Primary Sjögren's Syndrome
Conditions
Brief summary
Efgartigimod has the potential to improve disease manifestations by the reduction of IgG autoantibodies in Sjogren's Syndrome (SjD or pSS). This open-label extension study will evaluate the long-term safety of efgartigimod in participants with SjD who have completed the treatment period of the qualifying efgartigimod study (ARGX-113-2106).
Interventions
BIOLOGICALEfgartigimod
Patients receiving efgartigimod infusions
Sponsors
argenx
Iqvia Pty Ltd
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Is at least the legal age of consent for clinical trials when signing the ICF * Is capable of providing signed informed consent and complying with protocol requirements * Agrees to use contraceptive measures consistent with local regulations and the following: WOCBP must have a negative urine pregnancy test at baseline before receiving IMP * Has completed the qualifying efgartigimod SjD studies and agrees to continue study drug treatment without interruption in the extension study
Exclusion criteria
* Clinically significant disease (including newly diagnosed malignancy or cardiovascular disease) 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 * Pregnant or intention to become pregnant during the study * Any severe systemic SjD manifestation that may put the participant at undue risk based on the investigator's opinion
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Number of Participants With TEAEs, TESAEs and TEAESIs | From the first dose of study drug (Day 1) up to 60 days post last study drug, approximately 56 weeks | An adverse event (AE) was any untoward medical occurrence in a clinical study participant, temporally associated with the use of study drug, whether or not considered related to the study drug. A serious adverse event (SAE) was any untoward medical occurrence that, at any dose: 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 any other medically important event. Treatment-emergent adverse events (TEAEs) were defined as AEs with onset on or after the first administration of study drug up to and including 60 days after the last study drug administration. Adverse events in the 'Infections and infestations' SOC were defined as AE of Special Interest (AESIs) because efgartigimod causes a transient reduction in total IgG levels. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Number of CRESS Responders at Weeks 24 and 48 | Weeks 24 and 48 | A composite of relevant endpoints for Sjögren's syndrome (CRESS) measures systemic disease activity, patient-reported symptoms, tear gland function, salivary gland function, and serology, developed to assess treatment efficacy in participants with SjD. A responder is defined as improvement in at least 3 of the above mentioned 5 items of CRESS. The score ranges from 0 to 9 (higher score = worse symptoms). Responder rates for the efgartigimod-efgartigimod group in the follow-up study are supplemental to those in the antecedent study (ARGX-113-2106). Because responders from the ARGX-113-2106 study (mainly in the efgartigimod-efgartigimod group) potentially started the ARGX-113-2211 with lower baseline scores, further improvement on this efficacy measure is inherently challenging due to clinical and biological limitations. |
| Number of Participants With Minimal Clinically Important Improvement From Baseline in ESSDAI at Weeks 24 and 48 | Baseline (Day 1) and Weeks 24 and 48 | European alliance of associations for rheumatology (EULAR) SjD activity index (ESSDAI) measures systemic disease activity in 12 domains. The activity levels of each domain are multiplied by their respective weights to obtain the total score between 0 and 123 (higher score = worse symptoms). Minimally clinically important improvement in ESSDAI was defined as improvement of at least 3 points in ESSDAI score at Weeks 24 and 48. Baseline was defined as the last available non-missing measurement from the parent study ARGX-113-2106. Responder rates for the efg-efg group in the follow-up study are supplemental to those in the ARGX-113-2106 study. Because responders from the ARGX-113-2106 study (mainly in the efg-efg group) potentially started the ARGX-113-2211 with lower baseline scores, further improvement on this efficacy measure is inherently challenging due to clinical and biological limitations. |
