A Study to Evaluate the Efficacy, Safety and PD and PK of HBM9161 in MG Patients

• ClinicalTrials.gov Identifier: NCT04346888
• Recruitment Status: Completed
• First Posted: April 15, 2020
• Last Update Posted: September 8, 2021
• Sponsor: Harbour BioMed (Guangzhou) Co. Ltd.
• Information provided by (Responsible Party): Harbour BioMed (Guangzhou) Co. Ltd.

Study Description

Brief Summary:

Primary Objectives: To investigate the efficacy of HBM9161 in patients with attack of MG in China

Condition or disease	Intervention/treatment	Phase
Myasthenia Gravis	Drug: HBM9161 Injection (680mg and 340 mg); Drug: Placebos; Drug: HBM9161 Injection (340 mg)	Phase 2

Detailed Description:

This is a multicenter, randomized, double-blind and placebo-controlled study. The investigational drug is HBM9161 injection, and the indication is MG.

The subjects will be randomized to three dose groups (340mg, 680mg and placebo) for a 6 weeks' double-blind treatment period followed by an open-label extension treatment period. The study will investigate the safety, efficacy and pharmacodynamic and pharmacokinetic of HBM9161 in patients with attack of MG in China.

Study Design

• Study Type: Interventional (Clinical Trial)
• Actual Enrollment: 30 participants
• Allocation: Randomized
• Intervention Model: Parallel Assignment
• Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
• Primary Purpose: Treatment
• Official Title: A Multicenter, Randomized, Double-Blind, Placebo-Controlled Study to Evaluate the Efficacy, Safety and Pharmacodynamic and Pharmacokinetic of HBM9161 (HL161) Subcutaneous Injection in Patients With Generalized Myasthenia Gravis
• Actual Study Start Date: July 23, 2020
• Actual Primary Completion Date: August 24, 2021
• Actual Study Completion Date: August 24, 2021

Arms and Interventions

Arm	Intervention/treatment
Experimental: HBM9161 (680mg and 340 mg); Subcutaneous injection; Blinded: HBM9161 680mg; Open-label: HBM9161 340mg;	Drug: HBM9161 Injection (680mg and 340 mg); HBM9161 Injection (680mg and 340mg)
Experimental: HBM9161 (340 mg); Subcutaneous injection; Blinded: HBM9161 340mg; Open-label: HBM9161 340mg;	Drug: HBM9161 Injection (340 mg); HBM9161 Injection (340 mg)
Placebo Comparator: Placebo, HBM9161 (340 mg); Subcutaneous injection; Blinded: Placebo; Open-label: HBM9161 340mg;	Drug: Placebos; Placebo, HBM9161 Injection (340mg)

Outcome Measures

Primary Outcome Measures :

1. Change in the Myasthenia Gravis Activities of Daily Living (MG-ADL) score from baseline to Day 43 [ Time Frame: 43 days ]
   The MG-ADL profile provides an assessment of MG symptom severity and measures 8 items on a 0-3 scale, with 0 being the least severe. The total sum of the 13 items represents the ADL score. The ADL score can range from 0 (least severe) to 24 (most severe)

Secondary Outcome Measures :

1. Change in the Myasthenia Gravis Composite (MGC) score from baseline to Day 43 [ Time Frame: 43 days ]
   The total QMG score is obtained by summing the responses to each individual item (13 items; Responses: None=0, Mild=1, Moderate=2, Severe=3). The score ranges from 0 to 39, with lower scores indicating lower disease activity.
2. Change in the Quantitative Myasthenia Gravis (QMG) score from baseline to Day 43 [ Time Frame: 43 days ]
   The QMG test is a standardized quantitative strength scoring system and measures 13 items on a 0-3 scale, with 0 being the least severe. The total sum of the 13 items represents the QMG score. The QMG score can range from 0 (least severe) to 39 (most severe).
3. Change in the Myasthenia Gravis Quality of Life 15(MG-QoL15r) score from baseline to Day 43 [ Time Frame: 43 days ]
   The MG-QoL 15r scale is a patient-reported score that assesses the patient's perception of impairment and disability and the degree to which the patient tolerates disease manifestations. Each question was graded on a 3-point scale from 0=normal to 2=severe with a score of 0 to 30; the higher score indicates worse MG disease activity
4. Proportion of participants with a decrease on the MG-ADL Score by ≥ 2 points [ Time Frame: 43 days ]
5. Proportion of participants with an improvement and worse on the MGFA Post-intervention Status (MGFA-PIS) from baseline to Day 43. [ Time Frame: 43 days ]
6. Change in the MG-ADL score from baseline to Day 120 [ Time Frame: 120 days ]
   The MG-ADL profile provides an assessment of MG symptom severity and measures 8 items on a 0-3 scale, with 0 being the least severe. The total sum of the 13 items represents the ADL score. The ADL score can range from 0 (least severe) to 24 (most severe)
7. Change in the MGC score from baseline to Day 120 [ Time Frame: 120 days ]
   The total QMG score is obtained by summing the responses to each individual item (13 items; Responses: None=0, Mild=1, Moderate=2, Severe=3). The score ranges from 0 to 39, with lower scores indicating lower disease activity.
8. Change in the QMG score from baseline to Day 120 [ Time Frame: 120 days ]
   The QMG test is a standardized quantitative strength scoring system and measures 13 items on a 0-3 scale, with 0 being the least severe. The total sum of the 13 items represents the QMG score. The QMG score can range from 0 (least severe) to 39 (most severe).
9. Change in the MG-QoL15r score from baseline to Day 120 [ Time Frame: 120 days ]
   The MG-QoL 15r scale is a patient-reported score that assesses the patient's perception of impairment and disability and the degree to which the patient tolerates disease manifestations. Each question was graded on a 3-point scale from 0=normal to 2=severe with a score of 0 to 30; the higher score indicates worse MG disease activity
10. Proportion of participants with persistent improvement on the MGC score from baseline to Day 120 [ Time Frame: 120 days ]
    Improvement (decrease) in the MGC score by ≥ 3 points for 6 weeks
11. Proportion of participants with persistent improvement on the MG-ADL score from baseline to Day 120 [ Time Frame: 120 days ]
    Improvement (decrease) in the MG-ADL Score by ≥ 2 points for 6 weeks

