ClinicalTrials.gg
CompletedNCT03334058Updated Dec 14, 2020

A Study to Evaluate the Safety, PD, PK and Efficacy of ARGX-113 in Patients With Pemphigus

A Phase 2 interventional study of ARGX-113 in Pemphigus Vulgaris and Pemphigus Foliaceus, sponsored by argenx. Completed at 12 sites in 5 countries. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2020-12-14.

Sponsored by argenx · Phase 2, Interventional, and Treatment

Phase
Phase 2
Study type
Interventional
Enrollment
34
Allocation
Not applicable
Ages
18 Years and older
Sex
All
01

Study summary

The proposed study is an open-label, non-controlled, adaptive-design Phase II study to evaluate the safety, pharmacodynamics, pharmacokinetics, efficacy, and conditions of use (dosage, frequency of administration at maintenance) of ARGX-113 in patients with mild to moderate Pemphigus (Vulgaris or Foliaceus), either newly diagnosed or relapsing.

The total study duration for each patient is less than 6 months. It consists of a Screening period, an Induction, a maintenance treatment period followed by a treatment-free Follow-up (FU) period.

02

Conditions studied

  • Pemphigus Vulgaris
  • Pemphigus Foliaceus

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03

In context

Pemphigus

76 studies on the registry are indexed under Pemphigus; 18 are open to participants now.

This study's enrollment of 34 is above the median of 30 across 53 interventional studies indexed under Pemphigus.

Browse Pemphigus studies →

Lead sponsor

argenx is the lead sponsor of 87 studies on the registry; 29 are open to participants now.

Of its 22 completed or terminated interventional studies of FDA-regulated products, 16 (73%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  1. Male or female patients aged ≥ 18 years.
  2. Clinical diagnosis of PV or PF, that has been confirmed by positive direct immunofluorescence and by positive indirect immunofluorescence and/or ELISA.
  3. Mild to moderate disease severity (PDAI \< 45).
  4. Newly diagnosed patients or relapsing patients off therapy with or without a first course of prednisone of maximum 4 weeks, and for whom an initial period of ARGX-113 monotherapy is judged clinically acceptable; or newly diagnosed patients or relapsing patients off therapy on a first course of oral prednisone at stable dose for at least 2 weeks and for whom ARGX-113 monotherapy is considered not clinically acceptable; or patients who relapse despite oral prednisone at tapered dose +/- a conventional (e.g. azathioprine, mycophenolate mofetil).
  5. Identified serum levels of autoantibodies directed against Dsg 3 and/or Dsg-1 antigens at screening, using indirect immunofluorescence or ELISA.
  6. Ability to understand the requirements of the study, provide written (including consent for the use and disclosure of research-related health information), and comply with the study protocol procedures (including required study visits).

Exclusion criteria

Exclusion Criteria:

  1. Pregnant and lactating women, and those intending to become pregnant during the study or within 90 days after the last dosing. Women of should have a negative serum pregnancy test at Screening and a negative urine pregnancy test at Baseline, prior to administration of IMP.
  2. Male patients who are sexually active that do not intend to use effective methods of during the study or within 90 days after the last dosing.
  3. Confirmed diagnosis of paraneoplastic pemphigus, drug-induced pemphigus or any other non-PV/non-PF blistering disease.
  4. History of disease to active therapy (e.g. intravenous polyvalent human immunoglobulins [IVIg], rituximab, plasma exchange/ immunoadsorption).
  5. Use of therapies other than oral prednisone and conventional , that can interfere in the clinical course of the disease (e.g. intravenous [IV] prednisolone bolus, dapsone, sulfasalazine, tetracyclines, nicotinamide, plasmapheresis/ plasma exchange, immunoadsorption and IVIg) within 2 months prior to Baseline visit.
  6. Use of rituximab and other CD20 target biologics within 6 months prior to Baseline visit.
  7. History of anaphylactic reaction, or a known reaction to one of the components of the IMP.
  8. History of vaccination within the last 4 weeks prior to Baseline visit, or with a planned vaccination during the study, with the exception of seasonal vaccination (e.g. influenza vaccine).
  9. Recent serious infection (i.e., requiring injectable antimicrobial therapy or hospitalization) within the 8 weeks prior to Baseline visit.
  10. Known active or chronic viral infection with virus (HBV); refer to the Centers for Disease Control and Prevention (CDC) guidelines.
  11. Known seropositive or active infection with virus (HCV).
  12. Known history of or known viral infection with (HIV 1 and 2 antibodies).
  13. (BMI) at Screening > 35,0 kg/m2.
  14. Clinical evidence of significant active, unstable or uncontrolled concomitant disease (e.g. cardiovascular, pulmonary, hematologic, gastrointestinal, endocrinological and metabolic, hepatic, renal, neurologic, , infectious diseases, coagulopathies, other autoimmune disease) or condition (lack of peripheral venous access, recent major surgery, etc), which, in the opinion of the investigator, puts the patient at undue risk or may affect the interpretation of the results.
  15. Patients in general health condition not allowing study participation ( index \< 60%; see Appendix 14.2).
  16. At Screening, have laboratory abnormalities as below:

