Approval Probability
TA Base Rate
Adjusted LOA
ML Risk
Label indication VYVGART is indicated for the treatment of adult patients with generalized myasthenia gravis (gMG). VYVGART is a neonatal Fc receptor blocker indicated for the treatment of adult patients with generalized myasthenia gravis (gMG). ( 1 ) FDA label
Also known as Efgartigimod IV, Efgartigimod IV or Efgartigimod PH20 SC, Efgartigimod or Efgartigimod PH20, efgartigimod administration, efgartigimod alfa, efgartigimod alfa fcab, VYVGART, ARGX-113
Efgartigimod · 22 trials · 29 indications
The percentage of patients who do not experience, at any time during the study, a 2 or more-point deterioration from their averaged baseline MG-ADL score that is sustained for a period of 4 or more consecutive weeks. (stable or improved patients)
The Myasthenia Gravis Activities of Daily Living (MG-ADL) scale is an 8-item instrument used to assess MG symptoms and their effects on daily activities. The total score ranges from 0 (no symptoms) to 24 (most severe symptoms).
The MG-ADL (Myasthenia Gravis Activities of Daily Living) scale assesses MG symptoms and their effects on daily activities. The total score varies between 0 and 24, with higher total scores indicating more impairment.
Percentage of participants with chronic ITP with a sustained platelet count response was defined as achieving platelet counts of at least 50 × 10\^9/L for at least 4 of the 6 visits between Week 19 and 24 of the study.
An AE was any untoward medical occurrence in a clinical study participant, temporally associated with the use of study treatment, whether or not considered related to the study treatment. Any clinically significant abnormal laboratory test results (hematology, clinical chemistry, or urinalysis) or other safety assessments (electrocardiogram \[ECG\], radiological scans, vital signs measurements) were collected as AEs. All AEs starting on or after first dose administered and until completion of participant's last visit were considered as TEAEs. A serious AE (SAE) was any AE that resulted in death, was life-threatening, required inpatient hospitalization, resulted in persistent or significant disability/incapacity, was a congenital abnormality, or was medically significant.
The MG-ADL is an 8-item patient-reported scale to assess MG symptoms and their effects on daily activities. The scale comprises 2 items on daily life activities and 6 items on symptoms. The MG-ADL total score range is 0-24, with higher scores indicative of greater disease severity. A patient was considered an MG-ADL responder during C1 if there was a reduction of ≥2 points on the MG-ADL total score (compared to baseline of C1 \[C1B\]) for ≥4 consecutive weeks with the first reduction occurring no later than 1 week after the last infusion of IMP in C1.
Number of enrolled participants per month
Proportion of randomized participants who receive both doses of assigned study intervention, attend all assigned study visits, and complete at least the high contrast visual acuity, low contrast visual acuity, and Pelli-Robson assessments at all visits
Difference in change in high-contrast visual acuity from baseline to 1 month between groups
Difference in change in low contrast visual acuity (LCVA) (# of letters seen at 2.5% illumination) from baseline to 1 month between groups
An adverse event (AE) was any untoward medical occurrence in a clinical study participant, temporally associated with the use of study drug, whether or not considered related to the study drug. A serious adverse event (SAE) was any untoward medical occurrence that, at any dose: resulted in death, was life threatening, required inpatient hospitalization or prolongation of existing hospitalization, resulted in persistent or significant disability/incapacity, was a congenital anomaly/birth defect or any other medically important event. Treatment-emergent adverse events (TEAEs) were defined as AEs with onset on or after the first administration of study drug up to and including 60 days after the last study drug administration. Adverse events in the 'Infections and infestations' SOC were defined as AE of Special Interest (AESIs) because efgartigimod causes a transient reduction in total IgG levels.
A Composite of Relevant Endpoints for Sjögren's Syndrome (CRESS) responder is defined as improvements in at least 3 of the 5 items of CRESS (systemic disease activity, patient-reported symptoms, tear gland function, salivary gland function and serology. The score ranges from 0 to 9 (higher score = worse symptoms).
Composite Autonomic Symptom Score (COMPASS) 31 modified version (2-week recall) is a self-rated questionnaire to evaluate the severity and distribution of autonomic symptoms in various autonomic nerve disorders. It consists of 31 questions in 6 weighted domains (orthostatic intolerance, vasomotor, secretomotor, gastrointestinal {GI}-mixed upper and diarrhea, bladder, and pupillomotor). A weighted total score of 0 (mild) to 100 (severe) was determined by adding a maximum raw score for each domain. Higher scores indicated a more severe degree of autonomic symptoms.
The Malmö POTS Symptom Score (MaPS) score is a dedicated POTS symptom scoring questionnaire. The score consists of 12 questions that assess symptom burden related (tachycardia, palpitations, dizziness, presyncope) and unrelated to orthostatic intolerance (GI symptoms, insomnia, concentration difficulties). Participants graded their symptoms for the past 7 days using a visual analog scale ranging from 0 (no symptoms) to 10 (worst possible). The total score was calculated by summing up the items/individual items and range was 0 to 120 points, with higher scores indicating more severe symptoms.
