AzTrials
AzTrials

Postural Orthostatic Tachycardia SyndromePhase 2POTSNCT05633407

Efficacy and Safety Study of Efgartigimod in Adults With Post-COVID-19 POTS

A Phase 2 study testing Efgartigimod in people with Postural Orthostatic Tachycardia Syndrome, run by argenx at 11 sites in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
Search all trials

Trial summary

The study aims to investigate the safety, tolerability, efficacy, pharmacodynamics (PD), pharmacokinetics (PK), and immunogenicity of efgartigimod compared to placebo in participants with post-COVID-19 postural orthostatic tachycardia syndrome (POTS) (post-COVID-19 POTS). Read more about this study

Who is it for?
Ages 18 years and older
What is being tested?
Efgartigimod
Type of treatment
Injection or infusion
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
53 participants
Where
11 sitesUnited States
Study dates
23 Sep 2022to 18 Apr 2024
Phase
Phase 2
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Reached the age of consent when signing the informed consent form
  • Capable of providing signed informed consent and complying with protocol requirements
  • Diagnosed with new-onset POTS post-COVID-19 established by the following:
  • History of COVID-19 based on a previous positive test result from either laboratory-confirmed COVID-19 test (eg, a PCR test) or non-laboratory-confirmed COVID-19 test (eg, rapid antigen test); this positive result may be either documented or patient-reported
  • Tilt table or orthostatic vital sign measurements during screening consistent with consensus criteria: sustained HR increase of ≥30 bpm within 10 min of standing or head up tilt (≥40 bpm for individuals aged 18 to 19 years) and/or HR reaching >120 bpm within 10 min; absence of sustained 20 mmHg decrease in systolic blood pressure (SBP)
  • Ongoing symptoms of POTS confirmed by the investigator with at least 3 symptoms in each of the following areas lasting longer than 12 weeks after either diagnosis of COVID-19 or after hospital discharge for COVID-19:
Show all 11Show fewer
  • Vasomotor symptoms: fatigue, orthostatic intolerance, brain fog, exertional dyspnea, difficulty with concentration, venous pooling, and exercise intolerance ii. Sympathetic over-compensation symptoms: palpitation, heat intolerance, nausea with or without vomiting, insomnia, anxiety, lack of appetite, chest pain, and diaphoresis
  • COMPASS 31 ≥35 at screening
  • Agree to use contraceptives consistent with local regulations regarding the methods of contraception for those participating in clinical studies and the following:
  • Male participants: No male contraception is required Female participants of childbearing potential must have a negative serum pregnancy test at screening and a negative urine pregnancy test at baseline before receiving IMP. Contraceptive requirements.
  • Body mass index (BMI) <35 kg/m2

Who cannot join

  • Diagnosis of or receiving treatment for the following conditions before COVID-19: peripheral neuropathy, POTS, myalgic encephalomyelitis encephalitis/chronic fatigue syndrome, Ehlers Danlos syndrome confirmed by genetic testing, autonomic neuropathy, multiple sclerosis, stroke, spinal cord injury, or any known lesions in the central nervous system by imaging or neurological exam
  • History of or currently being treated for clinically significant ongoing cardiac arrythmia, heart failure, myocarditis, pulmonary embolism requiring anticoagulation, pulmonary fibrosis, or critical illness-related polyneuropathy or myopathy
  • Known autoimmune disease that, in the investigator's judgment, would interfere with an accurate assessment of clinical symptoms of post-COVID-19 POTS or puts the participant at undue risk
  • Known HIV disease or common variable immunodeficiency
  • History of malignancy unless considered cured by adequate treatment with no evidence of recurrence for ≥3 years before the first administration of IMP. Adequately-treated participants with the following cancers may be included at any time:
  • Basal cell or squamous cell skin cancer
Show all 27Show fewer
  • Carcinoma in situ of the cervix
  • Carcinoma in situ of the breast
  • Incidental histological finding of prostate cancer (TNM stage T1a or T1b)
  • Clinically significant uncontrolled active or chronic bacterial, viral, or fungal infection or positive SARS-CoV-2 PCR test at screening
  • Positive serum test at screening for an active infection with any of the following:
  • Hepatitis B virus (HBV) that is indicative of an acute or chronic infection, unless associated with a negative HB surface antigen (HBsAg) or negative HBV DNA test
  • Hepatitis C virus (HCV) based on HCV antibody assay unless a negative RNA test is available
  • HIV
  • A medical condition that could confound the results of the study or put the participant at undue risk in the investigator's judgment
  • Clinically significant disease, recent major surgery (within 3 months of screening), or intends to have surgery during the study; or any other condition that in the opinion of the investigator could confound the results of the study or put the participant at undue risk
  • Total IgG <4 g/L at screening
  • Received within 12 weeks or 5 half-lives (whichever is longer) before screening an investigational product
  • Received within 12 weeks before screening either intravenous immunoglobulin (Ig) IV or SC or plasmapheresis/plasma exchange (PLEX)
  • Received a live or live-attenuated vaccine less than 4 weeks before screening
  • Known hypersensitivity to IMP or 1 of its excipients
  • Previously participated in an efgartigimod clinical study and received at least 1 dose of IMP
  • Currently participating in another interventional clinical study
  • History (within 12 months of screening) of or current alcohol, drug, or medication abuse
  • Pregnant or lactating or intends to become pregnant during the study
  • Unwilling to remain on a stable regimen of medications during the study
  • Unwilling to avoid initiation of new physical rehabilitation or other physician-prescribed exercise programs during the 24-week treatment period

Trial locations and contacts

11 sites in 1 country.

