- ICH GCP
- Registre américain des essais cliniques
- Essai clinique NCT06744920
Une étude visant à étudier l'efficacité, l'innocuité et la tolérance du rémibrutinib par rapport au placebo chez les patients adultes atteints de myasthénie grave généralisée (RELIEVE)
Une étude de phase III randomisée, en double aveugle et contrôlée par placebo pour évaluer l'efficacité, l'innocuité et la tolérance du rémibrutinib chez les patients atteints de myasthénie grave généralisée, suivie d'une phase d'extension ouverte
A study to evaluate the efficacy, safety and tolerability of Remibrutinib versus placebo in adult patients with Generalized Myasthenia Gravis who are on stable, standard-of-care (SOC) treatment.
Aperçu de l'étude
Statut
Les conditions
Intervention / Traitement
Description détaillée
This study is a randomized, double-blind, placebo-controlled, multicenter, Phase III study, to evaluate the efficacy, safety and tolerability of remibrutinib in gMG patients who are on stable SOC treatment. Approximately 180 eligible participants will be randomized in a ratio of 1:1, to receive either remibrutinib or matching placebo.
The study consists of a Core Part (6-months double-blind treatment) and an Extension Part (up to 60-month open-label treatment).
Type d'étude
Inscription (Estimé)
Phase
- Phase 3
Contacts et emplacements
Lieux d'étude
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Gummersbach, Allemagne, 51643
- Novartis Investigative Site
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Hamburg, Allemagne, 20246
- Novartis Investigative Site
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Münster, Allemagne, 48149
- Novartis Investigative Site
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Hesse
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Frankfurt am Main, Hesse, Allemagne, 60590
- Novartis Investigative Site
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Buenos Aires, Argentine, C1012AAR
- Novartis Investigative Site
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Caba, Argentine, C1055AAF
- Novartis Investigative Site
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Capital Federal, Argentine, C1023AAB
- Novartis Investigative Site
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San Miguel de Tucumán, Argentine, T4000AXL
- Novartis Investigative Site
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Santa Fe Province
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Rosario, Santa Fe Province, Argentine, 2000
- Novartis Investigative Site
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Victoria
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Fitzroy, Victoria, Australie, 3065
- Novartis Investigative Site
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São Paulo, Brésil, 05403-000
- Novartis Investigative Site
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Estado de Bahia
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Salvador, Estado de Bahia, Brésil, 40050-410
- Novartis Investigative Site
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Federal District
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Brasília, Federal District, Brésil, 70200-730
- Novartis Investigative Site
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Rio Grande do Sul
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Caxias do Sul, Rio Grande do Sul, Brésil, 95070-560
- Novartis Investigative Site
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Porto Alegre, Rio Grande do Sul, Brésil, 90480-110
- Novartis Investigative Site
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Ontario
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London, Ontario, Canada, N6A 5W9
- Novartis Investigative Site
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Ottawa, Ontario, Canada, K1H 8L6
- Novartis Investigative Site
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Quebec
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Québec, Quebec, Canada, G1J 1Z4
- Novartis Investigative Site
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Beijing, Chine, 100730
- Novartis Investigative Site
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Beijing, Chine, 100034
- Novartis Investigative Site
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Qingdao, Chine, 266000
- Novartis Investigative Site
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Shanghai, Chine, 200080
- Novartis Investigative Site
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Shanghai, Chine, 200040
- Novartis Investigative Site
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Anhui
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Hefei, Anhui, Chine, 230001
- Novartis Investigative Site
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Guangdong
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Guangzhou, Guangdong, Chine, 510080
- Novartis Investigative Site
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Hebei
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Shijiazhuang, Hebei, Chine, 050030
- Novartis Investigative Site
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Henan
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Zhengzhou, Henan, Chine, 450003
- Novartis Investigative Site
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Hubei
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Wuhan, Hubei, Chine, 430030
- Novartis Investigative Site
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Jiangsu
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Wuxi, Jiangsu, Chine, 214023
- Novartis Investigative Site
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Jilin
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Changchun, Jilin, Chine, 130021
- Novartis Investigative Site
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Busan, Corée du Sud, 49241
- Novartis Investigative Site
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Seoul, Corée du Sud, 03080
- Novartis Investigative Site
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Seoul, Corée du Sud, 03722
- Novartis Investigative Site
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Seoul, Corée du Sud, 05278
- Novartis Investigative Site
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Barcelona, Espagne, 08035
- Novartis Investigative Site
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Lleida, Espagne, 25198
- Novartis Investigative Site
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Madrid, Espagne, 28034
- Novartis Investigative Site
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Málaga, Espagne, 29010
- Novartis Investigative Site
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Valencia, Espagne, 46026