    1. (AST) or alanine aminotransferase (ALT) > 3 × (ULN)
    2. Total serum of > 1.5 x ULN (except for Grade 1 hyperbilirubinemia as defined by the National Cancer Institute (NCI-CTCAE), due solely to a documented medical diagnosis of Gilbert's syndrome)
    3. Serum creatinine of > 1.5 mg/dL or \< 50 mL/min (using the Chronic Kidney Disease Epidemiology Creatinine formula)
    4. (Hb) ≤ 9 g/dL
    5. (INR) > 1.5 or activated partial thromboplastin time (aPTT) > 1.5 x ULN
    6. Total immunoglobulin G (IgG) level \< 6 g/L
    7. Presence of > 1 + proteinuria dipstick
  17. Patient having participated in another interventional study within the last 3 months prior to Baseline visit.
Terms in these criteria, in plain language(22)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Immunosuppression

A weakened immune system. It can come from an illness, such as HIV or some blood cancers, or from medicines that turn the immune system down, for example after an organ transplant or for an autoimmune disease; steroids at higher doses count.

Read whether the line is about a condition or about medicines, and which medicines and doses it means.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

Childbearing potential

Able to become pregnant: from the first period until menopause, unless permanently unable to through surgery (removal of the womb, or of both ovaries or both fallopian tubes).

Criteria for people of childbearing potential usually ask for a negative pregnancy test and for contraception during the study and for a time after it.

Contraception

Ways of preventing pregnancy. “Highly effective” methods fail less than 1% of the time a year when used correctly — for example an IUD or an implant.

Criteria usually say which methods count and how long to keep using them after the last dose, sometimes for male participants too. Some studies accept a partner’s vasectomy if it was confirmed successful and that person is the participant’s only sexual partner.

Autoimmune disease

A condition in which the immune system attacks the body’s own tissues, such as rheumatoid arthritis, lupus, psoriasis, type 1 diabetes or inflammatory bowel disease.

Immunotherapy studies often leave out active autoimmune disease, and some name exceptions, such as thyroid disease on replacement hormone. Check the exceptions this study lists.

Relapsed and refractory

Relapsed: the illness came back after treatment had worked. Refractory: it did not respond to treatment, or stopped responding while still on it.

Line of therapy

A line of therapy is one course of treatment, which may combine several drugs. First-line is the first course given; second-line follows when that stops working or is not tolerated.

“Two prior lines” means two courses that count separately under the study’s rules — not simply two drugs. Ask the study team if you are unsure how yours are counted.

Hypersensitivity

An allergy, or another reaction of the immune system, to a substance. “Hypersensitivity to the study drug” means a known allergic reaction to it — not every side effect a medicine can have.

Hepatitis B tests

Hepatitis B is a virus that infects the liver. These are separate tests: HBsAg positive usually means a current infection (a recent vaccination can briefly cause it too); total anti-HBc (HBcAb) positive means an infection now or in the past; HBV DNA measures how much virus is in the blood.

Some studies accept a past infection if HBV DNA is undetectable, sometimes with antiviral medicine during the study. Check what this study allows.

Hepatitis C tests

Hepatitis C is a virus that infects the liver. An HCV antibody test can stay positive after an infection has cleared (and is occasionally positive without one); an HCV RNA test shows whether the virus is there now.