11 sites in 1 country

United States11 sites
  • Johns Hopkins University

    Baltimore, Maryland, 21224

  • Harvard Medical School, Brigham and Women's Hospital

    Boston, Massachusetts, 02115

  • Case Western Reserve University

    Cleveland, Ohio, 44106

  • Apex Trials Croup, LLC

    Fort Worth, Texas, 76132

  • Northshore University Health System

    Glenview, Illinois, 60026

  • University of California, San Diego Sulpizio Cardiovascular Center

    La Jolla, California, 92037

  • Texas Institute of Cardiology

    McKinney, Texas, 75071

  • Vandetbilt University Medical Center / Clinical Research Center

    Nashville, Tennessee, 37232

  • Stanford Movement Disorder Center

    Palo Alto, California, 94304

  • Pioneer Clinical Research

    Rosharon, Texas, 77583

  • Metrodora Institute

    West Valley City, Utah, 84119

Other trials in United States

About this study

Official title: A Phase 2 Randomized, Double-blinded, Placebo-controlled Study to Evaluate the Efficacy and Safety of Efgartigimod IV in Adult Patients With Post-COVID-19 Postural Orthostatic Tachycardia Syndrome (POTS)

The study aims to investigate the safety, tolerability, efficacy, pharmacodynamics (PD), pharmacokinetics (PK), and immunogenicity of efgartigimod compared to placebo in participants with post-COVID-19 postural orthostatic tachycardia syndrome (POTS) (post-COVID-19 POTS).

Read the detailed description

The study aims to investigate the safety, tolerability, efficacy, pharmacodynamics (PD), pharmacokinetics (PK), and immunogenicity of efgartigimod compared to placebo in participants with post-COVID-19 postural orthostatic tachycardia syndrome (POTS) (post-COVID-19 POTS). Efgartigimod may be a viable treatment option for individuals diagnosed with post-COVID-19 POTS because it has been shown to reduce IgG levels, including IgG autoantibodies, which may underlie some of the autonomic disease manifestations in these patients.

Being tested
Efgartigimod, Placebo
Keywords
POTS, Long COVID, Postural Orthostatic Tachycardia Syndrome, efgartigimod
Medical subject headings
Postural Orthostatic Tachycardia Syndrome, Post-Acute COVID-19 Syndrome

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • EfgartigimodDrug

    Efgartigimod IV 10 mg/kg infusion qw for 24 weeks. Participants will be randomized to receive efgartigimod IV 10 mg/kg or matching placebo in a 2:1 ratio, respectively

  • PlaceboDrug

    Receive a matching placebo during weekly infusions during a treatment period of 24 weeks.

    Participants will be randomized to receive efgartigimod IV 10 mg/kg or matching placebo in a 2:1 ratio, respectively

Study groups in NCT05633407
Study groupRoleWhat they receive
EfgartigimodExperimentalReceive efgartigimod IV 10mg/kg during weekly infusions during a treatment period of 24 weeks
Receives: Drug: Efgartigimod
PlaceboPlacebo comparatorReceive a matching placebo during weekly infusions during a treatment period of 24 weeks
Receives: Drug: Placebo

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Change From Baseline to Week 24 in the COMPASS 31 (2-week Recall Version)

    Composite Autonomic Symptom Score (COMPASS) 31 modified version (2-week recall) is a self-rated questionnaire to evaluate the severity and distribution of autonomic symptoms in various autonomic nerve disorders. It consists of 31 questions in 6 weighted domains (orthostatic intolerance, vasomotor, secretomotor, gastrointestinal {GI}-mixed upper and diarrhea, bladder, and pupillomotor). A weighted total score of 0 (mild) to 100 (severe) was determined by adding a maximum raw score for each domain. Higher scores indicated a more severe degree of autonomic symptoms.

    Measured: Baseline (Day 1) and Week 24

  2. Change From Baseline to Week 24 in the MaPS

    The Malmö POTS Symptom Score (MaPS) score is a dedicated POTS symptom scoring questionnaire. The score consists of 12 questions that assess symptom burden related (tachycardia, palpitations, dizziness, presyncope) and unrelated to orthostatic intolerance (GI symptoms, insomnia, concentration difficulties). Participants graded their symptoms for the past 7 days using a visual analog scale ranging from 0 (no symptoms) to 10 (worst possible). The total score was calculated by summing up the items/individual items and range was 0 to 120 points, with higher scores indicating more severe symptoms.

