CClinicalTrials.gg
Active, not recruitingNCT05070858NIMBLEUpdated Jul 8, 2026

A Study to Test How Safe Pozelimab and Cemdisiran Combination Therapy and Cemdisiran Alone Are and How Well They Work in Adult Patients With Generalized Myasthenia Gravis

A Phase 3 interventional study of Pozelimab + Cemdisiran and Cemdisiran in Generalized Myasthenia Gravis, sponsored by Regeneron Pharmaceuticals. Active, not recruiting at 116 sites in 19 countries. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-07-08.

Sponsored by Regeneron Pharmaceuticals · Phase 3, Interventional, and Treatment

Phase
Phase 3
Study type
Interventional
Enrollment
288
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

This study is researching the experimental drugs called pozelimab and cemdisiran, and cemdisiran monotherapy. The study is focused on patients with generalized Myasthenia Gravis (gMG). Myasthenia gravis is a disease that causes weakness and fatigue in muscles in the body because the nerves and muscles are not communicating properly.

The aim of the study is to see how effective pozelimab and cemdisiran are when used in combination and when pozelimab and cemdisiran are used alone for patients with gMG.

The study is looking at several other research questions, including:

  • What side effects may happen from taking the study drugs
  • How the study drugs work inside the body
  • How much of the study drugs are in the blood at different times
  • Whether the body makes antibodies against pozelimab and cemdisiran (which could make the drugs less effective or could lead to side effects)
Read the detailed description

DBTP- Double Blind Treatment Period (24 weeks) ETP - Extension Treatment Period (28 weeks) OLTP- Open Label Treatment Period (68 weeks) FUP-Off treatment Follow Up Period (52 weeks)

02

Conditions studied

  • Generalized Myasthenia Gravis

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03

In context

Myasthenia Gravis

324 studies on the registry are indexed under Myasthenia Gravis; 146 are open to participants now.

This study's enrollment of 288 is above the median of 44 across 212 interventional studies indexed under Myasthenia Gravis.

Browse Myasthenia Gravis studies →

Lead sponsor

Regeneron Pharmaceuticals is the lead sponsor of 400 studies on the registry; 91 are open to participants now.

Of its 120 completed or terminated interventional studies of FDA-regulated products, 77 (64%) 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

Eligibility criteria

Key Inclusion Criteria:

  1. Male or female participants ≥18 years of age at screening (or ≥ legal age of adulthood based on local regulations, whichever is older)
  2. Participant with documented diagnosis of Myasthenia Gravis (MG) based on medical history and supported by previous evaluations as described in the protocol
  3. Documented prior history of positive serologic test or a positive result during screening of Anti-acetylcholine Receptor (AChR) antibodies or anti-Lipoprotein Receptor-related Protein 4 (LRP4) antibodies.
  4. Myasthenia Gravis Foundation of America (MGFA) Clinical Classification Class II to IVa at screening
  5. Myasthenia Gravis-Activities of Daily Living (MG-ADL) score ≥6 at screening. Ocular items should not contribute more than 50% of MG-ADL total score as described in the protocol
  6. Currently receiving an acetylcholinesterase inhibitor or documented reason for not using acetylcholinesterase inhibitor therapy per investigator
  7. Currently receiving an Immunosuppressive Therapy (IST) for MG, or documented reason why the participant is not taking an IST per investigator
  8. If currently receiving an IST, not anticipated to have IST dosage changed before randomization or during Double-Blind Treatment Period (DBTP).
  9. Willing and able to comply with clinic visits and study-related procedures, including completion of the primary series of the meningococcal vaccinations required per protocol

Key Exclusion Criteria:

  1. Patients with antibody profile that is only positive for Muscle-Specific tyrosine Kinase (MuSK) (MuSK positivity is based on a documented prior history of positive serologic test for antibodies to MuSK or a positive result during screening
  2. History of thymectomy within 12 months prior to screening or planned during the study
  3. History of malignant thymoma (patients with stage 1 may be enrolled), or history of cancer within the past 5 years, except for adequately treated basal cell skin cancer, squamous cell skin cancer, or in situ cervical cancer
  4. Myasthenic crisis or MGFA Class V within 1 month of screening
  5. Not meeting meningococcal vaccination requirements and, at a minimum, documentation of quadrivalent meningococcal vaccination within 5 years prior to randomization and serotype B vaccine (when available) within 3 years prior to randomization as described in the protocol
  6. Known contraindication to meningococcal vaccines (group ACWY conjugate and group B vaccines) as described in the protocol
  7. Participants who require antibiotics for meningococcal prophylaxis and have a contraindication, warning, or precaution precluding the use of penicillin class and penicillin-alternative antibiotics planned to be used for prophylaxis, or a history of intolerance leading to the discontinuation of these antibiotics
  8. Positive hepatitis B surface antigen or hepatitis C virus Ribonucleic Acid (RNA) during screening. NOTE: Cases with unclear interpretation should be discussed with the medical monitor
  9. History of Human Immunodeficiency Virus (HIV) infection or a positive test at screening per local requirements

NOTE: Other protocol-defined Inclusion/ Exclusion Criteria apply

05

Study design

Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Quadruple (Participant, Care provider, Investigator, Outcomes assessor)
Enrollment
288 participants (actual)

Study arms

  • Experimental
    Group 1

    Placebo in DBTP; Re-randomized to Combination or Cemdisiran in ETP and OLTP

    Drug: Pozelimab + Cemdisiran · Drug: Cemdisiran · Other: Placebo

  • Experimental
    Group 2

    Combination regimen throughout the study. For participants who have not reached week 108 will receive cemdisiran monotherapy in the OLTP.

    Drug: Pozelimab + Cemdisiran · Drug: Cemdisiran

  • Experimental
    Group 3

    Cemdisiran throughout the study

    Drug: Cemdisiran

  • Experimental
    Group 4

    Pozelimab monotherapy in DBTP followed by combination in ETP and OLTP. For participants who have not reached week 108 will receive cemdisiran monotherapy in the OLTP.

    Drug: Pozelimab + Cemdisiran · Drug: Cemdisiran · Drug: Pozelimab

Interventions

  • DrugPozelimab + Cemdisiran

    Subcutaneous administration as described in the protocol

  • DrugCemdisiran

    SC administration as described in the protocol

    Also known as: ALN-CC5

  • OtherPlacebo

    SC administration as described in the protocol

  • DrugPozelimab

    SC administration as described in the protocol

    Also known as: REGN3918

06

What researchers measure

Primary outcomes

  1. Change in Myasthenia Gravis-Activities of Daily Living (MG-ADL) total score

    The total MG-ADL score ranges from 0 to 24 points, with higher scores indicating greater functional impairment and disability

    Time frame: From baseline to week 24

Secondary outcomes

  1. Change from baseline in Quantitative Myasthenia Gravis (QMG) score

    QMG total scores range from 0 to 39, with higher scores representing greater impairment

    Time frame: Week 24

  2. Achievement of a ≥3-point reduction (improvement) in MG-ADL total score

    Time frame: From baseline to week 24

  3. Achievement of a ≥5-point reduction (improvement) in QMG total score

    Time frame: From baseline to week 24

  4. Achievement of a consistent response on the MG-ADL

    A participant with a ≥2-point reduction (improvement) in MG-ADL total score on 2 or more consecutive assessments spanning 4 or more weeks during the DBTP

    Time frame: From baseline to week 24

  5. Achievement of Minimal Symptom Expression (MSE)

    Score of 0 to 1 on the MG-ADL

    Time frame: Week 24

  6. Change from baseline in the Myasthenia Gravis Composite (MGC) total score

    MGC score ranges from 0 to 50, with higher score indicating higher impairment

    Time frame: Week 24

  7. Change from baseline in Myasthenia Gravis Quality of Life (MG-QOL15r) total score

    Total score ranges from 0 to 30 points; a higher score represents greater impairment

    Time frame: Week 24

  8. Achievement of a ≥2-, 4-, 5-, 6-, 7-, 8-, 9-, or 10-point reduction on MG-ADL total score

    Time frame: From baseline to week 24

  9. Achievement of a ≥3-, 4-, 6-, 7-, 8-, 9-, or 10-point reduction on QMG

    Time frame: From baseline to week 24

  10. Incidence and severity of Treatment-Emergent Adverse Events (TEAEs) in participants treated with pozelimab + cemdisiran, cemdisiran monotherapy or placebo