| Number of Participants With Low Disease Activity in ESSDAI at Weeks 24 and 48 | Weeks 24 and 48 | ESSDAI measures systemic disease activity in participants with SjD and consists of 12 domains. The activity levels of each domain (range: 0-3 points) are multiplied by their respective weights (range: 1-6 points) to obtain the total score between 0 and 123 (higher score = worse symptoms). Low disease activity in ESSDAI was defined as ESSDAI score of less than 5 at Weeks 24 and 48. Responder rates for the efgartigimod-efgartigimod group in the follow-up study are supplemental to those in the antecedent study (ARGX-113-2106). Because responders from the ARGX-113-2106 study (mainly in the efgartigimod-efgartigimod group) potentially started the ARGX-113-2211 with lower baseline scores, further improvement on this efficacy measure is inherently challenging due to clinical and biological limitations. |
| Number of Participants With Minimal Clinically Important Improvement From Baseline in clinESSDAI at Weeks 24 and 48 | Baseline (Day 1) and Weeks 24 and 48 | Clinical EULAR Sjögren's syndrome disease activity index (clinESSDAI) includes same 11 organ-specific domains as ESSDAI but with different domain weighting and this scale does not have biological domain.This way any change in clinESSDAI score reflects disease specific features irrespective of B-cell activity. clinESSDAI score ranges between 0-135 (higher score=worse symptoms).Minimal clinically important improvement in clinESSDAI was defined as improvement of at least 3 points in clinESSDAI score at Weeks 24 and 48.Baseline=last available non-missing measurement from parent study ARGX-113-2106.Responder rates for efgartigimod-efgartigimod group in follow-up study are supplemental to those in antecedent study (ARGX-113-2106).Because responders from ARGX-113-2106 study (mainly in efgartigimod-efgartigimod group) potentially started ARGX-113-2211 with lower baseline scores,further improvement on this efficacy measure is inherently challenging due to clinical and biological limitations. |
| Number of Participants With Low Disease Activity in clinESSDAI at Weeks 24 and 48 | Weeks 24 and 48 | clinESSDAI includes the same 11 organ-specific domains as ESSDAI but with different domain weighting and this scale does not have the biological domain. This way any change in clinESSDAI score reflects 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 Weeks 24 and 48. Responder rates for the efgartigimod-efgartigimod group in the follow-up study are supplemental to those in the antecedent study (ARGX-113-2106). Because responders from the ARGX-113-2106 study (mainly in the efgartigimod-efgartigimod group) potentially started the ARGX-113-2211 with lower baseline scores, further improvement on this efficacy measure is inherently challenging due to clinical and biological limitations. |
| Number of Participants With Minimal Clinically Important Improvement From Baseline in ESSPRI at Weeks 24 and 48 | Baseline (Day 1) and Weeks 24 and 48 | EULAR Sjögren's syndrome patient-reported index (ESSPRI) is a questionnaire developed to measure self-reported symptoms in participants with SjD and consists of 3 items that measure dryness, fatigue, and pain. The total global score ranges from 0 to 10 by averaging the numeric scores for pain, fatigue, and dryness, with higher scores indicating more symptoms. Minimal clinically important improvement in ESSPRI was defined as decrease of 1 point or at least \>=15% at Weeks 24 and 48. Baseline was defined as the last available non-missing measurement from the study ARGX-113-2106. Responder rates for the efg-efg group in the follow-up study are supplemental to those in the ARGX-113-2106 study. Because responders from the ARGX-113-2106 study (mainly in the efg-efg group) potentially started the ARGX-113-2211 with lower baseline scores, further improvement on this measure is inherently challenging due to biological and clinical limitations. |
| Change From Baseline in ESSDAI Score at Weeks 24 and 48 | Baseline (Day 1) and Weeks 24 and 48 | ESSDAI measures systemic disease activity in participants with SjD and consists of 12 domains: 11 organ-specific domains (cutaneous, pulmonary, renal, articular, muscular, peripheral nervous system, central nervous system, hematological, glandular, constitutional, and lymphadenopathic) and 1 biological domain reflecting B-cell activity that contributes to disease activity level scoring. The activity levels of each domain (range: 0-3 points) are multiplied by their respective weights (range: 1-6 points) to obtain the total score between 0 and 123 (higher score = worse symptoms). Baseline was defined as the last available non-missing measurement from the parent study ARGX-113-2106. |
| Change From Baseline in clinESSDAI Score at Weeks 24 and 48 | Baseline (Day 1) and Weeks 24 and 48 | clinESSDAI includes the same 11 organ-specific domains as ESSDAI but with different domain weighting and this scale does not have the biological domain. This way any change in clinESSDAI score reflects disease specific features irrespective of B-cell activity. The clinESSDAI score ranges between 0-135 (higher score = worse symptoms). Baseline was defined as the last available non-missing measurement from the parent study ARGX-113-2106. |
