i Politècnic La Fe

Valencia, València 46026

Spain