Clinical trial • Phase I/II • Neurology|Rare Disease
IM-101 for Generalized myasthenia gravis|Ocular myasthenia gravis
Phase I/II trial of IM-101 for Generalized myasthenia gravis|Ocular myasthenia gravis.
Overview
- Trial Therapeutic Area
- Neurology|Rare Disease
- Trial Disease
- Generalized myasthenia gravis|Ocular myasthenia gravis
- Trial Stage
- Phase I/II
- Drug Modality
- Peptide/protein/enzyme
Key dates
- Initial CTIS Submission Date
- 16-10-2025
- First CTIS Authorization Date
- 18-02-2026
Trial design
Randomised, 0.9% sodium chloride (normal saline) intravenous (placebo)-controlled, adaptive Phase I/II trial in Bulgaria, Italy, Spain and others.
- Randomised
- Yes
- Comparator
- 0.9% Sodium Chloride (Normal Saline) intravenous (placebo)
- Adaptive
- True, Part A is a Multiple Ascending Dose (3 ascending dose regimens, each with 3 administrations) design with dose-escalation cohorts followed by Part B expansion cohorts; escalation based on safety/tolerability assessments.
- Biomarker Stratified
- True, AChR antibody status (AChR antibody-positive vs AChR antibody-negative) and separate ocular (oMG) versus generalized (gMG) cohorts
- Single Multiple Or Escalation Dose Combined
- Yes
- Target Sample Size
- 52
- Trial Duration For Participant
- 112
Eligibility
Recruits 52 No vulnerable populations selected. Participants must be adults (aged ≥ 18 and < 75) and 'Able and willing to provide signed informed consent' (inclusion criteria). Consent is obtained from participants themselves; no assent or minor consent procedures are specified..
- Pregnancy Exclusion
- Pregnant, breastfeeding, or intending to conceive during the course of the study
- Vulnerable Population
- No vulnerable populations selected. Participants must be adults (aged ≥ 18 and < 75) and 'Able and willing to provide signed informed consent' (inclusion criteria). Consent is obtained from participants themselves; no assent or minor consent procedures are specified.
Inclusion criteria
- {"criterion_text":"- All Participants Able and willing to provide signed informed consent and willing to travel to the investigational sites for study visits and fulfill logistical requirements of study\n- Female participants of childbearing potential (ie, women who are not postmenopausal or who have not had a hysterectomy, bilateral oophorectomy, or bilateral tubal ligation) and male participants who have not been surgically sterilized by a vasectomy must use a reliable and highly effective contraception method throughout the study and for 3 months after the last dose of study intervention\n- Female participants of childbearing potential must have a negative serum pregnancy test at screening and a negative urine pregnancy test within 24 hours prior to the first dose of study intervention\n- All gMG Participants Myasthenia Gravis – Activities of Daily Living (MG-ADL) total score ≥ 6 at both screening and randomization, with at least 50% of the score attributed to non-ocular elements\n- All gMG Participants Myasthenia Gravis Foundation of America (MGFA) Class II to IVa classification.\n- AChR Antibody-positive gMG Participants Only Must have anti-AChR binding antibody.\n- AChR Antibody-negative gMG Participants Only AChR-binding antibody negative.\n- oMG Participants Only MGFA Clinical Classification Class I\n- oMG Participants Only MG-ADL total score 3 to 6 at both screening and randomization, assigned exclusively to ocular elements.\n- Willingness to consent to screening for genetic muscular diseases (mitochondrial myopathy, oculopharyngeal muscular dystrophy, congenital myasthenia syndrome, and progressive external ophthalmoplegia)\n- Male or female aged ≥ 18 years and < 75 years\n- Has no known weakness in infancy and develop muscle weakness after aged 16 years and diagnosed with acquired MG at least 6 months (180 days) prior to the date of the screening visit (signing of informed consent)\n- Diagnosed with MG, confirmed through: a. Abnormal neuromuscular transmission demonstrated by single fiber electromyography or repetitive nerve stimulation, or b. Positive response to an AChEI test (eg, edrophonium chloride test), or c. Improvement of signs or symptoms related to MG during treatment with an oral acetylcholinesterase inhibitor, as determined by the treating physician (pyridostigmine or neostigmine or edrophonium test)\n- Body weight ≥ 40 kg at screening\n- On a stable dose of background therapy for the treatment of MG for the time periods specified below, with no changes to the regimen expected during the treatment period: a. Oral corticosteroids: stable for ≥ 4 weeks before Day 1 with the daily dose not exceeding 20 mg/day for prednisone/prednisolone or 16 mg/day for methylprednisolone. b. Acetylcholinesterase inhibitors: stable for ≥ 4 weeks prior to randomization c. Azathioprine, mycophenolate mofetil, methotrexate: receiving for ≥ 6 months prior to screening, with a stable dose for ≥ 3 month prior to randomization. If discontinued prior to screening, participants must have stopped azathioprine, mycophenolate mofetil or methotrexate ≥ 12 weeks prior to Day 1\n- Vaccinated against meningococcal infection (Neisseria meningitidis) within 1 year of screening, and at least 2 weeks prior to Day 1 (participants must have received 2 doses of vaccine to be considered vaccinated)\n- Vaccinated against streptococcus pneumoniae, and haemophilus influenzae type B according to local standard"}
