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NCT07284420PHASE2Recruiting

ADAPT Forward 1 - ISA1 - a Study to Evaluate Empasiprubart IV as add-on Therapy to Efgartigimod IV in Participants With AChR-Ab Seropositive Generalized Myasthenia Gravis With a Partial Clinical Response to Efgartigimod

argenx

Start Date

12/19/2025

Completion Date

3/7/2028

Summary

This study is part of the ADAPT Forward platform study (NCT07294170). ADAPT Forward is a platform study with the aim to look at how safe different drugs are and how well they work for people with myasthenia gravis. The goal is to find the best therapeutic approach to reduce patients' side effects and improve their quality of life. The aim of this ISA1 is to evaluate the safety and therapeutic relevance of empasiprubart as add-on therapy to efgartigimod in participants with AChR-Ab seropositive generalized myasthenia gravis. The ADAPT Forward master protocol is registered on https://clinicaltrials.gov/study/NCT07294170 More information can be found here: https://clinicaltrials.argenx.com/adaptforward1

Detailed Description

Once the master protocol and ISA1 screening periods are completed, eligible participants can enroll in the run-in period (part A) where they will receive efgartigimod IV. Eligible participants can then continue to the add-on period (part B) where they will receive both efgartigimod IV and empasiprubart IV. Participants who are not eligible for part B will continue directly to the safety follow-up period (part C) where they will receive efgartigimod IV only. The study duration for each participant is approximately up to 54 weeks.

Eligibility Criteria

Age Range: 18 years to No maximum

Inclusion Criteria: * Is seropositive for anti-acetylcholine receptor antibodies (AChR-Ab) * Has confirmed diagnosis of gMG and is Myasthenia Gravis Foundation of America (MGFA) Class II, III, IVa, or IVb * Has documented immunization against encapsulated bacterial pathogens (Neisseria meningitidis and Streptococcus pneumoniae) within 5 years of ISA screening or is willing to receive immunization at least 14 days before the first study drug administration Exclusion Criteria: * Clinical diagnosis of systemic lupus erythematosus (SLE) * Any known complement deficiency * Current administration of a complement inhibitor or received zilucoplan or eculizumab \<2 months or ravulizumab \<6 months before the first study drug administration * Patients proven to be refractory to efgartigimod (ie, not achieving a clinically meaningful improvement in total Myasthenia Gravis Activities of Daily Living (MG-ADL) score defined as an improvement of ≥2 points)

Interventions

BIOLOGICAL

Efgartigimod IV

BIOLOGICAL

Empasiprubart IV

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Conditions

AChR-Ab Seropositive Generalized Myasthenia GravisMyasthenia GravisMGgMGGeneralized Myasthenia GravisGeneralized Myasthenia Gravis (gMG)

Locations

Profound Research LLC - Carlsbad

Carlsbad, California 92011

United States

Visionary Investigators Network

Miami, Florida 33176

United States

University of South Florida

Tampa, Florida 33620

United States

Massachusetts General Hospital

Boston, Massachusetts 02114-2621

United States

Henry Ford Health Systems

Detroit, Michigan 48202-2608

United States

Dent Neurologic Institute - Amherst

Amherst, New York 14226

United States

Duke Early Phase Clinical Research Unit - PPDS

Durham, North Carolina 27710-0001

United States

Ohio State Martha Morehouse Outpatient Care

Columbus, Ohio 43221-3502

United States

Erlanger Health System

Chattanooga, Tennessee 37403

United States

National Neuromuscular Research Institute

Austin, Texas 78756

United States

University of Texas- San Antonio - Health Science Center - PPDS

San Antonio, Texas 78229

United States

UZ Leuven - PPDS

Leuven, 3000

Belgium

Charité - Universitätsmedizin Berlin

Berlin, 10117

Germany

Eginitio Hospital

Athens, 115 28

Greece

AHEPA University General Hospital of Thessaloniki

Thessaloniki, 546 36

Greece

ASST Papa Giovanni XXIII - Ospedale Papa Giovanni XXIII

Bergamo, Lombardy 24127

Italy

Fondazione IRCCS Istituto Neurologico Carlo Besta

Milan, 20133

Italy

AORN Antonio Cardarelli

Naples, 80131

Italy

IUHW Narita Hospital

Narita, 286-8520

Japan

MICS Centrum Medyczne Bydgoszcz

Bydgoszcz, Kuyavian-Pomeranian Voivodeship

Poland

Centrum Medyczne Neurologia Slaska

Katowice, Silesian Voivodeship 40-689

Poland

Warszawski Uniwersytet Medyczny

Warsaw, 00-665

Poland

Hospital Regional Universitario de Malaga - Hospital General

Málaga, Malaga 29010

Spain

Hospital de La Santa Creu i Sant Pau

Barcelona, 08041

Spain