A Study of the Safety and Effectiveness of Efgartigimod in Patients With Primary Sjögren's Syndrome (pSS) (rho)
A Phase 2, Randomized, Placebo-controlled, Parallel-group, Double-blinded, proof-of Concept Study to Evaluate the Safety and Efficacy of Intravenous Efgartigimod in Adult Participants With Primary Sjögren's Syndrome
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 2
Contacts and Locations
Study Contact
Study Contact
- Name: Sabine Coppieters, MD
- Phone Number: 857-350-4834
- Email: Clinicaltrials@argenx.com
Study Locations
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Gent, Belgium, 9000
- Universitair Ziekenhuis Gent
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Debrecen, Hungary, 4032
- Debreceni Egyetem
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Szekesfehervar, Hungary, 8000
- Vita Verum Medical Egeszsegugyi Szolgaltato Bt.
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Groningen, Netherlands, 9713 GZ
- Universitair Medisch Centrum Groningen , Dept of Rheumatology and Clinical Immunology
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Elblag, Poland, 82-300
- Ambulatorium Barbara Bazela
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Grodzisk Mazowiecki, Poland, 05-825
- MCBK Iwona Czajkowska Anna Podrażka- Szczepaniak S.C.
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Krakow, Poland, 31-501
- FutureMeds Krakow
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Kraków, Poland, 30-363
- Centrum Medyczne Plejady
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Lublin, Poland, 20-412
- ETG Lublin
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Lublin, Poland, 20-607
- Reumed Spolka z o.o.
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Poznan, Poland, 60-848
- Clinical Research Center Spółka z ograniczoną odpowiedzialnością Medic-R Sp.k.
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Skórzewo, Poland, 60-185
- Centrum Medyczne Pratia Poznan
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Warsaw, Poland, 03-291
- Futuremeds Targowek
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Warsaw, Poland, 02-691
- Centrum Medyczne Reuma Park
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Warszawa, Poland, 00-874
- MICS Centrum Medyczne Warszawa
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Warszawa, Poland, 02-637
- KO-Med - Centrum Badań Medycznych NIGRiR
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Wroclaw, Poland, 50-088
- FutureMeds Wroclaw
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Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Is at least the legal age of consent for clinical trials when signing the informed consent form
- Is capable of providing signed informed consent and complying with protocol requirements
- Agrees to use contraceptive measures consistent with local regulations and measures described in the protocol
- Meets the following criteria at screening: ACR/EULAR 2016 pSS who met criteria ≤7 years before screening; ESSDAI ≥5; Anti-Ro/SS-A positive; Residual salivary flow (UWSF rate >0 and/or SWSF rate >0.10)
Exclusion Criteria:
- Known autoimmune disease or any medical condition that, in the investigator's judgment,would interfere with an accurate assessment of clinical symptoms of pSS or puts the participant at undue risk
- History of malignancy unless considered cured by adequate treatment with no evidence of recurrence for ≥3 years before the first administration of IMP.
