A study of efgartigimod PH20 SC given by prefilled syringe in adults with thyroid eye disease

2023-509198-22-00 Protocol ARGX-113-2309 Therapeutic confirmatory (Phase III) Ended

Start 21 Oct 2024 · End 15 Dec 2025 · Status Ended · 10 EU/EEA countries · 37 sites · Protocol ARGX-113-2309

Overview

Sponsor-declared trial summary

Phase Therapeutic confirmatory (Phase III)
Status Ended
Participants planned 123
Countries 10
Sites 37

Thyroid Eye Disease (TED)

To evaluate the efficacy of efgartigimod PH20 SC compared with placebo PH20 SC at Double- Blind treatment period (DBTP) week 24.

Key facts

Sponsor
Argenx
Participant type
Patients
Age range
18-64 years, 65+ years
Gender
Male and Female
Therapeutic area
Diseases [C] - Eye Diseases [C11]
Trial duration
21 Oct 2024 → 15 Dec 2025
Decision date (initial)
2024-09-29
Transition trial
No
Low-intervention
No
Rare-disease indication
No
Vulnerable population
Yes
Funding sources
argenx, BV

External identifiers

EU CT number
2023-509198-22-00
ClinicalTrials.gov
NCT06307626

Trial design

CTIS Part I — objectives, methods, condition coding

Main objective

Scope: Pharmacokinetic, Pharmacodynamic, Efficacy, Safety

To evaluate the efficacy of efgartigimod PH20 SC compared with placebo PH20 SC at Double- Blind treatment period (DBTP) week 24.

Secondary objectives 1

  1. To evaluate the efficacy of efgartigimod PH20 SC compared with placebo PH20 SC

Conditions and MedDRA coding

Thyroid Eye Disease (TED)

VersionLevelCodeTermSystem organ class
20.1 LLT 10057889 Graves' ophthalmopathy 10015919
23.1 LLT 10084358 Thyroid eye disease 100000004848
20.1 PT 10060742 Endocrine ophthalmopathy 100000004853

Study design 3 periods

#TitleAllocationBlindingRoles blindedArms
1 Double-Blind Treatment period
The Double-Blind Treatment period consists of efgartigimod arm or placebo arm.
Randomised Controlled Double [{"id":151822,"code":5,"name":"Carer"},{"id":151826,"code":2,"name":"Investigator"},{"id":151823,"code":4,"name":"Analyst"},{"id":151825,"code":3,"name":"Monitor"},{"id":151824,"code":1,"name":"Subject"}] Efgartigimod: Efgartigimod PH20 SC
Placebo: Placebo
2 Follow-up period
Follow-up observational period - participants whose eye symptoms have improved will be monitored for 52 weeks while they do not receive the study drug or placebo
Not Applicable None
3 Open-Label Treatment Period
Patients will receive efgartigimod in this period
Not Applicable None

Regulatory references

Scientific advice from competent authorities
Center For Drug Evaluation, Pharmaceuticals And Medical Devices Agency, Food And Drug Administration
Plan to share IPD
No

Eligibility criteria

Principal inclusion / exclusion criteria as submitted by sponsor

Inclusion criteria 6

  1. 1. The participant is at least 18 years of age
  2. 2. The participant is capable of providing signed informed consent and following with protocol requirements
  3. 3. The investigator determines active, moderate-to-severe thyroid eye disease (TED) associated with autoimmune thyroid conditions (Graves’ disease or Hashimoto’s thyroiditis) for the most severely affected eye
  4. 4. The participant has first onset of active TED symptoms within 12 months before screening
  5. 5. The participant must have normal thyroid function with the baseline disease under control or have mild hypo or hyperthyroidism at screening. Every effort should be made to correct the mild hypo or hyperthyroidism promptly and to maintain the normal thyroid function for the full duration of the study
  6. 6. The participant agrees to use birth control consistent with local regulations and the people of child-bearing potential must have a negative blood pregnancy test at screening and a negative urine pregnancy test before receiving the study drug