    Time frame: Through week 24

  11. Incidence and severity of Serious Adverse Events (SAEs) in participants treated with pozelimab + cemdisiran, cemdisiran monotherapy or placebo

    Time frame: Through week 24

  12. Incidence and severity of Adverse Events of Special Interest (AESIs) in participants treated with pozelimab + cemdisiran, cemdisiran monotherapy or placebo

    Time frame: Through week 24

  13. Concentrations of total pozelimab in serum

    Time frame: Through study duration, approximate 172 weeks

  14. Concentrations of total Complement component 5 (C5) in plasma

    Time frame: Through study duration, approximate 172 weeks

  15. Concentrations of cemdisiran and its metabolites in plasma

    Time frame: Through study duration, approximate 172 weeks

  16. Incidence of treatment-emergent Anti-Drug Antibodies (ADAs) to pozelimab over time

    Time frame: Through study duration, approximately 172 weeks

  17. Incidence of treatment-emergent ADAs to cemdisiran over time

    Time frame: Through study duration, approximate 172 weeks

  18. Change in total complement hemolysis activity assay (CH50) over time

    Time frame: Through study duration, approximately 172 weeks

  19. Percent change in CH50 over time

    Time frame: Through study duration, approximately 172 weeks

07

Study locations

116 sites
  • HonorHealth Neurology 2018
    Scottsdale, Arizona 85251, United States
  • University of California Irvine
    Irvine, California 92697, United States
  • University of Southern California
    Los Angeles, California 90033, United States
  • Colorado Springs Neurological Associates
    Colorado Springs, Colorado 80907-5307, United States
  • SFM Clinical Research, LLC
    Boca Raton, Florida 33487, United States
  • Diverse Clinical Research
    Miami, Florida 33175, United States
  • Aqualane Clinical Research
    Naples, Florida 34105, United States
  • Neurological Services of Orlando
    Orlando, Florida 32806, United States
  • Medsol Clinical Research Center Inc
    Port Charlotte, Florida 33952, United States
  • University of South Florida Morsani Center for Advanced Healthcare
    Tampa, Florida 33612, United States
  • NorthShore University Health System
    Glenview, Illinois 60026-1301, United States
  • St. Elizabeth's Hospital
    O'Fallon, Illinois 62269, United States
  • Northwest Neurology Ltd. - Clinedge - PPDS
    Rolling Meadows, Illinois 60080, United States
  • Wayne State University School of Medicine
    Detroit, Michigan 48201, United States
  • Dayton Center for Neurological Disorders
    Centerville, Ohio 45459, United States
  • University of Cincinnati Gardner Neuroscience Institute
    Cincinnati, Ohio 45219, United States
  • Penn Medicine University City
    Philadelphia, Pennsylvania 19104, United States
  • National Neuromuscular Research Institute
    Austin, Texas 78759, United States
  • Nerve and Muscle Center of Texas
    Houston, Texas 77030, United States
  • Universitair Ziekenhuis Antwerpen
    Edegem, Antwerp 2650, Belgium
  • AZ Sint-Lucas
    Ghent, Oost-Vlaanderen 9000, Belgium
  • IMV Pesquisa Neurologica
    Porto Alegre, Rio Grande do Sul 90110-000, Brazil
  • Jordy Sinapse Medicina LTDA
    Itapevi, São Paulo 06655-250, Brazil
  • Faculdade de Medicina Do ABC
    Santo André, São Paulo 09060-870, Brazil
  • Pseg Centro de Pesquisa Clinica S.A
    São Paulo, 04038-002, Brazil
  • Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo
    São Paulo, 05403-010, Brazil
  • University of Alberta
    Edmonton, Alberta T6G 2X8, Canada
  • London Health Sciences Centre
    London, Ontario N6A 5A5, Canada
  • Toronto General Hospital
    Toronto, Ontario M5G2C4, Canada
  • Peking Union Medical College Hospital
    Beijing, Beijing Municipality 100032, China
  • Fujian Medical University Union Hospital
    Fuzhou, Fujian 350001, China
  • Guangdong Hospital of Traditional Chinese Medicine
    Guangdong, Guangdong 510120, China
  • Nanfang Hospital Southern Medical University
    Guangzhou, Guangdong 510120, China
  • The University of Hong Kong-Shenzhen Hospital
    Shenzhen, Guangdong 518053, China
  • The First Affiliated Hospital of Guangzhou University of Chinese Medicine
    Guangzhou, Guangzhou 510405, China
  • Hainan General Hospital
    Haikou, Hainan 570311, China
  • Renmin Hospital of Wuhan University - Hubei Provincial People's Hospital
    Wuhan, Hubei 430060, China
  • Xiangya Hospital Central South University
    Changsha, Hunan 410008, China
  • The First Hospital of Jilin University
    Changchun, Jilin 130000, China
  • Qilu Hospital of Shandong University (Qingdan)
    Qingdao, Shandong 266035, China
  • Huashan Hospital Fudan University
    Shanghai, Shanghai Municipality 201107, China
