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BYM338/kg

Phase 3

Sporadic Inclusion Body Myositis | Monoclonal antibody | Neurology |Novartis AG|Trials Updated: Jan 5, 2021

BYM338/kg target and mechanism

Molecular targetACVR2B
Target classAntagonist
ModalityMonoclonal antibody

Also known as BYM338, bimagrumab, BYM338 (Bimagrumab)

Success Probability

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Market & Valuation

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Trial Design

RandomizedDouble-BlindPLACEBO_CONTROLLEDDMC
Total Trials10
Total Enrollment1,299

FDA Designations

No designations recorded

BYM338/kg clinical trials

BYM338/kg · 10 trials · 7 indications

Phase 3 1Phase 2 9
NCT02573467An Extension Study of the Efficacy, Safety and Tolerability of BYM338 (Bimagrumab) in Patients With Sporadic Inclusion Body Myositis Who Previously Participated in the Core Study CBYM338B2203Sporadic Inclusion Body Myositis
COMPLETED211 Analytics
PHASE3COMPLETED
An Extension Study of the Efficacy, Safety and Tolerability of BYM338 (Bimagrumab) in Patients With Sporadic Inclusion Body Myositis Who Previously Participated in the Core Study CBYM338B2203
Sporadic Inclusion Body MyositisUnlock trial analytics

Study Endpoints

Primary Endpoints

Number of Participants With Adverse Events (AEs), Serious Adverse Events (SAEs) and Deaths.
to end of study (up to 14 months, including the 6-month treatment-free follow-up period)

Safety monitoring was conducted throughout the study. AEs starting on or after the day of first administration of extension study drug until last administration of study drug + 56 days are considered. SAEs starting on or after the day of first administration of extension study drug are considered. Deaths which occurred on or after the day of first administration of extension study drug are considered.

Change From Core Study Baseline in 6 Minute Walking Distance Test (6MWD)
Core study baseline, weeks 52, 78, 104, and >=117

The 6MWD test measures the distance (in meters) that a participant can walk in a 6 minute time frame. A positive change from baseline indicates improvement. The efficacy analysis and time points were based on windowed visits relative to the first dose of the double-blind treatment in the core study.

Change From Baseline in Total Body Fat Mass by Dual Energy X-ray Absorptiometry (DXA) at Week 48
Baseline, Week 48

Dual energy X-ray absorptiometry (DXA) was used to assess changes in body composition, including total fat and lean body mass (FM and LBM) and appendicular skeletal fat and muscle mass (aFM and aLBM). DXA instruments had a source that generated x-rays split into two energies which measured bone mineral mass and soft tissue from which fat and fat-free mass (or lean body mass) were estimated.

Population I: Short Physical Performance Battery (SPPB) Total Score at Week 49
Week 49

SPPB evaluates lower extremities in three functional components: maintenance of standing balance, usual gait speed and chair stand. Each test yields a score on a scale from 0 to 4 (total score 0-12, with the higher score reflecting a higher level of function).

Population II: Short Physical Performance Battery (SPPB) Total Score at Week 49
Week 49

SPPB evaluates lower extremities in three functional components: maintenance of standing balance, usual gait speed and chair stand. Each test yields a score on a scale from 0 to 4 (total score 0-12, with the higher score reflecting a higher level of function).

Change From Baseline in Total Short Physical Performance Battery (SPPB) Score to Week 25
Baseline, week 25

Change from Baseline in total Short Physical Performance Battery (SPPB) Score to week 25; SPPB is a series of six activities involving three domains of physical function - balance, usual walking speed and rising from a chair , is commonly used globally to assess and quantify (score 0-12) lower extremity function and has been shown to predict future adverse health events. A decline of one or more points in the SPPB total score is predictive of a decrease in lower extremity function and future adverse clinical outcomes in older adults, including falls, hospitalizations, institutionalization, incident disability and death

Change From Baseline in Total Lean Body Mass Measured by DXA (Dual-energy X-ray Absorptiometry) at Weeks 12 and 24
baseline, weeks 12 and 24

