Myasthenia gravis (MG) is a rare, chronic, autoimmune, neuromuscular condition characterized by weakness of voluntary muscles that increases with exercise and recovers with rest. Generalized myasthenia gravis (gMG) is a severe form of MG that can include weakness of multiple muscle groups such the limbs, neck, diaphragm, and eye muscles.
Let's review how voluntary muscles work. Voluntary muscles in the body are controlled by nerve signals, or neurotransmitters, from the brain. The area where the nerve signals from the brain meet the muscle fiber is called the neuromuscular junction. The neuromuscular junction contains many receptors called acetylcholine receptors. These receptors are essential for initiating muscle movement.
When signals from the brain travel through the nerve, the nerve endings release a neurotransmitter called acetylcholine into the neuromuscular junction. The acetylcholine binds to acetylcholine receptors to stimulate the muscle fibers and enable them to contract.
In people with gMG, the immune system doesn't function correctly. Instead of helping the body fight off sickness by attacking intruders like bacteria and viruses, the body makes antibodies against the acetylcholine receptors. These antibodies switch on another part of the immune system, called the complement cascade, and damage the neuromuscular junction. As a result, the neuromuscular junction can no longer function and nerve impulses are not transmitted to the muscle, causing weakness.
Muscle weakness in patients with gMG characteristically becomes worse with repeated use, and then may get better after the muscle is rested.
The respiratory muscles (i.e., diaphragm) can be affected, which can cause life-threatening crisis and possibly require treatment in a hospital or ICU.
For more information about MG and gMG, please visit the other websites listed here.
Right now, doctors can use several treatments to alleviate symptoms of gMG. Although these treatments may help improve muscle weakness, most of these treatments have been developed for other illnesses and have not been specifically designed nor approved to treat gMG. Various side effects, from mild to serious, can occur from use of some of these treatments. We recommend that you speak to your physician for details.
If those treatments do not work, doctors sometimes try adding an intravenous complement inhibitor. The goal of Ra Pharma's ongoing research is to develop a self-administered, subcutaneous complement inhibitor designed to be used early in treatment, which we believe has the potential to provide benefit to many more patients.
Zilucoplan* is a small peptide (or a tiny protein) which we believe has the potential to benefit many more patients. Zilucoplan's size is designed to allow for self-administration at home as a daily injection.
In December 2018, Ra Pharma completed a Phase 2 clinical trial evaluating zilucoplan for gMG, in which zilucoplan achieved the primary and key secondary endpoints.
Ra Pharma is now enrolling eligible people with gMG into a global Phase 3 study, called the RAISE study.
*Zilucoplan is an investigational drug and its safety and effectiveness are currently being studied. Zilucoplan has not been approved by the FDA for the treatment of gMG or any other disease or condition.
To see if you could qualify for this study, click here.
For more information about the RAISE study, click here.
Want to learn more about clinical trials? Visit our "Resources" section to learn more.
The RAISE study is a placebo-controlled study with a 12-week study treatment period. Participants will be randomly assigned to receive either zilucoplan or placebo. Study participants will continue their standard of care treatment** during the study and, in addition, will receive study drug as a once-daily, self-administered (at home) subcutaneous injection.
Participation in the study will last approximately 16 weeks and would include approximately 7 study visits. Participants will have an option to continue to receive zilucoplan in a long-term extension study (the RAISE-XT study) after completing this clinical trial.
**Some standard of care treatments, such as IVIG and Soliris, may be not be allowed while on this study. Please contact us for more information.
If you are between the ages of 18 and 74 and have a diagnosis of gMG, you may be eligible to participate in the RAISE study.
Your doctor will need to see if you meet these and other eligibility criteria before you can be enrolled.
For participants who do not live near a study location, Ra Pharma may reimburse for costs associated with travel, if needed.
(Click the arrow to the right of a location to see contact information if it is available or you may fill out the Request Information form)
The Ra Pharma team is dedicated to the gMG community. We are working to spread awareness of the disease by partnering in local fundraising walks and events and providing information about our work on the disease that can easily be shared.
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