Exclusion criteria 12

  1. 1. Optic neuropathy (damage to optic nerve), defined as new visual field defect (blind spot), relative afferent pupillary defect (pupils respond differently to light), or color defect secondary to optic nerve involvement within the 6 months before screening
  2. 2. Corneal decompensation (swelling of the cornea) unresponsive to medical management
  3. 3. Previous orbital irradiation or surgery for TED
  4. 4. Use of some medications before screening (more information is found in the protocol)
  5. 5. Known autoimmune disease or any medical condition that would interfere with an accurate assessment of clinical symptoms of TED or puts the participant at undue risk
  6. 6. History of malignancy, cancer, unless considered cured by adequate treatment with no evidence of recurrence for ≥3 years. Adequately treated participants with the following cancers can 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 findings of prostate cancer
  7. 7. Clinically significant active infection that is not sufficiently resolved in the investigator’s opinion or positive serum test at screening for active infection with any of the following: Hepatitis B virus (HBV) , Hepatitis C virus (HCV) , HIV
  8. 8. Current participation in another interventional clinical study or previous participation in an efgartigimod clinical study and at least 1 dose of study drug received or has received at least 1 dose of commercially available efgartigimod
  9. 9. Known hypersensitivity to study drug or one of its excipients (inactive ingredients)
  10. 10. History of or current alcohol, drug, or medication abuse within 12 months before screening as assessed by the investigator.
  11. 11. Pregnant or lactating state or intention to become pregnant during the study
  12. 12. Live or live-attenuated vaccine received <4 weeks before screening

Endpoints

Primary and secondary outcome measures (English text)

Primary endpoints 1

  1. Percentage of participants who were proptosis responders at Double-Blind treatment period (DBTP) week 24.

Secondary endpoints 3

  1. Change in proptosis measurement in the study eye from baseline to Double-Blind Treatment Period (DBTP) week 24
  2. Change in the total GO-QoL score from baseline to Double-Blind Treatment Period (DBTP) week 24
  3. Percentage of participants with a resolution of diplopia (responders) at Double-Blind Treatment Period (DBTP) week 24.

Investigational products

Investigational medicinal products (IMPs), comparators, placebo, auxiliary

Test 1

Vyvgart 1 000 mg solution for injection in pre-filled syringe

PRD12092966 · Product

Active substance
Efgartigimod Alfa
Substance synonyms
IMMUNOGLOBULIN G1, ANTI-(FCRN RECEPTOR) (HUMAN MONOCLONAL ARGX-113 FC FRAGMENT), ARGX-113
Pharmaceutical form
SOLUTION FOR INJECTION
Route of administration
SUBCUTANEOUS
Max daily dose
1000 mg milligram(s)
Max total dose
48000 mg milligram(s)
Max treatment duration
48 Week(s)
Authorisation status
Authorised
ATC code
L04AA58 — -
Marketing authorisation
EU/1/22/1674/003
MA holder
ARGENX BV
MA country
EU
Paediatric formulation
No
Orphan designation
No
Modified vs. Marketing Authorisation
Yes
Modification description
Packaging and labelling for Clinical Trial use

Placebo 1

Placebo for efgartigimod

N/A · Product

Other product name
N/A
Pharmaceutical form
N/A
ATC code
N/A — N/A
Marketing authorisation
N/A
MA holder
N/A
MA country
Iceland
Paediatric formulation
No

Sponsors and contacts

Sponsor organisations, regulatory contacts, third parties

Argenx

Sponsor organisation
Argenx
Address
Industriepark-Zwijnaarde 7
City
Gent
Postcode
9052
Country
Belgium

Scientific contact point

Organisation
Argenx
Contact name
Chief Scientific Officer

Public contact point

Organisation
Argenx
Contact name
Vice President Clinical Development

Third parties 14

OrganisationCity, countryDuties
Icon Clinical Research Limited
ORG-100008322
Dublin 18, Ireland On site monitoring, Code 12, Code 13, Other
IQVIA Limited
ORG-100008655
Reading, United Kingdom Other, Code 8
Accellacare Limited
ORG-100044508
Dublin 18, Ireland Other
SGS Belgium
ORG-100007917
Mechelen, Belgium Data management
Quipment
ORG-100043496
Nancy, France Other
Fisher Clinical Services GmbH
ORG-100017323
Weil Am Rhein, Germany Other
Suvoda LLC
ORG-100043523
Conshohocken, United States Interactive response technologies (IRT)
Eresearchtechnology Inc.
ORG-100013039
Philadelphia, United States Other
PPD Global Central Labs (S) Pte Ltd
ORG-100041754
Singapore, Singapore Other, Laboratory analysis
PPD International Holdings LLC
ORG-100007655
Zaventem, Belgium Other, Laboratory analysis
Mapi Research Trust
ORG-100028753
Lyon, France Other
Stefanini
ORG-100044731
Zaventem, Belgium Other
Pharmaceutical Product Development LLC
ORG-100016999
Highland Heights, United States Other, Laboratory analysis
Greenphire LLC
ORG-100041621
King Of Prussia, United States Other