- Novartis Investigative Site
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Bordeaux, France, 33076
- Novartis Investigative Site
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Nice, France, 06000
- Novartis Investigative Site
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Paris, France, 75013
- Novartis Investigative Site
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Paris, France, 75940
- Novartis Investigative Site
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Strasbourg, France, 67081
- Novartis Investigative Site
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Toulouse, France, 31059
- Novartis Investigative Site
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Kutaisi, Géorgie, 4600
- Novartis Investigative Site
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Tbilisi, Géorgie, 0114
- Novartis Investigative Site
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Tbilisi, Géorgie, 0144
- Novartis Investigative Site
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Haryana
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Gurugram, Haryana, Inde, 122011
- Novartis Investigative Site
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Karnataka
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Mangalore, Karnataka, Inde, 575002
- Novartis Investigative Site
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Maharashtra
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Nashik, Maharashtra, Inde, 422005
- Novartis Investigative Site
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National Capital Territory of Delhi
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New Delhi, National Capital Territory of Delhi, Inde, 110029
- Novartis Investigative Site
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Punjab
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Ludhiana, Punjab, Inde, 141001
- Novartis Investigative Site
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Tamil Nadu
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Vellore, Tamil Nadu, Inde, 632004
- Novartis Investigative Site
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Telangana
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Hyderabad, Telangana, Inde, 500082
- Novartis Investigative Site
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Uttar Pradesh
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Lucknow, Uttar Pradesh, Inde, 226007
- Novartis Investigative Site
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BG
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Bergamo, BG, Italie, 24127
- Novartis Investigative Site
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TO
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Orbassano, TO, Italie, 10043
- Novartis Investigative Site
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Chiba, Japon, 2608677
- Novartis Investigative Site
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Fukuoka, Japon, 8128582
- Novartis Investigative Site
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Fukushima, Japon, 9601295
- Novartis Investigative Site
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Hiroshima, Japon, 7348551
- Novartis Investigative Site
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Hokkaido
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Sapporo, Hokkaido, Japon, 0630005
- Novartis Investigative Site
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Sapporo, Hokkaido, Japon, 0608543
- Novartis Investigative Site
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Hyōgo
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Nishinomiya, Hyōgo, Japon, 6638501
- Novartis Investigative Site
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Iwate
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Hanamaki, Iwate, Japon, 0250082
- Novartis Investigative Site
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Miyagi
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Sendai, Miyagi, Japon, 9838520
- Novartis Investigative Site
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Osaka
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Suita, Osaka, Japon, 5650871
- Novartis Investigative Site
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Saitama
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Higashi-Matsuyama, Saitama, Japon, 3550005
- Novartis Investigative Site
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Koshigaya, Saitama, Japon, 3438555
- Novartis Investigative Site
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Tokyo
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Shinjuku Ku, Tokyo, Japon, 1600023
- Novartis Investigative Site
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Shinjuku-ku, Tokyo, Japon, 1608582
- Novartis Investigative Site
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North Holland
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Amsterdam, North Holland, Pays-Bas, 1105 AZ
- Novartis Investigative Site
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Bydgoszcz, Pologne, 85-065
- Novartis Investigative Site
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Katowice, Pologne, 40-689
- Novartis Investigative Site
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Lodz, Pologne, 93-113
- Novartis Investigative Site
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Lublin, Pologne, 20-701
- Novartis Investigative Site
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Lublin, Pologne, 20-410
- Novartis Investigative Site
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Poznan, Pologne, 61-731
- Novartis Investigative Site
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Skorzewo, Pologne, 60-185
- Novartis Investigative Site
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Warsaw, Pologne, 01-684
- Novartis Investigative Site
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Warsaw, Pologne, 02-172
- Novartis Investigative Site
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Lublin Voivodeship
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Lublin, Lublin Voivodeship, Pologne, 20-064
- Novartis Investigative Site
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Lublin, Lublin Voivodeship, Pologne, 20-080
- Novartis Investigative Site
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POL
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Krakow, POL, Pologne, 31-505
- Novartis Investigative Site
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Brasov, Roumanie, 500283
- Novartis Investigative Site
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Bucharest, Roumanie, 040215
- Novartis Investigative Site
