Active Brain & Nervous System NIHR-supported project

A Phase 3, Randomized, Double-Blind, Placebo-Controlled, 3-Arm, 3-Period Study to assess the Efficacy and Safety of a New Formulation of Oral Cladribine compared with Placebo in Participants with Generalized Myasthenia Gravis (gMG) (MyClad)

In plain English

AI plain-English summary

A new oral tablet could offer people with generalised myasthenia gravis a short course of treatment that suppresses the immune attack on their own muscles, rather than requiring lifelong daily medication. This matters because generalised myasthenia gravis is a chronic autoimmune disease where the body’s immune system mistakenly attacks the proteins that allow voluntary muscles—those used for breathing, swallowing, walking, and facial movement—to contract. There is no cure, and current treatments often involve long-term immunosuppression with significant side effects. The drug cladribine is designed to selectively lower the levels of immune cells driving these inflammatory attacks, potentially offering a more targeted approach. If this Phase 3 trial succeeds, oral cladribine could become a short-course therapy that provides sustained symptom control without the burden of continuous daily medication. That would directly improve quality of life for people with this condition, reducing muscle weakness and the risk of life-threatening breathing difficulties. It would also offer clinicians a new, convenient treatment option for a disease where current therapies are limited.

View original technical description
Generalized Myasthenia Gravis (gMG) is a chronic neuromuscular disease that causes weakness in the voluntary muscles. Voluntary muscles include muscles that connect to a person’s bones, muscles in the face, throat, and diaphragm. They contract to move the arms and legs and are essential for breathing, swallowing and facial movements. Myasthenia gravis is an autoimmune disease, which means that the body’s defence system mistakenly attacks healthy cells or proteins needed for normal functioning. The onset of the disorder may be sudden. Symptoms may not be immediately recognized as myasthenia gravis. The degree of muscle weakness involved varies greatly among individuals. Currently, there is no known cure for myasthenia gravis. Most people with myasthenia gravis live to an average life expectancy. Cladribine is a short-course oral therapy for generalized myasthenia gravis (gMG). It is designed to lower the levels of the immune cells that drive inflammatory attacks in gMG. gMG is recognized as a T cell dependent, B cell mediated autoimmune disease, and the role of different B cell subtypes and regulatory T cells dysfunction has been described. Given the mechanism of action of cladribine on cell types involved in both MS and MG pathologies, it is hypothesized that cladribine will act on similar immune pathways of MG pathology. The current Phase 3 study is designed to demonstrate the efficacy and safety of oral cladribine compared to placebo in participants with gMG, as well as to collect additional long-term safety and efficacy data

Researchers

Saiju Jacob (Principal Investigator)

Related Research

Grants with similar aims, by meaning.

ChariotMS – A national (UK), multi-centre, randomised, double-blind, placebo-controlled (1:1) phase IIb efficacy trial with cost-utility analysis of cladribine tablets (3.5mg/kg over two years) in people with advanced multiple sclerosis (EDSS 6.5-8.5). Is cladribine superior to placebo in protecting upper limb function?
A national (UK), multi-centre, randomised, double-blind, placebo controlled (1:1) phase IIb efficacy trial with cost-utility analysis of cladribine tablets (3.5mg/kg over two years) in people with advanced multiple sclerosis (EDSS 6.5-8.5). Is cladribine superior to placebo in protecting upper limb function? (ChariotMS).
A national (UK), multi-centre, randomised, double-blind, placebocontrolled (1:1) phase IIb efficacy trial with cost-utility analysis of cladribine tablets (3.5mg/kg over two years) in people with advanced multiple sclerosis (EDSS 6.5-8.5). Is cladribine superior to placebo in protecting upper limb function? (ChariotMS).
A national (UK), multi-centre, randomised, double-blind, placebo-controlled (1:1) phase IIb efficacy trial with cost-utility analysis of cladribine tablets (3.5mg/kg over two years) in people with advanced multiple sclerosis (EDSS 6.5-8.5). Is cladribine superior to placebo in protecting upper limb function?
ChariotMS A national (UK), multi-centre, randomised, double-blind, placebo-controlled (1:1) phase IIb efficacy trial with cost-utility analysis of cladribine tablets (3.5mg/kg over two years) in people with advanced multiple sclerosis (EDSS 6.5-8.5). Is cladribine superior to placebo in protecting upper limb function?

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