An adverse event (AE) was any untoward medical occurrence in a clinical study participant, temporally associated with the use of study drug, whether or not considered related to the study drug. A serious adverse event (SAE) was any untoward medical occurrence that at any dose resulted in death, was life threatening, required inpatient hospitalization or prolongation of existing hospitalization, resulted in persistent or significant disability/incapacity, was a congenital anomaly/birth defect or any other medically important event. Treatment-emergent adverse events (TEAEs) were defined as AEs with onset on or after the first administration of study drug up to and including 60 days after the last study drug administration.
AE : adverse event; SAE : serious adverse event; AESI : adverse event of special interest
Blood samples will be collected from each participant for measurement of serum concentrations of efgartigimod
Blood samples will be collected from each participant for measurement of serum concentrations of efgartigimod
Total Immunoglobulin G levels will be measured from blood samples
Total Immunoglobulin G (IgG) levels will be measured from blood samples
Changes from Baseline in vital signs, electrocardiogram parameters (ECGs), physical examination abnormalities and clinical laboratory assessments.
TEAEs were defined as AEs that first occurred or worsened in severity after the first administration of the treatment. A treatment emergent SAE was any untoward medical occurrence that resulted in death; was life-threatening; required inpatient hospitalization or prolongation of existing hospitalization;resulted in persistent or significant disability or incapacity; was a congenital abnormality or birth defect; or other medically significant events. All TEAEs observed were graded using the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI-CTCAE) version 4.03 with descriptions of severity for each AE based on the following general guideline: Grade 1= mild; Grade 2 = moderate; Grade 3 = severe or medically significant but not immediately life-threatening; Grade 4 = life-threatening consequences; Grade 5 = death related to AE.
The patients' diastolic and systolic blood pressure were measured pre-dose on dosing days 1,8,15 and 22 and also during the follow up period. The mean change from baseline at each time point is presented. Baseline is defined as the last non-missing value before first dose of study medication.
The patients' heart rate was measured pre-dose on dosing days 1,8,15 and 22 and also during the follow up period. The mean change from baseline at each time point is presented. Baseline is defined as the last non-missing value before first dose of study medication.
The patients' temperature was measured pre-dose on dosing days 1,8,15 and 22 and also during the follow up period. The mean change from baseline at each time point is presented. Baseline is defined as the last non-missing value before first dose of study medication.
The patients' weight as measured pre-dose on dosing days 1,8,15 and 22 and also during the follow up period. The mean change from baseline at each time point is presented. Baseline is defined as the last non-missing value before first dose of study medication.
ECG parameters of heart rate, PR, QT, and QRS interval were read locally and performed pre-dose on dosing days 1,8,15 and 22 and on the last follow up visit on Day 78. Any patients recording abnormal clinically relevant findings during the study are presented.
Sampling for clinical laboratory tests including hematology, clinical chemistry, and urinalysiswas performed pre-dose on dosing Days 1, 8, 15 and 22 and throughout the follow up period. Patients fasted for at least 8 hours prior to this sampling. Abnormal laboratory values, or test results were not reported as TEAEs unless they were associated with clinical signs and symptoms that were considered clinically relevant, required therapy or led to treatment discontinuation. Patients reporting TEAEs in any of the laboratory parameters during the study are presented.
The proportion of patients who exhibit reduction in serum C7 antibody levels at week 26 as compared to week 1.
Occurrence of adverse events and effects.
The overall improvement of EB symptoms at week 26 as compared to week 1, measured by percentage change of a participant's EBDASI score (overall total score, total activity score, and total damage score). The EBDASI is scored in the range of 0 - 506, with a lower score corresponding to mild disease and higher score corresponding to more severe disease.