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Sibiu, Roumanie, 550245
- Novartis Investigative Site
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London, Royaume-Uni, SW17 0QT
- Novartis Investigative Site
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Belgrade, Serbie, 11000
- Novartis Investigative Site
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Niš, Serbie, 18108
- Novartis Investigative Site
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Novi Sad, Serbie, 21000
- Novartis Investigative Site
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Kaohsiung City, Taïwan, 833
- Novartis Investigative Site
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Tainan, Taïwan, 704302
- Novartis Investigative Site
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Taipei, Taïwan, 10002
- Novartis Investigative Site
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Taipei, Taïwan, 111045
- Novartis Investigative Site
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Taoyuan, Taïwan, 33305
- Novartis Investigative Site
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Arizona
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Phoenix, Arizona, États-Unis, 85013
- Neuromuscular Research Center
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Scottsdale, Arizona, États-Unis, 85258
- Honor Health Research Institute
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California
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Fullerton, California, États-Unis, 92835
- Fullerton Neuro and Headache Ctr
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Los Angeles, California, États-Unis, 90033
- University Of Southern California
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Sacramento, California, États-Unis, 94115
- California Pacific Medical Center
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District of Columbia
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Washington D.C., District of Columbia, États-Unis, 20010-2975
- Medstar Washington Hospital Center
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Florida
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Boca Raton, Florida, États-Unis, 33487
- SFM Clinical Research LLC
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Homestead, Florida, États-Unis, 33033
- Homestead Assoc In Research Inc
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Maitland, Florida, États-Unis, 32751
- Neurology Associates PA
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Orlando, Florida, États-Unis, 32804
- AdventHealth
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Orlando, Florida, États-Unis, 32806
- Neurological Services of Orlando PA
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Illinois
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Chicago, Illinois, États-Unis, 60637
- University of Chicago Medical Centr
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Maryland
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Bethesda, Maryland, États-Unis, 20817-1807
- Mid Atlantic Epilepsy and Sleep Ctr
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Massachusetts
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Boston, Massachusetts, États-Unis, 02114
- Massachusetts General Hospital
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Michigan
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East Lansing, Michigan, États-Unis, 48824
- Michigan State University-Department of Neurology
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New York
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Buffalo, New York, États-Unis, 14209
- Dent Neurological Institute
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Ohio
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Cleveland, Ohio, États-Unis, 44195
- Cleveland Clinic Foundation
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Pennsylvania
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Pittsburgh, Pennsylvania, États-Unis, 15213
- University of Pittsburgh Medical Center
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Texas
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Houston, Texas, États-Unis, 77030
- Houston Methodist Hospital
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Houston, Texas, États-Unis, 77030
- UT Health Science Center
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San Antonio, Texas, États-Unis, 78229-3900
- University of Texas Health Science Center at San Antonio
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Washington
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Seattle, Washington, États-Unis, 98195
- University of WA Division of Cardio
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Wisconsin
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Greenfield, Wisconsin, États-Unis, 53228-1321
- Center for Neurological Disorders G
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Critères de participation
Critère d'éligibilité
Âges éligibles pour étudier
Accepte les volontaires sains
Sexes éligibles pour l'étude
La description
Inclusion Criteria:
- Adult patients with gMG (age 18-85 years)
- Confirmed diagnosis of Myasthenia Gravis Foundation of America (MGFA) Class II-IV gMG at screening and likely not in need of a respirator for the duration of the study, as judged by the Investigator
- Documented evidence of positive serologic testing for AChR+ antibody or MuSK+ antibody at screening, OR seronegative for both AChR and MuSK antibodies at screening
- Baseline MG-ADL score ≥ 6 with ≥ 50% of the total score due to non ocular symptoms
- Participants who have been receiving a standard-of-care treatment as specified in the protocol
- Able to safely swallow the study medication according to investigator clinical judgement based on a bedside swallowing test or another formal swallowing test in line with local practice, both at Screening and Baseline
Exclusion Criteria:
- Prior to baseline have been treated with intravenous immunoglobulins or plasma exchange (IVIg/PLEX) in the past month, with rituximab in the past 6 months, eculizumab in the past 2 months, ravulizumab or other complement inhibitors in the past 3 months, efgartigimod or other anti-FcRn therapies in the past 3 months, or had a thymectomy in the past 6 months or a planned thymectomy during the trial period
- Women of child bearing potential, defined as all women physiologically capable of becoming pregnant, from menarche until becoming post-menopausal, unless they are using highly effective methods of contraception during dosing and for 1 week after stopping of study treatment
Other protocol-defined inclusion/exclusion criteria may apply.