Mixed Model for Repeated Measures (MMRM) of change from baseline in total LBM (kg) by treatment and visit To assess dose-response relationship of bimagrumab and facilitate an adequate dose selection for future phase III studies, without the need for supportive data from another dose-response finding study, at least three doses were required, ranging from a non-effective or minimally effective dose to a dose where maximal efficacy is expected. Original study was initiated with only two doses of bimagrumab, therefore, a lower dose arm of 70mg has been added to this study with Amendment 2, changing the randomization ratio from 1:1:1 to 2:1:2:2 to either placebo, bimagrumab 70mg, bimagrumab 210mg, or bimagrumab 700mg. Since the 70mg dose was expected to show suboptimal efficacy and fewer patients were randomized to this group, it was used only for dose response modelling and not for hypothesis testing. Consequently, no efficacy evaluations for the bimagrumab 70mg Arm were performed

Number of Participants With Adverse Events as a Measure of Safety and Tolerability
Up to 29 month

Any Adverse Event was defined as occurrence of any symptom regardless of intensity grade, Serious Adverse Event (SAEs) assessed as medical occurrences that result in death, are life threatening, require hospitalization or prolongation of hospitalization or result in persistent or significant disability/incapacity

Change From Baseline in 6 Minute Walking Distance (6MWD) Test at Week 52
Baseline, Week 52

The 6MWD test measured the distance (in meters) that a participant walked in a 6 minute timeframe. A positive change from baseline indicates improvement.

Percentage Change From Baseline of Thigh Muscle Volume (TMV) by MRI Scan at Week 4, 8, 16, and 24
Baseline, Weeks 4, 8, 16, 24

Thigh Muscle Volume (TMV) change was evaluated by a responder analysis. Patients whose loss of muscle TMV by MRI was no more than or equal to 2% at Week 4,8,16 and 24 was considered responders.

muscle volume of the thigh (measurement gathered using MRI, magnetic resonance imaging)
baseline to 24 weeks
Effect of BYM338 on Thigh Muscle Volume by MRI
8 weeks

Change in thigh muscle volume

Secondary Endpoints

Change From Core Study Baseline in Quadriceps Quantitative Muscle Testing (QMT) on the Right Side
Core study baseline, week 52, week 78, week 104 and >=week 117
Change From Core Study Baseline in Sporadic Inclusion Body Myositis (sIBM) Functional Assessment (sIFA) Score
Core study baseline, week 52, week 78, week 104, and >=week 117
Estimated Annual Number of Falls Per Participant Within Treatment Group
Core baseline to end of extension double-blind treatment (up to a maximum of 32 months)
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Study Design & Arms

AllocationNON_RANDOMIZED
MaskingQUADRUPLE
ModelPARALLEL
PurposeTREATMENT

Treatment Arms

ArmTypeDescription
BYM338/bimagrumab 10 mg/kgEXPERIMENTALParticipants received BYM338 10 mg/kg administered via intravenous infusion every 4 weeks for up to a maximum of 8 months after which they entered a 6-month, treatment-free follow-up period.
BYM338/bimagrumab 3 mg/kgEXPERIMENTALParticipants received BYM338 3 mg/kg administered via intravenous infusion every 4 weeks for up to a maximum of 8 months after which they entered a 6-month, treatment-free follow-up period.
BYM338/bimagrumab 1 mg/kgEXPERIMENTALParticipants received BYM338 1 mg/kg administered via intravenous infusion every 4 weeks for up to a maximum of 8 months after which they entered a 6-month, treatment-free follow-up period.
PlaceboPLACEBO_COMPARATORParticipants received placebo administered via intravenous infusion every 4 weeks for up to a maximum of 8 months after which they entered a 6-month, treatment-free follow-up period.
BYM338 10 mg/kgEXPERIMENTALBimagrumab (BYM338) 10 mg/kg up to maximum 1200 mg, every 4 weeks until week 44 (12 doses)
Follow-up (arm 1)OTHERPatients in Population I received 6 doses of bimagrumab 70 mg, 210 mg, 700 mg or placebo - one approximately every four weeks - over a 20-week period providing drug exposure for a total of 24 weeks.
Follow-up (arm 2)NO_INTERVENTIONPatients in Population II received either bimagrumab 700 mg or placebo in the core study and did not receive any investigational treatment in the extension study.
BYM338 70 mgEXPERIMENTALBYM338 70 mg intravenous infusion
BYM338 210 mgEXPERIMENTALBYM338 210 mg intravenous infusion
BYM338 700 mgEXPERIMENTALBYM338 700 mg intravenous infusion
bimagrumab 700 mgEXPERIMENTALApproximately 70 patients who met all inclusion criteria and none of the exclusion criteria were treated with the bimagrumab high dose administered via intravenous infusion starting Day 1 until Week 20
bimagrumab 210 mgEXPERIMENTALApproximately 70 patients who met all inclusion criteria and none of the exclusion criteria were treated with the bimagrumab medium dose administered via intravenous infusion starting Day 1 until Week 20
Bimagrumab 70 mgEXPERIMENTALApproximately 35 patients who met all inclusion criteria and none of the exclusion criteria were treated with bimagrumad low dose administered via intravenous infusion starting Day 1 until Week 20
BYM338EXPERIMENTALBYM338 Group