  • The Second Affiliated Hospital of the Chinese Peoples' Liberation Army Air Force Medical University
    Xi’an, Shanxi 710032, China
  • Sichuan Provincial People's Hospital
    Chengdu, Sichuan 610072, China
  • Tianjin Medical University General Hospital
    Tianjin, Tianjin Municipality 300050, China
  • Aalborg Universitetshospital
    Aalborg, North Denmark 09000, Denmark
  • Aarhus University Hospital
    Aarhus N, 8200, Denmark
  • Rigshospitalet, Copenhagen
    Copenhagen, 2100, Denmark
  • Odense Universitetshospital
    Odense, 05000, Denmark
  • Centre Hospitalier Universitaire de Nice
    Nice, Alpes Maritimes 6002, France
  • CHU Bicetre
    Le Kremlin-Bicêtre, 94275, France
  • Centre Hospitalier Regional Universitaire (CHRU) de Nancy
    Nancy, 54035, France
  • Hopital de la Pitie Salpetriere
    Paris, 75013, France
  • Israeli-Georgian Medical Research Clinic Healthycore, LTD
    Tbilisi, 0112, Georgia
  • LTD New Hospitals
    Tbilisi, 0114, Georgia
  • Pineo Medical Ecosystem
    Tbilisi, 0114, Georgia
  • LTD National Center of Urology Named after L. Managadze
    Tbilisi, 0144, Georgia
  • Multiprofile Clinic Consilium Medulla
    Tbilisi, 0186, Georgia
  • Friedrich Baur Institute
    München, Bavaria 80336, Germany
  • University Hospital Essen
    Essen, North Rhine-Westphalia 45127, Germany
  • Universitatsklinikum Munster
    Münster, North Rhine-Westphalia 48149, Germany
  • Universitatsklinikum Leipzig
    Leipzig, Saxony 04103, Germany
  • Charite - Universitatsmedizin Berlin
    Berlin, 10117, Germany
  • Universitatsklinikum Jena
    Jena, 07747, Germany
  • Government General Hospital, Guntur
    Guntur, Andhra Pradesh 522001, India
  • Institute of Neurosciences
    Surat, Gujarat 395001, India
  • Nizam's Institute of Medical Sciences (NIMS)
    Panjagutta, Hyderabad 500082, India
  • Kasturba Medical College (KMC)
    Udupi, Karnataka 576104, India
  • Amrita Institute of Medical Sciences and Research Centre (AIMS)
    Kochi, Kerala 682041, India
  • Deenanath Mangeshkar Hospital and Research Centre
    Pune, Maharashtra 411004, India
  • Seth G.S. Medical College & K.E.M. Hospital, Mumbai
    Pārel, Mumbai 400012, India
  • All India Institute of Medical Sciences New Delhi
    New Delhi, National Capital Territory of Delhi 110029, India
  • Polakulath Narayanan Renai Medicity Multi Specialty Hospital, Kochi
    Kochi, Punjab 141008, India
  • Christian Medical College & Hospital
    Ludhiana, Punjab 141008, India
  • Apex Hospital
    Jaipur, Rajasthan 302017, India
  • City Neuro Centre, Hyderabad
    Hyderabad, Telangana 500034, India
  • Bangalore Medical College and Research Institute (BMCRI) - Victoria Hospital
    Bangalore, 560002, India
  • Postgraduate Institute of Medical Education & Research
    Chandigarh, 160012, India
  • Azienda Ospedaliera Sant'andrea
    Rome, Lazio 00189, Italy
  • Fondazione IRCCS Di Rilievo Nazionale Istituto Nazionale Neurologico Carlo Besta
    Milan, Lombardy 20133, Italy
  • Azienda Ospedaliero Universitaria Pisana
    Pisa, Tuscany 56126, Italy
  • Azienda Ospedaliera Papa Giovanni XXIII
    Bergamo, 24127, Italy
  • Universita' Degli Studi di Roma La Sapienza
    Roma, 00161, Italy
  • Kobe City Medical Center General Hospital
    Kobe, Hyōgo 650-0047, Japan
  • Kochi Medical School Hospital
    Nankoku, Kochi 783-8505, Japan
  • Okinawa National Hospital
    Ginowan-Shi, Okinawa 901-2214, Japan
  • Okinawa Prefectural Nanbu Medical Center and Children's Medical Center
    Shimajiri, Okinawa 901-1193, Japan
  • Saitama Medical University, Saitama Medical Center
    Kawagoe, Saitama 350-8550, Japan
  • Medical Hospital of Tokyo Medical and Dental University
    Bunkyo, Tokyo 113-8519, Japan
  • Tokyo Medical University Hospital
    Shinjuku, Tokyo 160-0023, Japan
  • Nihon University Itabashi Hospital
    tabashi City, Tokyo 173-8610, Japan
  • Yamaguchi University Hospital
    Ube, Yamaguchi 755-8505, Japan
  • Chiba University Hospital
    Chiba, 260-8677, Japan
  • Hiroshima City Hiroshima Citiz
    Hiroshima, 730-8518, Japan
  • Japanese Red Cross Osaka Hospital
    Osaka, 543-8555, Japan
  • Clinical Research Center Spolka z Ograniczona Odpowiedzialnoscia Medic-R Sp.k
    Poznan, Greater Poland Voivodeship 61-731, Poland
  • NZOZ Neuro-kard
    Poznan, Greater Poland Voivodeship 61-853, Poland
  • Centrum Neurologii Klinicznej, Krakowska Akademia Neurologii
    Krakow, Lesser Poland Voivodeship 31-505, Poland
  • NeuroProtect
    Warsaw, Mazovian 01-684, Poland
  • Uniwersyteckie Centrum Kliniczne WUM, Centralny Szpital Kliniczny
    Warsaw, Mosavian 02-097, Poland
  • Gdanski Uniwersytet Medyczny
    Gdansk, Pomeranian Voivodeship 80-952, Poland