Exclusion criteria
- {"criterion_text":"- All Participants Previous exposure to IM-101\n- Known or suspected history of drug or alcohol abuse or dependence within 1 year prior to screening\n- Evidence of hepatitis B, hepatitis C, or human immunodeficiency virus (HIV-1 or HIV-2) viral infection at screening\n- Active systemic bacterial, viral, or fungal infection within 14 days prior to first dose of the study intervention\n- Presence of fever as documented by a temperature ≥ 37.8°C (100.04°F) by oral or ≥ 37.3°C (99.14°F) by skin (axillary) or ≥ 38.3°C (100.94°F) by tympanic within 7 days prior to the first dose of the study intervention\n- Use of the following within the time periods specified: a. Intravenous immunoglobulin (IVIg) or subcutaneous immunoglobulin within the 4 weeks prior to screening b. Use of plasma exchange (PLEX) within 4 weeks prior to screening c. Use of rituximab, tacrolimus, or cyclophosphamide within 6 months prior to screening d. Use of neonatal Fc receptor (FcRn) blocker within 6 weeks prior to screening e. Use of C5 inhibitor approved for the treatment of gMG at the recommended dose regimen for within 2 months (zilucoplan or eculizumab) or 3 months (ravulizumab) prior to screening\n- Has been treated with any complement inhibitor, but failed due to intolerability or lack of efficacy\n- Clinical laboratory abnormalities at screening, including: a. Aspartate aminotransferase (AST)/alanine aminotransferase (ALT) > 2 × the upper limit of normal (ULN) b. Total bilirubin > 1.5 × ULN c. Estimated glomerular filtration rate < 60 mL/min/1.73 m2 based on the Modification of Diet in Renal Disease equation\n- Participation in another interventional treatment study or use of any experimental therapy within 30 days before screening or within 5 half-lives of the study drug, whichever is longer\n- Pregnant, breastfeeding, or intending to conceive during the course of the study\n- Planned surgical procedure requiring general anesthesia during the course of the study\n- Anti-MuSK antibody Positive\n- Any medical or psychological condition(s), clinically significant laboratory abnormality or risk factor that, in the opinion of the Investigator or the Medical Monitor, might interfere with participation in the study, pose any added risk to the participant, or confound the assessment of the participant or outcome of the study.\n- oMG Participants Only Participant with fixed ophthalmoplegia\n- oMG Participants Only History of eyelid retraction surgery\n- oMG Participants Only Family history of clinically meaningful ptosis or diplopia or other known diseases that lead to eyelid drooping, peripheral muscle weakness, or diplopia.\n- History of thymectomy, or any other thymic surgery within 12 months prior to screening or planned during the study\n- History of malignant thymoma (patients with Stage I may be enrolled), or history of cancer within the past 5 years of screening, except for adequately treated basal cell skin cancer, squamous cell skin cancer, or in situ cervix cancer\n- History of any immunologic disorder other than MG, or any other conditions that would interfere with an accurate assessment of clinical gMG or oMG or that would require chronic oral, intravenous, intramuscular, or intra-articular corticosteroid therapy. Well-controlled thyroid disease, as per the Investigator or the participant’s regular treating physician recorded in the source documents, is not exclusionary\n- History of, or current diagnosis of active tuberculosis (TB), or currently undergoing treatment for latent TB, or untreated latent TB infection as determined by results within 3 months of the screening visit of a positive TB skin test with purified protein derivative with induration ≥ 5 mm. Additionally, the participant should be excluded if they have current household contacts with active TB, or the participant has a positive QuantiFERON TB Gold test at screening unless they have completed chemoprophylaxis for the latent TB infection (as per applicable local guidelines) prior to the screening visit.\n- History of N. meningitidis infection\n- Clinical features that, in the opinion of the Investigator, are consistent with gMG crisis/exacerbation or clinical deterioration, within 28 days prior to randomization (Day 1)\n- History of hypersensitivity to any ingredient contained in the study intervention"}
Endpoints
Primary endpoints