Locations

10 EU/EEA countries · 37 investigational sites

By country

CountryMS statusPlanned subjectsSites
Austria Ended 4 2
Bulgaria Ended 7 4
France Ended 4 4
Germany Ended 6 5
Italy Ended 9 5
Latvia Ended 2 3
Poland Ended 5 6
Slovenia Ended 2 2
Spain Ended 8 5
Sweden Ended 1 1
Rest of world
Serbia, Japan, Switzerland, China, United Kingdom, Turkey, United States
75

Investigational sites

Austria

2 sites · Ended
Medizinische Universitaet Innsbruck
Clinical Ophtalmology and Optometry, Anichstrasse 35, 6020, Innsbruck
Institut Fuer Forschung Und Innovation In Der Augenchirurgie
Vienna Institute for Research in Ocular Surgery, Heinrich-Collin-Strasse 30, Penzing, Vienna

Bulgaria

4 sites · Ended
Multiprofile Hospital For Active Treatment Hadji Dimitar OOD
Endocrinology and metabolic diseases department, Ulitsa Dimitir Pehlivanov 5, 8800, Sliven
Assoc. Prof. Dr. Desislava Koleva Outpatient clinic for individual practice for specialized medical assistance in eye diseases "St. Luka" EOOD
N/A, Floor 2, Ulitsa Perushtitsa 13b, Plovdiv
Medical Center Hera EOOD
NA, Ulitsa Klisura 20, 1510, Sofiya
Military Medical Academy
Clinic of Endocrinology and Metabolic Diseases, Ulitsa Sveti Georgi Sofiyski 3, 1606, Sofiya

France

4 sites · Ended
Centre Hospitalier Universitaire De Saint Etienne
Ophtalmologie, St Priest En Jarez, 25 Boulevard Pasteur, St Etienne Cedex 2
Hospices Civils De Lyon
Endocrinologie, 28 Avenue Du Doyen Jean Lepine, 69500, Bron
Quinze-Vingts National Ophthalmology Hospital
Ophtalmology – Service Pr Paques, 28 Rue De Charenton, 75012, Paris
Centre Hospitalier Universitaire De Lille
Endocrinologie, Rue Michel Polonovski, 59037, Lille Cedex

Germany

5 sites · Ended
Universitaetsklinikum Ulm AöR
Augenheilkunde, Prittwitzstrasse 43, Mitte, Ulm
Medical Center - University Of Freiburg
Klinik für Augenheilkunde, Killianstrasse 5, Stuehlinger, Freiburg Im Breisgau
Universitaetsklinikum Essen AöR
Klinik für Augenheilkunde, Hufelandstrasse 55, Holsterhausen, Essen
Universitaetsklinikum Giessen und Marburg GmbH
Klinik für Augenheilkunde, Baldingerstrasse 1, 35043, Marburg
Universitaetsmedizin Goettingen
Augenklinik, Robert-Koch-Strasse 40, Weende, Goettingen

Italy

5 sites · Ended
Azienda Ospedaliero-Universitaria Sant Andre
Azienda Ospedaliero-Universitaria Sant'Andrea, UOC Medicina Specialistica Endocrino-Metabolica, Via Di Grottarossa 1035-1039, 00189, Rome
Azienda Ospedaliera Ordine Mauriziano Di Torino
S.C. Endocrinologia, Diabetologia e Malattie del Metabolismo, Via Ferdinando Magellano 1, 10128, Turin
Azienda Ospedaliero-Universitaria Di Cagliari
Hospital San Giovanni Di Dio Ophthalmology department via Ospedale, 46 09124 Cagliari (Italy), Via Ospedale N. 54, 09124, Cagliari
Azienda Ospedaliero Universitaria Pisana
AOU Pisana, Ospedale Cisanello, UO Endocrinologia II Via Paradisa, 2 - 56124 Pisa, Via Roma 67, 56126, Pisa
Ospedale San Raffaele S.r.l.
IRCCS Ospedale San Raffaele, U.O. di Oculistica, Via Olgettina 60, 20132, Milan

