BeatMG: Phase II Trial of Rituximab In Myasthenia Gravis

Completed · Phase 2 · Has a placebo group

Conditions studied: Myasthenia Gravis

In brief

The specific primary objective of this study is to determine whether rituximab is a safe and beneficial therapeutic for Myasthenia Gravis (MG) that warrants further study in a phase III efficacy trial.

Key facts

Study ID

NCT02110706

Run by

Yale University

People needed

52

Starts

2014-05-01

Expected to finish

2018-05-01

Last updated by the study team

2020-03-06

Who can join

Age: 21 and older, up to 90. Sex: any. Healthy volunteers: not accepted.

You may qualify if…

• Subjects 21 to 90 years old
• Subjects must have generalized MG, defined as MGFA clinical classification grades 2 (mild), 3 (moderate), or 4 (severe, but not intubated) at the time of screening/randomization.
• Elevated AChR antibody titer
• Subject's signs and symptoms should not be better explained by another disease process.
• Subjects must be on a stable standard immunosuppressive regimen:
• Prednisone only: Prednisone dose must be at least 15mg/day (or the equivalent on alternate days), and the dose of prednisone must have been stable for at least 4 weeks (28 days) prior to the baseline visit.
• Prednisone plus another immunosuppressive therapy (IST). Immunosuppressive therapies other than prednisone, specifically azathioprine, mycophenolate mofetil, cyclosporine, tacrolimus or methotrexate, are permitted, but the dose must have been stable for at least 6 months prior to the baseline visit.
• (Note: The prednisone dose must be stable as defined in the prednisone only group. The IST dose must remain stable throughout the course of the study).
• Subjects must be willing to complete the study and return for follow-up visits.
• No history of thymoma, tumor, infection, or interstitial lung disease on chest CT, MRI, or chest x-ray. Note: Chest x-ray will be completed at screening to look of interstitial lung disease. A chest CT or MRI to evaluate for thymoma must be completed as part of prescreening.
• Able and willing to give written informed consent and comply with the requirements of the study protocol.
• Subjects must be able to give written informed consent before participating in this study. A copy of the signed consent must be kept in the subject's medical record.
• Men and women of reproductive potential must agree to use an acceptable method of birth control during treatment and for twelve months (1 year) after completion of treatment.

You may not qualify if…

• A history of chronic degenerative, psychiatric, or neurologic disorder other than MG that can produce weakness or fatigue.
• Other major chronic or debilitating illnesses within six months prior to study entry.
• Female subjects who are premenopausal and are:
• pregnant on the basis of a serum pregnancy test,
• breast-feeding, or
• not using an effective method of double barrier (1 hormonal plus 1 barrier method or 2 simultaneous barrier methods) or birth control (birth control pills, male condom, female condom, intrauterine device, Norplant, tubal ligation, or other sterilization procedures).
• Altered levels of consciousness, dementia, or abnormal mental status.
• Thymectomy in the previous six months.
• Subjects who have been medicated with immunosuppressive drugs not listed in inclusion #5 within the last 8 weeks (56 days) prior to the baseline visit
• Subjects who have been medicated with an immunosuppressive agent such as azathioprine, mycophenolate mofetil, cyclosporine, tacrolimus or methotrexate, that is withdrawn within 8 weeks (56 days) of the Baseline Visit.
• Subjects who have received IVIg or PLEX treatment within the last 4 weeks (28 days) prior to the baseline visit.
• Unstable dose or a stable dose of > 480 mg/day of pyridostigmine in 2 weeks prior to screening visit.
• Daily use of non-steroidal anti-inflammatory drugs (NSAIDs).
• History of renal or hepatic insufficiency or elevated liver enzymes (AST or ALT >2.5 x Upper Limit of Normal).
• History of bone marrow hypoplasia, leucopenia, thrombocytopenia, significant anemia, clinical or laboratory evidence of immunodeficiency syndromes.
• Forced Vital Capacity (FVC) <50% of percent predicted.
• General Safety \& Laboratory Exclusion Criteria
• ANC < 1.5 x 103 cells/microliter
• Hemoglobin: < 8.0 gm/dL
• Platelets: < 100,000/mm
• Positive Hepatitis B or C serology (Hep B surface antigen and Hep C antibody)
• History of positive HIV (HIV conducted during screening if applicable)
• Treatment with any investigational agent within 4 weeks of screening or 5 half-lives of the investigational drug (whichever is longer)
• Receipt of a live vaccine within 4 weeks prior to randomization
• Previous treatment with rituximab (MabThera® / Rituxan®)

Where it is running

• University of Alabama at Birmingham — Birmingham, Alabama, United States
• University of California - Davis — Davis, California, United States
• University of California - Los Angeles — Los Angeles, California, United States
• University of Colorado - Denver — Denver, Colorado, United States
• Yale School of Medicine, Department of Neurology — New Haven, Connecticut, United States
• University of Miami School of Medicine — Miami, Florida, United States
• Emory University — Atlanta, Georgia, United States
• Northwestern University — Evanston, Illinois, United States
• University of Kansas Medical Center — Kansas City, Kansas, United States
• Brigham & Women's Hospital — Boston, Massachusetts, United States
• Washington University — St Louis, Missouri, United States
• SUNY Downstate Medical Center — Brooklyn, New York, United States
• SUNY Buffalo — Buffalo, New York, United States
• Columbia University Medical Center — New York, New York, United States
• Weill Cornell Medical Center — New York, New York, United States
• University of Rochester — Rochester, New York, United States
• SUNY Stony Brook — Stony Brook, New York, United States
• Montefiore Medical Center — The Bronx, New York, United States
• University of Cincinnati — Cincinnati, Ohio, United States
• Ohio State University — Columbus, Ohio, United States
• Oregon Health and Science University — Portland, Oregon, United States
• University of Pittsburgh — Pittsburgh, Pennsylvania, United States
• University of Texas Southwestern Medical Center — Dallas, Texas, United States
• University of Utah — Salt Lake City, Utah, United States
• University of Virginia — Charlottesville, Virginia, United States

Full record on ClinicalTrials.gov

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