Long-term safety and tolerability of bimagrumab (BYM338) in sporadic inclusion body myositis.

Neurology

From the Neuromuscular Research Center (K.S.), Phoenix, AZ; Department of Neurology (T.I.C., A.A.A), Brigham and Women's Hospital and Harvard Medical School, Boston, MA; Novartis Institutes for BioMedical Research (B.S., D.L.), Basel, Switzerland; Novartis Healthcare Pvt Ltd (H.A.), Hyderabad, India; Novartis Pharma AG (L.B.T), Basel, Switzerland. Dr. Cochrane is now at Biogen Inc, Cambridge, MA. Dr. Sloth is now at Novo Nordisk, Copenhagen, Denmark.

Published: October 2020

Objective: To assess the long-term safety and tolerability and to monitor benefits of extended use of bimagrumab in individuals with sporadic inclusion body myositis (sIBM) who completed a single-dose core study.

Methods: In this multicenter, open-label extension study, 10 adults received bimagrumab 10 mg/kg IV every 4 weeks up to 2 years (104 weeks). Safety (primary endpoint) was assessed by recording adverse events (AEs). Clinical benefits were assessed by changes from baseline in thigh muscle volume (TMV), lean body mass (LBM), 6-minute walk distance (6MWD), handgrip, and quadriceps strength.

Results: Participants had a mean age of 70.1 (SD 10.4) years. All participants (n = 10) discontinued the treatment due to early termination of the study (n = 7) or AEs (n = 3; myocardial infarction, esophageal carcinoma, and dementia, none of which were treatment related). The most common AEs were muscle spasms and falls (both 9 of 10, 90%), followed by diarrhea (6 of 10, 60%) and acne and skin eruption (both 5 of 10, 50%). At weeks 8 and 16, mean TMV increased from baseline by 4.1% (SD 4.3%) and 4.5% (SD 6.3%). Mean LBM increased from baseline and was sustained at 6.9% (SD 3.9%) at week 76. Means of 6MWD showed a progressive decline from baseline to week 76, during which there was a modest numerical increase in handgrip strength and no significant changes in quadriceps strength.

Conclusions: Long-term treatment up to 2 years with bimagrumab had a good safety profile and was well tolerated in individuals with sIBM. An increase in muscle mass was noted on a group level; however, there was no evidence of clinical improvement.

Clinicaltrialsgov Identifier: NCT02250443.

Classification Of Evidence: This study provides Class IV evidence that for patients with sIBM, long-term bimagrumab treatment was safe and well tolerated and did not lead to functional improvement.

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http://dx.doi.org/10.1212/WNL.0000000000010417DOI Listing

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