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OncoMatch/Clinical Trials/NCT05868837

Rituximab EfFicacy IN MyasthEnia Gravis (REFINE)

Is NCT05868837 recruiting? Yes, currently enrolling (May 2026). This Phase 3 trial studies Rituximab for myasthenia gravis, generalized.

Phase 3RecruitingFondazione Policlinico Universitario Agostino Gemelli IRCCSNCT05868837Data as of May 2026

Treatment: RituximabThe primary objective of this phase III trial is to investigate if Rituximab can reduce patients' functional impairment caused by MG. The secondary objectives of this trial are to assess whether treatment with rituximab in patients with MG will: * Allow faster and greater corticosteroid tapering * Reduce the frequency of exacerbations * Improve quality of life * Offer an acceptable safety and tolerability profile.

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Extracted eligibility criteria

Biomarker criteria

Required: CHRNA1 anti-AChR antibody positive

Positive serologic test for anti-AChR or anti-MuSK antibody titers as confirmed at screening

Required: MUSK anti-MuSK antibody positive

Positive serologic test for anti-AChR or anti-MuSK antibody titers as confirmed at screening

Prior therapy

Cannot have received: alemtuzumab (alemtuzumab)

Alemtuzumab (Lemtrada®, Campath®)

Cannot have received: total lymphoid irradiation

Total lymphoid irradiation

Cannot have received: bone marrow transplant

Bone marrow transplant

Cannot have received: T-cell vaccination therapy

T-cell vaccination therapy

Cannot have received: natalizumab (natalizumab)

Natalizumab (Tysabri®)

Cannot have received: immunosuppressive treatment (excluding corticosteroids) (azathioprine, mycophenolate mofetil, mycophenolic acid, cyclosporine, tacrolimus, methotrexate, cyclophosphamide, tocilizumab, belimumab, eculizumab, rituximab, ocrelizumab, ofatumumab, obinutuzumab, inebilizumab)

Exception: excluding corticosteroids

ANY immunosuppressive treatment (excluding corticosteroids) at ANY time prior to randomization (such as Azathioprine, Mycophenolate mofetil or Mycophenolic acid, Cyclosporine (except eye drop), Tacrolimus (except topical), Methotrexate, Cyclophosphamide, Tocilizumab (Actemra®), Belimumab (Benlysta®), Eculizumab (Soliris®), rituximab (MabThera®, Rituxan®), ocrelizumab (Ocrevus®), ofatumumab (Arzerra®), obinutuzumab (Gazyva®), inebilizumab, or any experimental B-cell depleting agent)

Cannot have received: intravenous immunoglobulin

Intravenous immunoglobulin (IVIg) within the 4 weeks prior to Day 1

Cannot have received: plasma exchange

Plasma exchange (PLEX) treatment within the 4 weeks prior to Day 1

Cannot have received: prednisone < 20 mg/day or < 40 mg over a 2-day period (or equivalent dose of other corticosteroids) (prednisone)

Prednisone < 20 mg/day or < 40 mg over a 2-day period (or equivalent dose of other corticosteroids)

Cannot have received: pyridostigmine > 480 mg/day or unstable dose (pyridostigmine)

Pyridostigmine > 480 mg/day or unstable dose in the 2 weeks prior to Day 1

Cannot have received: live attenuated vaccine

Receipt of a live attenuated vaccine within 4 weeks prior to randomization

Cannot have received: blood transfusion

Blood transfusion within 4 weeks prior to screening or during the screening period

Lab requirements

Blood counts

CD19+ B-cell count < 40 cells/μL; ANC < 1.2 × 10^3 cells/μl; platelet count < 75,000/μL; hemoglobin < 8.0 g/dL; total immunoglobulin < 600 mg/dL

Kidney function

eGFR < 45 mL/min/1.73 m2

Liver function

AST or ALT > 2.5 × ULN; total bilirubin > 1.5 × ULN (unless due to Gilbert's syndrome)

Any of the following laboratory abnormalities at screening: AST or ALT > 2.5 × ULN; total bilirubin > 1.5 × ULN (unless due to Gilbert's syndrome); eGFR < 45 mL/min/1.73 m2; CD19+ B-cell count < 40 cells/μL; ANC < 1.2 × 10^3 cells/μl; platelet count < 75,000/μL; hemoglobin < 8.0 g/dL; total immunoglobulin < 600 mg/dL

Structured fields extracted by AI. May contain errors — verify against the official protocol.

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