Latvia

3 sites · Ended
Pauls Stradins Clinical University Hospital
Centre of Endocrinology, Pilsonu Iela 13, 1002, Riga
Rigas Austrumu kliniska universitates slimnica SIA
Ophthalmology clinic, Hipokrata Iela 2, LV-1079, Riga
Daugavpils Regional Hospital SIA
Endocrinology department, Vasarnicu Iela 20, 5417, Daugavpils

Poland

6 sites · Ended
Uniwersytecki Szpital Kliniczny W Bialymstoku
Klinika Endokrynologii, Diabetologii i Chorób Wewnętrznych, Centrum Badań Klinicznych, Ul. Marii Curie-Sklodowskiej 24a, 15-276, Bialystok
Uniwersyteckie Centrum Stomatologii I Medycyny Specjalistycznej Sp. z o.o.
Poradnia Internistyczna, Ul. Marcelinska 42, 60-354, Poznan
Instytut Centrum Zdrowia Matki Polki
Klinika Endokrynologii i Chorób Metabolicznych, Ul. Rzgowska 281/289, 93-338, Lodz
Uniwersyteckie Centrum Kliniczne
Klinika Okulistyki, Ul. Mariana Smoluchowskiego 17, 80-214, Gdansk
Eb Group Sp. z o.o.
Centrum Zdrowia MDM, Ul. Inflancka 4a, 00-189, Warsaw
Szpital Sw. Rozy Sp. z o.o. S.K.
N/A, Ul. Skotnicka 230a, 30-394, Cracow

Slovenia

2 sites · Ended
OLHB zdravstvena dejavnost d.o.o.
Oftalmology, Finžgarjeva ulica 4, 1000 Ljubljana, Slovenia, Finzgarjeva Ulica 4, 1000, Ljubljana
University Medical Center Ljubljana
Eye Clinic, Grablovičeva 46, 1000 Ljubljana, Zaloska Cesta 7, 1000, Ljubljana

Spain

5 sites · Ended
Hospital Clinico Universitario De Valladolid
Ophthalmology service, Avenida Ramon Y Cajal 3, 47003, Valladolid
Institut Catala De Retina S.L.
Ophthalmology service, Calle De La Pau Alcover 67, 08017, Barcelona
Clinica De Oftalmologia De Cordoba S.L.
Ophthalmology service, Avenida De La Arruzafa 9, 14012, Cordoba
Valles Ophthalmology Research S.L.
Ophthalmology service, Carrer Pedro I Pons 1, 08195, Sant Cugat Del Valles
Hospital Universitario 12 De Octubre
Ophthalmology service, Avenida De Cordoba Sn, 28041, Madrid

Sweden

1 site · Ended
Region Oestergoetland
Ögonkliniken (Ophthalmology), Universitetssjukhuset I Linkoping, 581 85, Linkoping

Country notifications

Trial-start, recruitment-start, end and early-termination notifications submitted per Member State

Country Trial startTrial end Recruitment startRecruitment end Early termination
Austria 2024-11-29 2025-03-27
Bulgaria 2024-10-31 2024-12-19
France 2024-10-29 2024-12-10
Germany 2025-04-10 2025-04-15
Italy 2024-12-16 2025-02-28
Latvia 2025-01-14 2025-04-03
Poland 2025-02-28 2025-03-19
Slovenia 2025-10-02
Spain 2024-10-21 2024-11-12
Sweden 2025-06-30 2025-09-24

Results and documents

Annex IV summary of results, Annex V layperson summary, and all documents registered in CTIS for this trial

Documents 134 files

Public protocol annexes, IB summaries, regulatory submissions and post-authorisation documents registered in CTIS.

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Application history

4 submissions — initial application plus substantial / non-substantial modifications

#TypeCodeSubmittedReference MSConclusionDecision date
1 INITIAL IN 2024-05-31 Spain Acceptable
2024-09-23
2024-09-23
2 SUBSTANTIAL MODIFICATION SM-1 2025-03-12 Spain Acceptable
2025-05-29
2025-05-29
3 SUBSEQUENT ADDITION OF MSC APP-3 2025-06-30 2025-08-20
4 SUBSTANTIAL MODIFICATION SM-2 2025-10-01 Spain Acceptable
2025-11-25
2025-11-26