Plan d'étude
Comment l'étude est-elle conçue ?
Détails de conception
- Objectif principal: Traitement
- Répartition: Randomisé
- Modèle interventionnel: Affectation parallèle
- Masquage: Double
Armes et Interventions
Groupe de participants / Bras |
Intervention / Traitement |
|---|---|
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Expérimental: Remibrutinib arm
Core Part: Remibrutinib tablet taken orally [Extension Part: Open-label remibrutinib tablet taken orally] |
Remibrutinib (Blinded) active treatment
Autres noms:
Remibrutinib (Open Label) active treatment
Autres noms:
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Comparateur placebo: Placebo arm
Core Part: Placebo tablet taken orally [Extension Part: Open-label remibrutinib tablet taken orally] |
Placebo Remibrutinib (Open Label) active treatment
Autres noms:
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Que mesure l'étude ?
Principaux critères de jugement
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
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Change from baseline to Month 6 in Myasthenia Gravis Activity of Daily Living (MG-ADL) total score
Délai: Baseline to Month 6
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The MG-ADL is a categorical scale that assesses MG symptoms and their effects on daily activities. MG-ADL is composed of items related to patient's assessment of functional disability secondary to ocular (2 items), bulbar (3 items), respiratory (1 item), and gross motor or limb (2 items) impairment related to effects from MG. Each item is assessed on a 4-points scale where a score 0 represents normal function and a score 3 represents loss of ability to perform that function (total score 0 to 24). |
Baseline to Month 6
|
Mesures de résultats secondaires
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
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Change from baseline to Month 6 in Quantitative Myasthenia Gravis (QMG) total score
Délai: Baseline to Month 6
|
The Quantitative Myasthenia Gravis (QMG) Score is a 13-item direct physician assessment scoring system that quantifies disease severity, based on impairments of body functions and structures. The total QMG score ranges from 0 to 39, where higher scores indicated greater disease severity. The QMG score is composed of the following items: ocular (2 items), facial (1 item), bulbar (2 items), gross motor (6 items), axial (1 item) and respiratory (1 item). |
Baseline to Month 6
|
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Proportion of participants with ≥ 5 points reduction from baseline to Month 6 of QMG total score without rescue medication and/or strongly confounding prohibited medication
Délai: Baseline to Month 6
|
The Quantitative Myasthenia Gravis (QMG) Score is a 13-item direct physician assessment scoring system that quantifies disease severity, based on impairments of body functions and structures. The total QMG score ranges from 0 to 39, where higher scores indicated greater disease severity. The QMG score is composed of the following items: ocular (2 items), facial (1 item), bulbar (2 items), gross motor (6 items), axial (1 item) and respiratory (1 item). |
Baseline to Month 6
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Proportion of participants with ≥ 3 points reduction from baseline to Month 6 of Myasthenia Gravis Activity of Daily Living (MG-ADL) scale total score without rescue medication and/or strongly confounding prohibited medication
Délai: Baseline to Month 6
|
The MG-ADL is a categorical scale that assesses MG symptoms and their effects on daily activities. MG-ADL is composed of items related to patient's assessment of functional disability secondary to ocular (2 items), bulbar (3 items), respiratory (1 item), and gross motor or limb (2 items) impairment related to effects from MG. Each item is assessed on a 4-points scale where a score 0 represents normal function and a score 3 represents loss of ability to perform that function (total score 0 to 24). |
Baseline to Month 6
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Proportion of participants achieving Minimal Symptom Expression (MSE) at Month 6, defined as MG-ADL score of 0 or 1 at Month 6 without rescue therapy and/or strongly confounding prohibited medication
Délai: Month 6
|
The MG-ADL is a categorical scale that assesses MG symptoms and their effects on daily activities. MG-ADL is composed of items related to patient's assessment of functional disability secondary to ocular (2 items), bulbar (3 items), respiratory (1 item), and gross motor or limb (2 items) impairment related to effects from MG. Each item is assessed on a 4-points scale where a score 0 represents normal function and a score 3 represents loss of ability to perform that function (total score 0 to 24). |