- {"endpoint_text":"- [Part A, Multiple Ascending Dose Cohorts] Incidence of TEAEs, including clinically significant changes in physical examinations or ECGs during study treatment [Part B, Expansion Cohorts] Incidence of TEAEs including clinically significant changes in physical examinations or ECGs during study treatment","definition_or_measurement_approach":"Incidence of treatment-emergent adverse events (TEAEs) recorded during study treatment; includes clinically significant changes observed on physical examinations or ECGs during the treatment period."}
- {"endpoint_text":"- [Part A, Multiple Ascending Dose Cohorts] Incidence of treatment-emergent SAEs [Part B, Expansion Cohorts] Incidence of SAEs during study treatment","definition_or_measurement_approach":"Incidence of serious adverse events (SAEs) occurring during the study treatment period."}
- {"endpoint_text":"- [Part A, Multiple Ascending Dose Cohorts] Incidence of TEAEs leading to premature study intervention discontinuation [Part B, Expansion Cohorts] Incidence of AEs that led to premature discontinuation","definition_or_measurement_approach":"Count and incidence of adverse events that resulted in premature discontinuation of the study intervention during treatment."}
- {"endpoint_text":"- [Part A, Multiple Ascending Dose Cohorts] Incidence of AESIs during study treatment period [Part B, Expansion Cohorts] Incidence of AESIs during study treatment period","definition_or_measurement_approach":"Incidence of Adverse Events of Special Interest (AESIs) monitored and recorded during the study treatment period."}
- {"endpoint_text":"- [Part B, Expansion Cohorts] 1. gMG cohorts: Change from baseline to Week 16 in the MG-ADL total score 2. oMG cohort: Change from baseline to Week 16 in MGII ocular score","definition_or_measurement_approach":"Efficacy endpoints measured as change from baseline to Week 16: (1) MG-ADL total score for generalized MG cohorts; (2) MGII ocular score for ocular MG cohort."}
Secondary endpoints
- {"endpoint_text":"- [Part A, Multiple Ascending Dose Cohorts] Incidence and prevalence of ADAs and NAb to IM-101 [Part B, Expansion Cohorts] Incidence and prevalence of ADAs and NAb of IM-101 over time","definition_or_measurement_approach":"Assessment of anti-drug antibodies (ADAs) and neutralizing antibodies (NAb) to IM-101 over time; incidence and prevalence measured by immunogenicity assays."}
- {"endpoint_text":"- [Part A, Multiple Ascending Dose Cohorts] Changes from baseline in vital signs, laboratory assessments, and other safety variables [Part B, Expansion Cohorts] Changes from baseline in vital signs, laboratory assessments, and other safety variables","definition_or_measurement_approach":"Safety laboratory tests, vital signs, and other safety variables compared to baseline during treatment."}
- {"endpoint_text":"- Part A; Serum PK IM-101, Cmax, tmax, AUC0-tau, Ctrough, CL, Vz, t1/2, ratio for Cmax & AUC0-tau Part B [gMG] 1.Change from baseline to wk16 in QMG total; MGC scale; MG-QoL15r 2. %age participants with MG-ADL ≥ 2-point & ≥ 3-point change at Wk16 3. %age participants with MSE; MG-ADL of 0 or 1 [oMG] 1.Change from baseline to Wk16 in MG-ADL ocular domain & MGII total score 2.Quantitative change from baseline to Wk16 in QMG total score [All]1.%age requiring rescue therapy over 16-wk treatment period","definition_or_measurement_approach":"Pharmacokinetic parameters (Cmax, tmax, AUC, Ctrough, clearance, volume, half-life) for IM-101. Clinical efficacy secondary measures include change in QMG, MGC, MG-QoL15r, responder rates for MG-ADL at Week 16, percent requiring rescue therapy over 16-week treatment."}
- {"endpoint_text":"- [Part A, Multiple Ascending Dose Cohorts] Obtain serum IM-101 concentration for modeling and simulation [Part B, Expansion Cohorts] CH50, AH50, and total C5 and free C5 at baseline and timepoints during and following treatment","definition_or_measurement_approach":"Serum IM-101 concentrations for PK modeling; complement assays CH50, AH50 and total/free C5 measured at baseline and specified timepoints."}
- {"endpoint_text":"- [Part A, Multiple Ascending Dose Cohorts] CH50, AH50, and total C5 and free C5 at baseline and timepoints during and following treatment [Part B, Expansion Cohorts] 1. Serum IM-101 concentrations over the treatment period 2.\tSparse sample collections to support population PK modeling and simulations","definition_or_measurement_approach":"Complement functional assays and serum IM-101 concentrations over treatment; sparse PK sampling to support population PK modeling and simulation."}
Recruitment
- Planned Sample Size
- 52
- Recruitment Window Months
- 48
- Consent Approach
- Informed consent must be provided as a signed informed consent form by each participant (inclusion criterion: 'Able and willing to provide signed informed consent'). Participants are adults (≥18 and <75). Subject information and informed consent forms are provided in multiple languages (English, Bulgarian, Spanish, Polish, Italian) as evidenced by available ICF documents in those languages. No assent/minor consent procedures are specified.