Showing the first 100 of 116 sites across 19 countries.

08

References and documents

Publications

  • Vu T, Habib AA, Jacob S, Mantegazza R, Murai H, Vissing J, Shaibani A, Levine T, Hussain Y, Meisel A, Adamczak-Ratajczak A, Ilkowski J, Sgobbi P, Guerreiro A, Luo S, Pavani R, Chaudhari U, Jalali N, DeVeaux M, Moore W, Meagher KA, Burczynski ME, Kokate S, Sherman S, Pawaskar D, Singh N, Souttou A, Sirulnik A, Perlee L, Yancopoulos GD, Howard JF Jr; NIMBLE Trial Investigators. Efficacy and safety of cemdisiran siRNA in myasthenia gravis (NIMBLE): a double-blind, randomised, placebo-controlled, phase 3 trial. Lancet. 2026 May 2;407(10540):1712-1725. doi: 10.1016/S0140-6736(26)00690-2. Epub 2026 Apr 21. PubMed 42030965 ↗

Individual participant data

Plan to share: Yes — All Individual Patient Data (IPD) that underlie publicly available results will be considered for sharing

Supporting information: Study protocol, Sap, Icf, Csr, Analytic code

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Jul 8, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT05070858
Lead sponsor
Regeneron Pharmaceuticals
Responsible party
Sponsor
First posted
Oct 7, 2021
Start date
Dec 14, 2021
Primary completion
Jul 8, 2025
Completion
Nov 11, 2028 (estimated)
Last update
Jul 8, 2026

Study contacts

Clinical Trial Management
study director · Regeneron Pharmaceuticals

Oversight

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

Not currently enrolling

This study is active, not recruiting, as verified in Jun 2026. You cannot join it, but the record below documents what was studied.

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