Month 6
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Change from baseline to Month 6 in Myasthenia Gravis Composite score (MGC) total score
Délai: Baseline to Month 6
|
The MGC is a 10-item instrument that measures the symptoms and signs of MG based on physician examination and patient history. Items relate to ptosis, double vision, eye closure, talking, chewing, swallowing, breathing, neck flexion, shoulder abduction, and hip flexion. Each item is scored on an ordinal scale with 4 possible categories and weighted. The total score ranges from 0 to 50, where higher scores indicating more severe impairments. |
Baseline to Month 6
|
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Change from baseline to Month 6 in revised Myasthenia Gravis Quality of Life Questionnaire (MG-QOL15r) survey score
Délai: Baseline to Month 6
|
The revised MG-QoL15 is a 15-item health related quality of life questionnaire completed by participants, designed to measure quality of life in gMG. Items on the MG-QoL15 relate to physical, social, and psychological components and are scored from 0 (not at all) to 2 (very much). The cumulative scores range from 0 to 30, with higher scores representing worse quality of life and dissatisfaction with MG-related dysfunction. |
Baseline to Month 6
|
|
Incidence of adverse events
Délai: Baseline to Month 6
|
Incidence of adverse events including changes in clinical laboratory values, vital signs, electrocardiograms and suicidality results qualifying and reported as AEs. |
Baseline to Month 6
|
|
Proportion of time during which participants showed a reduction of ≥ 2 points in MG-ADL total score, that was maintained up to Month 6
Délai: Baseline to Month 6
|
The MG-ADL is a categorical scale that assesses MG symptoms and their effects on daily activities. MG-ADL is composed of items related to patient's assessment of functional disability secondary to ocular (2 items), bulbar (3 items), respiratory (1 item), and gross motor or limb (2 items) impairment related to effects from MG. Each item is assessed on a 4-points scale where a score 0 represents normal function and a score 3 represents loss of ability to perform that function (total score 0 to 24). |
Baseline to Month 6
|
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Proportion of early MG-ADL responders during treatment (early responders with first MG-ADL improvement from baseline of ≥ 2 points occurring by week 4)
Délai: Baseline to week 4
|
The MG-ADL is a categorical scale that assesses MG symptoms and their effects on daily activities. MG-ADL is composed of items related to patient's assessment of functional disability secondary to ocular (2 items), bulbar (3 items), respiratory (1 item), and gross motor or limb (2 items) impairment related to effects from MG. Each item is assessed on a 4-points scale where a score 0 represents normal function and a score 3 represents loss of ability to perform that function (total score 0 to 24). Participants with a first MG-ADL improvement from baseline of ≥ 2 points occurring by week 4 are considered early responders. |
Baseline to week 4
|
|
Change from baseline to Month 6 in EuroQol-5 Dimensions-5 Level (EQ-5D-5L)
Délai: Baseline to Month 6
|
The EQ-5D-5L is a widely used questionnaire designed to assess health status in adults. The measure is divided into two distinct sections, the descriptive system and the EQ visual analogue scale (EQ VAS). The first section includes one item addressing each of five dimensions (mobility, self-care, usual activity, pain/discomfort, and anxiety/depression). Participants rate each of these items from 1 of the 5 levels: no problems, slight problems, moderate problems, severe problems, or unable to/extreme. A composite health state is then defined by combining the levels for each dimension into a 5-digit number. The second section includes the EQ visual analogue scale (EQ VAS) that measures self-rated (global) health status utilizing a vertically oriented visual analogue scale where 100 represents the "best imaginable health state" and 0 represents the "worst imaginable health state." Respondents are asked to rate their current health by placing a mark along this continuum. |
Baseline to Month 6
|
|
Proportion of participants achieving a reduction from baseline of ≥ 3 points in MGC total score at Month 6
Délai: Baseline to Month 6
|
The MGC is a 10-item instrument that measures the symptoms and signs of MG based on physician examination and patient history. Items relate to ptosis, double vision, eye closure, talking, chewing, swallowing, breathing, neck flexion, shoulder abduction, and hip flexion. Each item is scored on an ordinal scale with 4 possible categories and weighted. The total score ranges from 0 to 50, where higher scores indicating more severe impairments. |