Geography
- Total Number Of Sites
- 20
- Total Number Of Participants
- 83
Bulgaria
- Earliest CTIS Part Ii Submission Date
- 19-01-2026
- Latest Decision Or Authorization Date
- 18-02-2026
- Processing Time Days
- 30
- Number Of Sites
- 5
- Number Of Participants
- 22
Sites
- Site Name
- Uniteversity Muliprofile Hospital For Active Treatment Tsaritsa Yoanna-Isul EAD
- Department Name
- Clinic of intensive treatment of neurology diseases
- Contact Person Name
- Evgenia Vasileva
- Contact Person Email
- dr.evgenia.vasileva@gmail.com
- Site Name
- Multiprofile Hospital For Active Treatment Avis Medika OOD
- Department Name
- Department of neurology diseases
- Contact Person Name
- Hristo Lilovski
- Contact Person Email
- hristolilovski@gmail.com
- Site Name
- University Multiprofile Hospital For Active Treatment Dr. Georgi Stranski EAD
- Department Name
- Neurology Clinic
- Contact Person Name
- Maya Danovska-Mladenova
- Contact Person Email
- mdanovska@yahoo.com
- Site Name
- Medical Center Hera EOOD
- Contact Person Name
- Plamen Pelov
- Contact Person Email
- drpelov@abv.bg
- Site Name
- Haelan Care 4 Medical Center Ltd.
- Contact Person Name
- Dayana Kyuchukova
- Contact Person Email
- dr.kuchukova@sitelinkeu.com
Italy
- Earliest CTIS Part Ii Submission Date
- 21-01-2026
- Latest Decision Or Authorization Date
- 18-02-2026
- Processing Time Days
- 28
- Number Of Sites
- 3
- Number Of Participants
- 15
Sites
- Site Name
- IRCCS Foundation Istituto Neurologico Carlo Besta
- Department Name
- Neurology
- Contact Person Name
- Carlo Giuseppe Antozzi
- Contact Person Email
- carlo.antozzi@istituto-besta.it
- Site Name
- Ospedale San Raffaele S.r.l.