- Adequately treated participants with the following cancers may be included at any time: Basal cell or squamous cell skin cancer; Carcinoma in situ of the cervix; Carcinoma in situ of the breast; Incidental histological finding of prostate cancer (TNM stage T1a or T1b) Clinically significant uncontrolled active acute or chronic bacterial, viral, or fungal infection
- Positive serum test at screening for an active infection with any of the following: HBV that is indicative of an acute or chronic infection, unless associated with a negative HBsAg or negative HBV DNA test; HCV based on HCV antibody assay unless a negative RNA test is available; HIV based on test results of a CD4 count of <200 cells/mm3 that are associated with an AIDS-defining condition, HIV based on test results of a CD4 count of >200 cells/mm3 not adequately treated with antiviral therapy
- Clinically significant disease, recent major surgery (within 3 months of screening), or intention to have surgery during the study; or any other medical condition that, in the investigator's opinion, would confound the results of the study or put the participant at undue risk
- Immunoglobulin G (IgG) levels cannot be below a certain threshold ( 4g/L)
- Positive covid test at study start
- Some of the medications such as vaccines with live components or medicines that may be prescribed cannot be taken either shortly before or during this study
- Current participation in another interventional clinical study or previously participation in an efgartigimod clinical study and treatment with ≥1 dose of IMP
- Known hypersensitivity to IMP or 1 of its excipients
- History (within 12 months of screening) of current alcohol, drug, or medication abuse as assessed by the investigator
- Pregnant or lactating state or intention to become pregnant during the study
- Secondary Sjögren's syndrome overlap syndromes where another confirmed autoimmune rheumatic or systemic inflammatory condition is the primary diagnosis
- Chinese traditional medicine with known immunomodulatory action
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Triple
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
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Experimental: Efgartigimod IV arm
patients receiving infusions of Efgartigimod IV
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Patients receiving efgartigimod infusions
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Placebo Comparator: Placebo arm
patients receiving infusions of placebo IV
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Patients receiving placebo infusions
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
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Percentage of Participants Meeting Overall CRESS Response of at Least 3 of 5 Items at Week 24
Time Frame: Week 24
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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).
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Week 24
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Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
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Number of Participants With TEAEs, AESI, and SAEs
Time Frame: Up to 32 weeks
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A treatment-emergent adverse event (TEAE): adverse events reported from the first dose up to and including 60 days after the final dose were considered treatment-emergent.
Serious adverse event (SAE): adverse event that 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 other situations.
Adverse event of special interest (AESI): adverse event related to 'Infections and infestations'.
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Up to 32 weeks
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Percentage of Participants With MCII in ESSDAI at Week 24
Time Frame: Week 24
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European Alliance of Associations for Rheumatology (EULAR) Sjögren's Syndrome Disease Activity Index (ESSDAI) measures systemic disease activity in participants with pSjD and consists of 11 organ-specific domains and 1 biological domain that contribute to disease activity level scoring.
Each domain is given a certain weight, which gives a score between 0 and 123 (higher score =worse symptoms).
Minimally clinically important improvement (MCII) in ESSDAI was defined as improvement of at least 3 points in ESSDAI score at Week 24.
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Week 24
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Percentage of Participants With Low Disease Activity in ESSDAI at Week 24
Time Frame: Week 24
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ESSDAI measures systemic disease activity in participants with pSjD and consists of 11 organ-specific domains and 1 biological domain that contribute to disease activity level scoring.
Each domain is given a certain weight, which gives a score between 0 and 123 (higher score =worse symptoms).
Low disease activity in ESSDAI was defined as ESSDAI score of less than 5 at Week 24.
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Week 24
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Percentage of Participants With MCII in clinESSDAI at Week 24
Time Frame: Week 24
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Clinical (clin)ESSDAI includes the same 11 organ-specific domains as ESSDAI but with different domain weighting and without the biological domain.
This way any change in clinESSDAI score would reflect disease specific features, irrespective of B-cell activity.
The clinESSDAI score ranges between 0-135 (higher score = worse symptoms).
Minimal clinically important improvement (MCII) in clinESSDAI was defined as improvement of at least 3 points in clinESSDAI score at Week 24.
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Week 24
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Percentage of Participants With Low Disease Activity in clinESSDAI at Week 24
Time Frame: Week 24
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clinESSDAI includes the same 11 organ-specific domains as ESSDAI but with different domain weighting and without the biological domain.
This way any change in clinESSDAI score would reflect disease specific features, irrespective of B-cell activity.
The clinESSDAI score ranges between 0-135 (higher score = worse symptoms).
Low disease activity in clinESSDAI was defined as clinESSDAI score of less than 5 at Week 24.
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Week 24
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Percentage of Participants With MCII in ESSPRI at Week 24
Time Frame: Week 24
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Minimal clinically important improvement in ESSPRI was defined as decrease of 1 point or at least ≥15% at Week 24.