After treatment, hepatitis C counts as cured when HCV RNA is still undetectable 12 weeks or more after the treatment ended. Studies often accept people cured this way.

HIV

The human immunodeficiency virus, which weakens the immune system.

Many studies now accept people whose HIV is controlled on treatment, judged by the viral load and the CD4 count. Check the limits this study sets.

BMI (body mass index)

Weight in kilograms divided by height in metres squared. Example: 70 kg and 1.75 m gives 70 ÷ (1.75 × 1.75) ≈ 22.9.

What counts as overweight or obesity differs between countries (some use lower cut-offs), so go by the range the study states.

Cancer (malignancy)

Malignancy means cancer. Criteria about another or earlier malignancy ask whether you have had a different cancer, usually within a set number of years.

Some are commonly allowed, such as treated skin cancers other than melanoma and early cancers removed completely — check the exceptions this study lists.

Karnofsky performance status (KPS)

A 0–100 scale of how well someone can carry out everyday activities. 100 is no complaints and no signs of illness; 70 is able to look after yourself but not to work or keep up normal activity; 50 is needing considerable help and frequent medical care.

Studies often ask for 60 or 70 and above. Your doctor gives the score.

Clinically significant

Judged by the study doctor to matter for your health or for the study. It is a doctor’s decision, so ask the study team if you are unsure whether something counts.

ALT and AST (liver enzymes)

Two enzymes measured in a routine blood test of the liver. Higher levels can mean the liver is under strain or damaged. SGPT and SGOT are older names for ALT and AST.

Criteria usually give a limit as a multiple of the upper limit of normal (ULN), often higher when cancer has spread to the liver.

ULN (upper limit of normal)

The top of the normal range for a blood test, as set by the laboratory that runs it. Each lab prints its own range next to your result.

“≤ 2.5 × ULN” means the result can be up to two and a half times that top value.

Bilirubin

A yellow substance made when red blood cells are broken down, which the liver clears. A high level can mean a problem with the liver or the bile ducts.

Criteria often allow more for people with Gilbert’s syndrome, a harmless inherited condition that raises bilirubin.

CTCAE grade

The US National Cancer Institute’s scale of how severe an adverse event is — any unwanted medical event during a study, such as a symptom, an illness or an abnormal test result, whether or not a treatment caused it. Whether it did is judged separately.

1
Mild.
2
Moderate.
3
Severe.
4
Life-threatening.
5
Death due to the event.

“Side effects of earlier treatment resolved to grade 1 or less” means they have settled to mild or gone.

Creatinine clearance (CrCl)

How quickly the kidneys clear creatinine, a waste product, from the blood. A study may estimate it from a blood test with age, weight and sex (often by the Cockcroft–Gault formula), or measure it using blood and urine collected over a set time. Given in mL/min; higher is better.

Hemoglobin (Hb)

The protein in red blood cells that carries oxygen. A low level is anaemia, which can cause tiredness and breathlessness. Measured in g/dL or g/L (9 g/dL is 90 g/L).

INR, PT and aPTT (clotting tests)

Blood tests of how long blood takes to clot. The INR is the prothrombin time (PT) put on a common scale; about 1 is usual for someone not taking a blood thinner.

Criteria often make an exception for people on a blood thinner such as warfarin, whose INR is raised on purpose.

05

Study design

Phase
Phase 2
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
34 participants (actual)

Study arms

  • Experimental
    ARGX-113

    Drug: ARGX-113

Interventions

  • human IgG1-derived Fc fragment that binds to human neonatal Fc receptor (FcRn)

06

What researchers measure

Primary outcomes

  1. Safety and tolerability as measured by the incidence and severity of treatment-emergent (serious) adverse events over the study.

    Time frame: Up to 6 months

Secondary outcomes

  1. Evaluation of serum levels of total IgG and subtypes (IgG1, IgG2, IgG3, IgG4)

    Time frame: Up to 6 months

  2. Evaluation of serum levels of anti Dsg-1 and -3 autoantibodies

    Time frame: Up to 6 months

  3. Pemphigus Disease Area Index (PDAI)

    The score has a range from 0 to 263, the higher the score, the more severe the disease.