Eligibility Criteria

• Ages Eligible for Study: 18 Years to 99 Years (Adult, Older Adult)
• Sexes Eligible for Study: All
• Accepts Healthy Volunteers: No

Criteria

Inclusion Criteria:

1. Signed Informed Consent Form.
2. Male or female ≥ 18 years of age.

3. A female participant is eligible to participate if she is of:

   1. Non-childbearing potential (physically infertile, including women who have been menopausal for 2 years or more);
   2. Childbearing potential, negative serum pregnancy test results at screening visits, and agree to consistently use acceptable and effective contraceptive methods until 14 days after the final visit.
4. A male participant must take effective contraception during this clinical trial or their heterosexual partner must take effective contraception.

5. Positive serologic test for AChR-Ab or MUSK-Ab at the screening visit and at least 1 of the following:

   1. History of abnormal neuromuscular transmission test demonstrated by sign-fiber-electromyography or repetitive nerve stimulation OR
   2. History of positive edrophonium chloride test OR
   3. Participant has demonstrated improvement in MG signs on oral cholinesterase inhibitors as assessed by the treating physician.

Exclusion Criteria:

1. Use of rituximab, belimumab, eculizumab or any monoclonal antibody/Fc-fusion biologic for immunomodulation within 6 months prior to screening.
2. Immunoglobulins given by SC, IV(IVIG), or intramuscular route, or plasmapheresis/plasma exchange (PE) within 4 weeks before screening.
3. Thymectomy performed < 12 months prior to screening.
4. Total IgG level <6g/L (at screening).
5. Participant has any laboratory abnormality (at screening) that, in the opinion of the investigator, is clinically significant, has not resolved at baseline, and could jeopardize or would compromise the participant's ability to participate in this study.
6. Have known autoimmune disease other than MG that would interfere with the course and conduct of the study (such as uncontrolled thyroid disease).
7. Have an active infection, a recent serious infection (i.e., requiring injectable antimicrobial therapy or hospitalization) within the 8 weeks prior to screening.
8. History of or known infection with human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), or Mycobacterium tuberculosis. Participants must have negative test results for HBV surface antigen, HBV core antibody, HCV antibody, HIV 1 and 2 antibodies and a negative TB test at screening.

Contacts and Locations

Locations

China, Shanghai

Huashan Hospital, Fudan University

Shanghai, Shanghai, China

Sponsors and Collaborators

Harbour BioMed (Guangzhou) Co. Ltd.

Investigators

• Principal Investigator: Chongbo Zhao; Huashan Hospital

  Study Documents (Full-Text)

Documents provided by Harbour BioMed (Guangzhou) Co. Ltd.:

Study Protocol and Statistical Analysis Plan  [PDF] September 14, 2020

More Information

Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):

Yan C, Duan RS, Yang H, Li HF, Zou Z, Zhang H, Zhou H, Li XL, Zhou H, Jiao L, Chen J, Yin J, Du Q, Lee M, Chen Y, Chen X, Zhao C. Therapeutic Effects of Batoclimab in Chinese Patients with Generalized Myasthenia Gravis: A Double-Blinded, Randomized, Placebo-Controlled Phase II Study. Neurol Ther. 2022 Jun;11(2):815-834. doi: 10.1007/s40120-022-00345-9. Epub 2022 Apr 12.

• Responsible Party: Harbour BioMed (Guangzhou) Co. Ltd.
• ClinicalTrials.gov Identifier: NCT04346888
• Other Study ID Numbers: 9161.3
• First Posted: April 15, 2020
• Last Update Posted: September 8, 2021
• Last Verified: September 2021

• Studies a U.S. FDA-regulated Drug Product: No
• Studies a U.S. FDA-regulated Device Product: No

Keywords provided by Harbour BioMed (Guangzhou) Co. Ltd.:

MG

Additional relevant MeSH terms:

Myasthenia Gravis; Nervous System Diseases; Paraneoplastic Syndromes, Nervous System; Nervous System Neoplasms; Neoplasms by Site; Neoplasms; Paraneoplastic Syndromes; Autoimmune Diseases of the Nervous System; Neurodegenerative Diseases; Neuromuscular Junction Diseases; Neuromuscular Diseases; Autoimmune Diseases; Immune System Diseases