Interventions

NameTypeDescription
BimagrumabDRUGBYM338, a 150 mg/mL concentrate for solution for i.v. infusion, was provided in colorless glass vials with a rubber stopper and aluminum flip-off caps.
PlaceboDRUGMatching placebo to BYM338 was provided in colorless glass vials with a rubber stopper and aluminum flip-off caps.
BYM338 10 mg/kgDRUGintravenous infusion every four weeks
BYM338 (Bimagrumab)DRUG -
BYM338/bimagrumabDRUGBYM338, a 150 mg/mL concentrate for solution for i.v. infusion, was provided in colorless glass vials with a rubber stopper and aluminum flip-off caps.
BYM338DRUGBYM338
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Eligibility Criteria

Age Range36 Years to N/A
SexALL
Healthy VolunteersNo
Study Sites38

Inclusion Criteria: * Patients who completed the core study * Written informed consent must be obtained before any extension study assessment is performed. * Able to communicate well with the investigator. * Willing to participate for the entire duration of the extension study with commitment to fo...

Countries:United StatesAustraliaBelgiumDenmarkFranceItalyJapanNetherlandsSwitzerlandUnited KingdomCzechiaRussiaSouth KoreaSpainTaiwanGermanyArgentinaAustriaChileColombiaHungaryMexicoTurkey (Türkiye)
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Frequently asked questions about BYM338/kg

What is BYM338/kg used for?

BYM338/kg, also known as bimagrumab, has been studied in several conditions involving muscle loss and metabolic disease. These include sarcopenia, muscle wasting after hip fracture surgery, sporadic inclusion body myositis, type 2 diabetes mellitus, and cachexia associated with chronic obstructive pulmonary disease.

What does bimagrumab target?

Bimagrumab targets ACVR2B, a receptor in the activin signaling pathway. It acts as an antagonist at this target. By blocking ACVR2B, the drug is designed to interfere with signaling that limits muscle growth, which is the rationale behind studying it in conditions characterized by muscle wasting or atrophy.

Who is developing BYM338?

BYM338, or bimagrumab, is developed by Novartis AG, which trades under the ticker NVS. Novartis has sponsored the clinical trial program evaluating the drug across muscle wasting and metabolic indications.

What phase is BYM338 in?

BYM338 is in Phase 2 development. It is an investigational drug and has not been approved by the FDA. Four clinical trials of bimagrumab have been completed, and there are currently no active trials listed for this asset.

What clinical trials has bimagrumab been studied in?

Bimagrumab has been evaluated in four completed trials. These include NCT03005288 in type 2 diabetes, NCT02573467 in sporadic inclusion body myositis, NCT02468674 in sarcopenia, and NCT02333331, a dose range finding study in sarcopenia. Total enrollment across these trials was 486 participants.

Is BYM338 the same as bimagrumab?

Yes, BYM338 and bimagrumab are the same drug. BYM338 is the code name, while bimagrumab is the international nonproprietary name. The 10 mg/kg dose is sometimes written as BYM338 10 mg/kg. All of these names refer to the same investigational compound developed by Novartis.