ESSPRI is a questionnaire that has been developed to measure self-reported symptoms in participants with pSjD.
The score ranges from 0 (no symptoms) to 10 (more symptoms).
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Week 24
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Change From Baseline in ESSDAI Score at Week 24
Time Frame: Baseline (Day 1) and Week 24
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ESSDAI measures systemic disease activity in participants with pSjD and consists of 11 organ-specific domains and 1 biological domain that contribute to disease activity level scoring.
Each domain is given a certain weight, which gives a score between 0 and 123 (higher score = worse symptoms).
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Baseline (Day 1) and Week 24
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Change From Baseline in clinESSDAI Score at Week 24
Time Frame: Baseline (Day 1) and Week 24
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clinESSDAI includes the same 11 organ-specific domains as ESSDAI but with different domain weighting and without the biological domain.
This way any change in clinESSDAI score would reflect disease specific features, irrespective of B-cell activity.
The clinESSDAI score ranges between 0-135 (higher score = worse symptoms).
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Baseline (Day 1) and Week 24
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Change From Baseline in ESSPRI Score at Week 24
Time Frame: Baseline (Day 1) and Week 24
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ESSPRI is a questionnaire that has been developed to measure self-reported symptoms in participants with pSjD.
The score ranges from 0 (no symptoms) to 10 (more symptoms).
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Baseline (Day 1) and Week 24
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Percentage of Participants With STAR Score of at Least 5 at Week 24
Time Frame: Week 24
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Sjögren's Tool for Assessing Response (STAR) is a composite endpoint assessing multiple clinically relevant disease features.
A STAR responder is defined as a score of at least 5 points.
Due to the weighting, participants must be a responder on either systemic disease activity (ESSDAI), patient-reported symptoms (ESSPRI), or both to be an overall STAR responder.
The score ranges between 0 and 9 (higher score = worse outcome).
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Week 24
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Plasma Concentration of Efgartigimod
Time Frame: Pre-dose at Day 1, Weeks 1, 2, 4, 8, 12, 16, and 20; 30 minutes post-dose at Day 1, Weeks 1, 2, 4, 8, 12, 16, 20 and 24
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Serum samples were collected at indicated time points to assess the pharmacokinetic (PK) profile of efgartigimod.
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Pre-dose at Day 1, Weeks 1, 2, 4, 8, 12, 16, and 20; 30 minutes post-dose at Day 1, Weeks 1, 2, 4, 8, 12, 16, 20 and 24
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Percentage Change From Baseline in Total IgG Levels in Serum at Week 24
Time Frame: Baseline (Day 1) and Week 24
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Blood samples were collected at indicated timepoints to assess the total Immunoglobulin (Ig)G levels in serum.
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Baseline (Day 1) and Week 24
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Number of Participants With ADA Against Efgartigimod in Serum
Time Frame: Up to Week 24
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Blood samples were collected to assess anti-drug antibodies (ADAs) against efgartigimod.
Treatment-boosted ADA was defined as participants who had a baseline positive sample and the titer value increased 4-fold or more compared to baseline.
Treatment-induced ADA was defined as participants who had a baseline negative sample and at least 1 positive post-baseline samples.
Treatment-unaffected ADA was defined as participants who had a baseline positive sample, but the titer value did not increase 4-fold or more compared to baseline.
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Up to Week 24
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Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Musculoskeletal Diseases
- Mouth Diseases
- Stomatognathic Diseases
- Pathologic Processes
- Arthritis
- Joint Diseases
- Rheumatic Diseases
- Connective Tissue Diseases
- Autoimmune Diseases
- Immune System Diseases
- Disease
- Eye Diseases
- Arthritis, Rheumatoid
- Xerostomia
- Salivary Gland Diseases
- Dry Eye Syndromes
- Lacrimal Apparatus Diseases
- Syndrome
- Sjogren's Syndrome
Other Study ID Numbers
Other Study ID Numbers
- ARGX-113-2106
- 2021-005911-30 (EudraCT Number)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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