    Measured: Baseline (Day 1) and Week 24

  3. Number of Participants With TEAEs and TESAEs

    An adverse event (AE) was any untoward medical occurrence in a clinical study participant, temporally associated with the use of study drug, whether or not considered related to the study drug. A serious adverse event (SAE) was any untoward medical occurrence that at any dose resulted in death, was life threatening, required inpatient hospitalization or prolongation of existing hospitalization, resulted in persistent or significant disability/incapacity, was a congenital anomaly/birth defect or any other medically important event. Treatment-emergent adverse events (TEAEs) were defined as AEs with onset on or after the first administration of study drug up to and including 60 days after the last study drug administration.

    Measured: From the first dose of study drug (Day 1) up to 60 days post last dose of study drug, up to 236 days

Secondary outcomes (7)
  1. Percentage of Participants With Improved PGI-S at Week 24

    The Patient Global Impression-Severity (PGI-S) is a participant-rated, single-item scale to assess the severity of a health condition. The scale was used to assess the severity of symptoms over the past week (1-week recall) and overall experience of symptoms over the past 2 weeks (2-week recall). Both were rated on a 4-point type Likert scale, with scores ranging from 1 (none), 2 (mild), 3 (moderate), and 4 (severe). Higher scores indicate greater symptom severity. An "improved PGI-S" was defined by a change from baseline of -3, -2 and -1.

    Measured: Baseline (Day 1) and Week 24

  2. Percentage of Participants With Improved in PGI-C at Week 24

    The Patient Global Impression-Change (PGIC) is a single-item scale to capture the participant's perception of a change in their overall symptom severity. Overall change in symptoms was rated on a 7-point Likert scale, with scores ranging from 1 (much better), 2 (somewhat better), 3 (a little better), 4 (no change), 5 (a little worse), 6 (somewhat worse), and 7 (much worse). Higher PGI-C scores signify worse outcome. An "improved PGI-C" was defined by a change from baseline of 1, 2 and 3.

    Measured: Baseline (Day 1) and Week 24

  3. Change From Baseline to Week 24 in the PROMIS Fatigue Short Form 8a

    The Patient-Reported Outcomes Measurement Information System (PROMIS) Fatigue Short Form 8a assesses the impact and perceived fatigue during the last 7 days. This validated 8-question scale has 5 response options, with scores ranging from 1 (not at all) to 5 (very much). Total scores ranged from 8 to 40; higher scores indicated higher fatigue levels and were converted to a T-score with a mean of 50 and standard deviation of 10. A decrease in T-score (negative change from baseline) indicated improvement in fatigue.

    Measured: Baseline (Day 1) and Week 24

  4. Change From Baseline to Week 24 in the PROMIS Cognitive Function Short Form 6a

    PROMIS Cognitive Function Short Form 6a assesses the frequency of cognitive difficulties experienced in the past 7 days. The questionnaire comprises 6 questions on subjective cognitive difficulties regarding a participant's concentration, memory, language, mental acuity, and perceived changes in cognitive functioning. The participant marks their response on a 5-point Likert scale (1: never and 5: very often). Scores ranged from 6 to 30; higher scores indicated worse perceived cognitive functioning and were converted to a T-score with a mean of 50 and standard deviation of 10. An increase in T-score (positive change from baseline) indicated better cognitive function.

    Measured: Baseline (Day 1) and Week 24

  5. Percent Change From Baseline in Total IgG Levels at Week 24

    Blood samples for immunoglobulin G (IgG) analysis were collected at specified time points. Total IgG concentrations were quantified using validated methods at a central laboratory.

    Measured: Baseline (Day 1) and Week 24

  6. Serum Concentration of Efgartigimod

    Serum samples were collected at specified timepoints to determine the concentration of efgartigimod.

    Measured: Pre-dose and post-dose at Baseline (Day 1), Weeks 1, 4, 12 and at Week 24

  7. Number of Participants With ADAs Against Efgartigimod

    Blood samples were collected at specified timepoints to assess anti-drug antibodies (ADAs) against efgartigimod. ADA incidence reported here was defined as total number of participants with treatment-induced and treatment-boosted ADA. Treatment-induced ADA was defined as a baseline negative sample and at least 1 positive post-baseline sample. Treatment-boosted ADA was defined as a baseline positive sample and the titer value increased 4-fold or more compared to baseline.

    Measured: Up to Week 24

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted1 Dec 2022
  2. Study start23 Sep 2022
  3. Primary completion18 Apr 2024
  4. Study completion18 Apr 2024

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 2
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Triple blind
Who is masked
Participant, Care provider, Investigator
Enrolment
53 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05633407
Sponsor's protocol ID
ARGX-113-2104
Acronym
POTS
Status last verified
May 2025
First submitted
8 Nov 2022
Last updated
23 May 2025
Data monitoring committee
No
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Efgartigimod in people with Postural Orthostatic Tachycardia Syndrome, run by argenx at 11 sites in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 11 inclusion and 27 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 23 May 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 11 sites in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 23 May 2025). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Change From Baseline to Week 24 in the COMPASS 31 (2-week Recall Version) (time frame: Baseline (Day 1) and Week 24). The study lists 3 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 23 May 2025.

Free account

Log in to keep searching

You’ve used your 3 free searches. AzTrials is free: log in or create a free account to keep searching clinical trials and save the ones you want to follow.

Create a free accountLog in