    Time frame: Up to 6 months

  4. Time to disease control (DC), control being defined as the absence of new lesions and established lesions beginning to heal

    Time frame: Up to 6 months

  5. Time until relapse, relapse being defined as the appearance of 3 or more new lesions a month that do not heal spontaneously within 1 week, or as the extension of established lesions

    Time frame: Up to 6 months

  6. Pharmacokinetic parameters of ARGX 113: Tmax

    Time frame: Up to 6 months

  7. Pharmacokinetic parameters of ARGX 113: Cmax

    Time frame: Up to 6 months

  8. Incidence of anti-drug antibodies (ADA) to ARGX 113

    Time frame: Up to 6 months

07

Study locations

12 sites
  • University of Lübeck and UKSH, Department of Dermatology and Lübeck Institute of Experimental Dermatology
    Lübeck, Germany
  • Clinic of Dermatology and Allergology - Philipps University Marburg
    Marburg, Germany
  • University of Debrecen Medical Center Department of Dermatology
    Debrecen, Hungary
  • University of Pécs Clinical Center , Department of Dermatology, Venerology and Oncodermatology
    Pécs, Hungary
  • University of Szeged Faculty of Medicine Albert Szent-Györgyi Medical Center Department of Dermatology and Allergology
    Szeged, Hungary
  • HaEmek Medical center, Dermatology Department
    'Afula, Israel
  • Department of Dermatology, The Chaim Sheba Medical Center
    Tel Aviv, Israel
  • Department of dermatology, The Tel Aviv Sourasky Medical Center
    Tel Aviv, Israel
  • Dermopathic Institute of the Immaculate - Foundation "Luigi Maria Monti"
    Rome, Italy
  • Foundation Policlinico A. Gemelli - Dermatology Department
    Rome, Italy
  • National Medical University named after O.O.Bohomolets, Department of Dermatology and Venereology based on Oleksandrivska Clinical Hospital of Kyiv City, Department of Dermatology
    Kyiv, Ukraine
  • Municipal Institution "Zaporizhzhya Regional Dermatology and Venereology Clinical Dispensary" of Zaporizhzhya Regional Council
    Zaporizhzhya, Ukraine
08

References and documents

Publications

  • Maho-Vaillant M, Sips M, Golinski ML, Vidarsson G, Goebeler M, Stoevesandt J, Bata-Csorgo Z, Balbino B, Verheesen P, Joly P, Hertl M, Calbo S. FcRn Antagonism Leads to a Decrease of Desmoglein-Specific B Cells: Secondary Analysis of a Phase 2 Study of Efgartigimod in Pemphigus Vulgaris and Pemphigus Foliaceus. Front Immunol. 2022 May 18;13:863095. doi: 10.3389/fimmu.2022.863095. eCollection 2022. PubMed 35663943 ↗
  • Goebeler M, Bata-Csorgo Z, De Simone C, Didona B, Remenyik E, Reznichenko N, Stoevesandt J, Ward ES, Parys W, de Haard H, Dupuy P, Verheesen P, Schmidt E, Joly P; ARGX-113-1701 Investigator Study Group. Treatment of pemphigus vulgaris and foliaceus with efgartigimod, a neonatal Fc receptor inhibitor: a phase II multicentre, open-label feasibility trial. Br J Dermatol. 2022 Mar;186(3):429-439. doi: 10.1111/bjd.20782. Epub 2021 Nov 28. PubMed 34608631 ↗
09

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reached

Ran from Oct 2017 to primary completion in Oct 2020, 36 months.

How these figures are worked out, and which studies are left out of them.

Registered
Oct 23, 2017
First posted
Nov 7, 2017
StartActual
Oct 18, 2017
Primary completionActual
Oct 28, 2020
CompletionActual
Oct 28, 2020
Last update
Dec 14, 2020
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Dec 14, 2020, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT03334058
Lead sponsor
argenx
Responsible party
Sponsor
First posted
Nov 7, 2017
Start date
Oct 18, 2017
Primary completion
Oct 28, 2020
Completion
Oct 28, 2020
Last update
Dec 14, 2020

Study contacts

Patrick Dupuy, MD
study director · argenx

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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Studies of the drug tested here: Efgartigimod alfa

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