- Department Name
- Neurology
- Contact Person Name
- Stefano Carlo Previtali
- Contact Person Email
- previtali.stefano@hsr.it
- Site Name
- Azienda Socio Sanitaria Territoriale Degli Spedali Civili Di Brescia
- Department Name
- Neurology
- Contact Person Name
- Alessandro Padovani
- Contact Person Email
- alessandro.padovani@unibs.it
Spain
- Earliest CTIS Part Ii Submission Date
- 10-02-2026
- Latest Decision Or Authorization Date
- 18-02-2026
- Processing Time Days
- 8
- Number Of Sites
- 4
- Number Of Participants
- 14
Sites
- Site Name
- Hospital Universitario Central De Asturias
- Department Name
- Neurology
- Contact Person Name
- Germán Moris de la Tassa
- Contact Person Email
- gmorist@gmail.com
- Site Name
- Clinica Universidad De Navarra
- Department Name
- Neurology
- Contact Person Name
- Jaime Gállego Pérez de Larraya
- Contact Person Email
- jgallego@unav.es
- Site Name
- Hospital Clinico San Carlos
- Department Name
- Neurology
- Contact Person Name
- Alejandro Horga Hernández
- Contact Person Email
- ahorga@gmail.com
- Site Name
- Hospital Universitario La Paz
- Department Name
- Neurology
- Contact Person Name
- Exuperio Díez Tejedor
- Contact Person Email
- exuperio.diez@salud.madrid.org
Poland
- Earliest CTIS Part Ii Submission Date
- 16-01-2026
- Latest Decision Or Authorization Date
- 22-02-2026
- Processing Time Days
- 37
- Number Of Sites
- 8
- Number Of Participants
- 32
Sites
- Site Name
- Ilkowski I Partnerzy sp.p. Lekarzy
- Department Name
- NZOZ Neuro-Kard
- Contact Person Name
- Jan Ilkowski
- Contact Person Email
- jan.ilkowski@neurokard.pl
- Site Name
- Samodzielny Publiczny Zaklad Opieki Zdrowotnej Szpital Uniwersytecki W Krakowie
- Department Name
- Zespół Poradni Specjalistycznych - Botaniczna 3, Poradnia Neurologiczna
- Contact Person Name
- Agnieszka Słowik
- Contact Person Email
- neurologiabk@su.krakow.pl
- Site Name
- Samodzielny Publiczny Szpital Kliniczny Nr 1 Im.Prof.Stanislawa Szyszko Slaskiego Uniwersytetu Medycznego W Katowicach
- Department Name
- Oddział Neurologiczny
- Contact Person Name
- Monika Adamczyk-Sowa
- Contact Person Email
- msowa@sum.edu.pl
- Site Name
- Centrum Medyczne Neuroprotect
- Contact Person Name
- Mariusz Grudniak
- Contact Person Email
- mariusz.grudniak@neuroprotect.pl
- Site Name
- Neurologia Śląska Centrum Medyczne
- Contact Person Name
- Marek Śmiłowski
- Contact Person Email
- marek.smilowski@neurologiaslaska.pl
- Site Name
- Twoja Przychodnia Nowosolskie Centrum Medyczne Sp. z o.o.
- Contact Person Name
- Agata Kłósek
- Contact Person Email
- klosek@twojaprzychodnia.com
- Site Name
- Twoja Przychodnia Poznanskie Centrum Medyczne Sp. z o.o.
- Contact Person Name
- Katarzyna Jurkiewicz
- Contact Person Email
- jurkiewicz@twojaprzychodnia.com
- Site Name
- Samodzielny Publiczny Szpital Kliniczny (additional listed site)
Sponsor
Primary sponsor
- Full Name
- Immunabs Inc.
- Organisation Type
- Pharmaceutical company
- Country Of Registered Address
- Korea, Republic of
Contract research organisations
- Name
- IQVIA RDS Ireland Limited
- Responsibilities
- Eu Legal rep; contact: john.vaughan@iqviq.com
- Name
- IQVIA Limited
- Responsibilities
- CRO services (contact: ahmet.guzeloz@iqvia.com)
- Name
- Q Squared Solutions Limited
- Responsibilities
- CRO/vendor services (contact: Suresh.Vaddiraju@iqvia.com)
Third parties
- {"country":"Ireland","full_name":"IQVIA RDS Ireland Limited","duties_or_roles":"Eu Legal rep","organisation_type":"Pharmaceutical company"}
- {"country":"United Kingdom","full_name":"IQVIA Limited","duties_or_roles":"","organisation_type":"Pharmaceutical company"}
- {"country":"United Kingdom","full_name":"Q Squared Solutions Limited","duties_or_roles":"","organisation_type":"Non-Pharmaceutical company"}
- {"country":"Korea, Republic of","full_name":"Jnpmedi Inc.","duties_or_roles":"","organisation_type":"Pharmaceutical company"}
Investigational products
- Investigational Product Name
- IM-101 120mg/mL
- Active Substance
- IM-101
- Modality
- Peptide/protein/enzyme
- Routes Of Administration
- INTRAVENOUS INJECTION
- Route
- INTRAVENOUS INJECTION
- Authorisation Status
- Investigational
- Investigational Product Name
- 0.9% Sodium Chloride (Normal Saline)
- Modality
- Other
- Routes Of Administration
- INTRAVENOUS
- Route
- INTRAVENOUS
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