Abstract
Objective To evaluate the safety and efficacy of zilucoplan in an interim analysis of RAISE-XT (NCT04225871). Collating long-term clinical data will contribute to an increased understanding of the safety profile of zilucoplan in generalized myasthenia gravis (gMG).
Methods RAISE-XT, a Phase 3, multicenter, open-label extension study, recruited patients with gMG who participated in randomized Phase 2 (NCT03315130) and Phase 3 (NCT04115293) zilucoplan studies. All patients self-administered daily subcutaneous injections of 0.3 mg/kg zilucoplan. Primary outcome was incidence of treatment-emergent adverse events (TEAEs). Key secondary outcomes included Myasthenia Gravis Activities of Daily Living (MG-ADL) score.
Results 199 patients enrolled in RAISE-XT; 104 continued zilucoplan from their qualifying study (zilucoplan group) and 95 switched to zilucoplan from placebo (placebo-switch group). Median exposure at data cut-off was 253.0 (range 29–765) days. 169 (84.9%) patients experienced a TEAE; 46 (23.1%) patients experienced a serious TEAE. Most common TEAEs were headache and worsening of MG, both in 33 (16.6%) patients. At extension study Week 12, after 24 weeks of zilucoplan, the zilucoplan group achieved a least square mean change in MG-ADL score from double-blind study baseline of −6.30 (95% CI: −7.44, −5.15). MG-ADL reduction from baseline for the placebo-switch group, after 12 weeks of zilucoplan, was −6.32 (95% CI: −8.00, −4.65).
Conclusion In this interim analysis of RAISE-XT, zilucoplan demonstrated a favorable long-term safety profile. Efficacy in patients who had previously received zilucoplan continued to improve and was demonstrated for those who switched from placebo. The study is ongoing. Funding: UCB Pharma.