| Change From Baseline in ESSPRI Score at Weeks 24 and 48 | Baseline (Day 1) and Weeks 24 and 48 | ESSPRI is a questionnaire developed to measure self-reported symptoms in participants with SjD and consists of 3 items that measure dryness, fatigue, and pain. Each item includes a numeric rating scale ranging from 0: no symptoms (dryness, fatigue, or pain) to 10: maximal imaginable (dryness, fatigue, or pain). The total global score ranges from 0 to 10 and the ESSPRI is calculated by averaging the numeric scores for pain, fatigue, and dryness, with higher scores indicating more symptoms. Baseline was defined as the last available non-missing measurement from the parent study ARGX-113-2106. |
| Number of STAR Responders at Weeks 24 and 48 | Weeks 24 and 48 | Sjögren's tool for assessing response (STAR) is a composite endpoint assessing multiple clinically relevant disease features. A STAR responder is defined as a participant with a score of at least 5 points. Due to the weighting, participant 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). Responder rates for the efgartigimod-efgartigimod group in the follow-up study are supplemental to those in the antecedent study (ARGX-113-2106). Because responders from the ARGX-113-2106 study (mainly in the efgartigimod-efgartigimod group) potentially started the ARGX-113-2211 with lower baseline scores, further improvement on this efficacy measure is inherently challenging due to clinical and biological limitations. |
| Percent Change From Baseline in Total IgG Levels in Serum at Week 48 | Baseline (Day 1) and Week 48 | Blood samples were collected at indicated timepoints to assess the total Immunoglobulin (Ig)G levels in serum. Total IgG concentrations were quantified using validated methods at a diagnostical laboratory. Baseline was defined as the last available non-missing measurement from the parent study ARGX-113-2106. |
| Percent Change From Baseline in Autoantibodies in Serum at Week 48 | Baseline (Day 1) and Week 48 | Blood samples were collected at indicated timepoints to assess serum autoantibodies: anti-Ro/Sjögren's syndrome-related antigen A (SS-A) and anti-La/Sjögren's syndrome-related antigen B (SS-B). Baseline was defined as the last available non-missing measurement from the parent study ARGX-113-2106. |
| Serum Concentrations of Efgartigimod | Pre-dose and post-dose at Baseline (Day 1) and pre-dose at Weeks 24 and 48 | Serum samples were collected at indicated timepoints to assess the pharmacokinetic (PK) profile of efgartigimod. |
| Number of Participants With ADA Against Efgartigimod Over the 48-week Treatment Period | From Baseline (Day 1) up to 48 weeks | Blood samples were collected to assess anti-drug antibodies (ADAs) against efgartigimod. Samples were analyzed by the designated laboratory in a 3-tiered approach using validated immunogenicity assays. ADA incidence included total number of participants with treatment-boosted and treatment-induced ADA. 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. Number of participants with ADA incidence is presented here. |
Countries
Belgium, Hungary, Poland
Participant flow
Recruitment details
This open-label, multicenter extension study was conducted at 11 sites in Belgium, Hungary, and Poland in adult participants with Sjögren's disease (SjD) who completed parent efgartigimod study ARGX-113-2106 (NCT05817669).
Pre-assignment details
The study consisted of a treatment period (48 weeks) in which all participants received efgartigimod. A total of 24 participants were treated in this study.
Baseline characteristics
| Characteristic | — |
|---|---|
| Age, Continuous | 51.2 years STANDARD_DEVIATION 13.09 |
| Ethnicity (NIH/OMB) Hispanic or Latino | 0 Participants |
| Ethnicity (NIH/OMB) Not Hispanic or Latino | 7 Participants |
| Ethnicity (NIH/OMB) Unknown or Not Reported | 0 Participants |
| Race (NIH/OMB) American Indian or Alaska Native | 0 Participants |
| Race (NIH/OMB) Asian | 0 Participants |
| Race (NIH/OMB) Black or African American | 0 Participants |
| Race (NIH/OMB) More than one race | 0 Participants |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | 0 Participants |
| Race (NIH/OMB) Unknown or Not Reported | 0 Participants |
| Race (NIH/OMB) White | 24 Participants |
| Sex: Female, Male Female | 23 Participants |
| Sex: Female, Male Male | 1 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | 0 / 17 | 0 / 7 |
| other Total, other adverse events | 15 / 17 | 6 / 7 |
| serious Total, serious adverse events | 0 / 17 | 2 / 7 |
Outcome results
None listed