| Arm | Type | Description |
|---|---|---|
| treatment | EXPERIMENTAL | Efgartigimod infusion |
| Efgartigimod IV | EXPERIMENTAL | Participants receiving efgartigimod IV during the double-blinded treatment period and the open-label treatment period(s) |
| Placebo IV | EXPERIMENTAL | Participants receiving placebo IV during the double-blinded treatment period and receiving efgartigimod IV during the open-label treatment period(s) |
| Placebo | PLACEBO_COMPARATOR | Patients receiving placebo during part A and receiving efgartigimod IV during part B |
| Efgartigimod IV - continuous regimen | EXPERIMENTAL | Participants receiving efgartigimod IV on a continuous regimen |
| Efgartigimod IV - cyclic regimen | EXPERIMENTAL | Participants receiving efgartigimod IV on a cyclic regimen |
| efgartigimod | EXPERIMENTAL | patients receiving efgartigimod |
| ARGX-113 | EXPERIMENTAL | - |
| Efgartigmod alfa | ACTIVE_COMPARATOR | 10 patients will receive efgartigimod alfa All participants will receive standard of care high dose corticosteroids for 3 days with a prednisone taper over 3 weeks. |
| Efgartigimod IV + Empasiprubart IV | EXPERIMENTAL | Participants receive efgartigimod IV in part A, B and C and empasiprubart IV in part B |
| Efgartigimod IV (part A + C) | EXPERIMENTAL | Participants not eligible for part B, receiving efgartigimod IV in part A and C |
| Efgartigimod IV arm | EXPERIMENTAL | patients receiving infusions of Efgartigimod IV |
| Placebo arm | PLACEBO_COMPARATOR | patients receiving infusions of placebo IV |
| Efgartigimod or Efgartigimod PH20 SC | EXPERIMENTAL | Patients receiving Efgartigimod IV treatment or Efgartigimod PH 20 SC treatment |
| ARGX-113 Dose A + SoC | EXPERIMENTAL | Patients will be randomized in a 1:1:1 ratio to ARGX-113 (Dose A or Dose B) or placebo |
| ARGX-113 Dose B +SoC | EXPERIMENTAL | Patients will be randomized in a 1:1:1 ratio to ARGX-113 (Dose A or Dose B) or placebo |
| Placebo + SoC | PLACEBO_COMPARATOR | Patients will be randomized in a 1:1:1 ratio to ARGX-113 (Dose A or Dose B) or placebo |
| Mild renal impairment | EXPERIMENTAL | Patients with 60 \<= eGFR \<90 |
| Moderate renal impairment | EXPERIMENTAL | Patients with 30 \<= eGFR \<60 |
| Severe renal impairment | EXPERIMENTAL | Patients with eGFR \<30 |
| Normal renal function | EXPERIMENTAL | Patients with eGFR \>=90 |
| Name | Type | Description |
|---|---|---|
| efgartigimod administration | DRUG | efgartigimod infusion |
| Efgartigimod IV | BIOLOGICAL | Intravenous infusion of efgartigimod |
| Placebo IV | OTHER | Intravenous infusion of placebo |
| efgartigimod | BIOLOGICAL | Intravenous infusion of efgartigimod |
| Placebo | OTHER | Intravenous infusion of placebo |
| ARGX-113 | BIOLOGICAL | Intravenous administration of ARGX-113 |
| Efgartigimod Alfa | DRUG | 2,016 mg will be administered subcutaneously by a healthcare provider on Day 0 and Day 3 of the trial. Rescue therapy with therapeutic plasma exchange will be given to any participant based on the results of Day 7 evaluation. |
| Empasiprubart IV | BIOLOGICAL | Intravenous infusion of empasiprubart |
| Efgartigimod IV or Efgartigimod PH20 SC | BIOLOGICAL | Intravenous infusion of Efgartigimod or Subcutaneous injection of Efgartigimod PH20 SC |
Inclusion Criteria: * 1\. Signed informed consent. 2. Age 18-80 years 3. Acetylcholine receptor antibody positive, myasthenia gravis patients, with stable disease for the past four or more months. Stable disease is defined as no change in dosage or interval in IVIG treatments and without any signif...
Efgartigimod is an investigational monoclonal antibody developed by argenx SE (ticker ARGX) that is being studied in neurology and immunology indications. It is designed as an antagonist of FCGRT. Clinical development spans generalized myasthenia gravis, immune thrombocytopenia, epidermolysis bullosa, and lupus nephritis across Phase 1, Phase 2, and Phase 3 studies.
Efgartigimod targets FCGRT, also known as the neonatal Fc receptor, and acts as an antagonist. By binding FCGRT, the antibody is designed to reduce recycling of immunoglobulin G. This mechanism is being explored in antibody-mediated conditions such as AChR-Ab seropositive generalized myasthenia gravis and immune thrombocytopenia.
Efgartigimod is developed by argenx SE, which trades under the ticker ARGX. The company is running the clinical program, including studies in generalized myasthenia gravis, immune thrombocytopenia, and epidermolysis bullosa. Efgartigimod is also referred to as efgartigimod IV and efgartigimod PH20 SC in different administration forms.
Efgartigimod is in clinical development, with trials across Phase 1, Phase 2, and Phase 3. The program includes four studies in total, of which three are active and two are completed, with combined enrollment of 301 participants. It is investigational and has not been established as approved for the indications under study.
Efgartigimod trials include NCT07284420, a Phase 2 study of empasiprubart IV added to efgartigimod IV in AChR-Ab seropositive generalized myasthenia gravis, and NCT07194850, a Phase 2 study in chronic immune thrombocytopenia in participants aged 12 to under 18. NCT07011589 is a Phase 1 epidermolysis bullosa study, and NCT06765161 is a Phase 3 myasthenia gravis study.
Yes, efgartigimod IV and efgartigimod PH20 SC are names used for efgartigimod in different administration forms. Efgartigimod IV refers to intravenous administration, while efgartigimod PH20 SC refers to a subcutaneous formulation. Both refer to the same monoclonal antibody developed by argenx SE.