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
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
Site Name
Neurologia Śląska Centrum Medyczne
Contact Person Name
Marek Śmiłowski
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
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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