Baseline to Month 6
|
|
Change from baseline in MG-ADL total score
Délai: Baseline to Month 66
|
The MG-ADL is a categorical scale that assesses MG symptoms and their effects on daily activities. MG-ADL is composed of items related to patient's assessment of functional disability secondary to ocular (2 items), bulbar (3 items), respiratory (1 item), and gross motor or limb (2 items) impairment related to effects from MG. Each item is assessed on a 4-points scale where a score 0 represents normal function and a score 3 represents loss of ability to perform that function (total score 0 to 24). |
Baseline to Month 66
|
|
Change from baseline in QMG total score
Délai: Baseline to Month 66
|
The Quantitative Myasthenia Gravis (QMG) Score is a 13-item direct physician assessment scoring system that quantifies disease severity, based on impairments of body functions and structures. The total QMG score ranges from 0 to 39, where higher scores indicated greater disease severity. The QMG score is composed of the following items: ocular (2 items), facial (1 item), bulbar (2 items), gross motor (6 items), axial (1 item) and respiratory (1 item). |
Baseline to Month 66
|
|
Change from baseline in MGC total score
Délai: Baseline to Month 66
|
The MGC is a 10-item instrument that measures the symptoms and signs of MG based on physician examination and patient history. Items relate to ptosis, double vision, eye closure, talking, chewing, swallowing, breathing, neck flexion, shoulder abduction, and hip flexion. Each item is scored on an ordinal scale with 4 possible categories and weighted. The total score ranges from 0 to 50, where higher scores indicating more severe impairments. |
Baseline to Month 66
|
|
Proportion of participants achieving a reduction from core part in oral corticosteroids (OCS) dose till the end of extension part
Délai: Baseline to month 66
|
Participants receiving oral corticosteroids are required to be on a stable dose for at least 4 weeks prior to baseline. The dose can be reduced or discontinued during the open label extension period at investigator discretion. Oral corticosteroids use will be recorded. |
Baseline to month 66
|
|
Incidence of adverse events
Délai: Month 7 to month 66
|
Incidence of adverse events including changes in clinical laboratory values, vital signs, electrocardiograms and suicidality results qualifying and reported as AEs. |
Month 7 to month 66
|
Collaborateurs et enquêteurs
Parrainer
Dates d'enregistrement des études
Dates principales de l'étude
Début de l'étude (Réel)
Achèvement primaire (Estimé)
Achèvement de l'étude (Estimé)
Dates d'inscription aux études
Première soumission
Première soumission répondant aux critères de contrôle qualité
Première publication (Réel)
Mises à jour des dossiers d'étude
Dernière mise à jour publiée (Réel)
Dernière mise à jour soumise répondant aux critères de contrôle qualité
Dernière vérification
Plus d'information
Termes liés à cette étude
Mots clés
Termes MeSH pertinents supplémentaires
- Maladies du système nerveux
- Tumeurs par site
- Tumeurs
- Maladies neuromusculaires
- Maladies auto-immunes
- Maladies du système immunitaire
- Maladies auto-immunes du système nerveux
- Maladies neurodégénératives
- Syndromes paranéoplasiques, système nerveux
- Tumeurs du système nerveux
- Syndromes paranéoplasiques
- Maladies de la jonction neuromusculaire
- Myasthénie grave
- rémibrutinib
Autres numéros d'identification d'étude
- CLOU064O12301
- 2023-510026-32 (Autre identifiant: EU CTIS)
- 2023 (Subvention/contrat des NIH des États-Unis)
Plan pour les données individuelles des participants (IPD)
Prévoyez-vous de partager les données individuelles des participants (DPI) ?
Description du régime IPD
Novartis is committed to sharing with qualified external researchers, access to patient-level data and supporting clinical documents from eligible studies. These requests are reviewed and approved by an independent review panel on the basis of scientific merit. All data provided is anonymized to respect the privacy of patients who have participated in the trial in line with applicable laws and regulations. This trial data availability is according to the criteria and process described on www.clinicalstudydatarequest.com.
Informations sur les médicaments et les dispositifs, documents d'étude
Étudie un produit pharmaceutique réglementé par la FDA américaine
Étudie un produit d'appareil réglementé par la FDA américaine
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