The purpose of the HARMONY 360 investigation is to explore the feasibility of using MyoSense 360 digital measures to develop models capable of detecting clinically meaningful changes in generalized Myasthenia Gravis (gMG) trajectory over 12 months under real-world conditions. Its main objective is not yet to demonstrate the final conformity of the device (exploratory study under article 82), but to collect preliminary data of safety and clinical performance that will help to refine the final product and inform the subsequent pivotal study.
The primary objective focuses on developing models to detect disease trajectory changes defined by the clinically significant +/- 2 points MG-ADL threshold. Secondary objectives include assessing usability, adherence, and the feasibility of models for worsening/exacerbation prediction. Finally, risks and anticipated Adverse Device Effects (ADEs) associated with the device use will be monitored continuously throughout the investigation. Consistent with its Proof of Concept stage, the study defines no claims of clinical performance, effectiveness or safety.
Age ≥ 18 years at screening
Positive antibody testing for ACHR or MuSK antibodies; or,
LRP-4 antibodies or seronegative patients with additional positive single fiber examination; or,
Abnormal single-fiber EMG (SFEMG) jitter in at least one clinically weak muscle; or,
Known medical or psychological condition(s) or risk factor(s) that, as judged by the investigator, might interfere with the subject's full participation in the study, pose any additional risk for the subject, or confound the assessment of the subject or outcome of the study.
Person under guardianship or curatorship
Current drugs or/and alcohol abuse that could influence performance on the tests, as judged by the investigator
Participant has participated in another interventional clinical study within 30 days prior to screening or who are currently enrolled in another study that, in the - Investigator's opinion, could interfere with their full participation in this study or confound the assessment of the subject or study outcomes
Single group
MyoSense 360
DeviceThe investigational version of MyoSense 360 consists of two mobile applications running on the patient's smartphone (CentrePoint Connect and InClinical), an ActiGraph LEAP activity monitor (Ametris product), as well as two cloud computing platforms
To explore the feasibility of using digital measures collected by MyoSense 360 to develop models to detect changes in disease trajectory in adults with generalized Myasthenia Gravis over a 12-month period, under real-life, unsupervised conditions.
The primary endpoint will be the ability of the model to detect changes categorized as a 3-class variable: * improved: decreased Myasthenia Gravis Activities of Daily Living (MG-ADL) total score ≥2 points * unchanged: increased or decreased MG-ADL total score \<2 points * worsening: increased MG-ADL total score by ≥2 points
To explore the feasibility of using digital measures collected by MyoSense 360 to develop models to predict sustained worsening within a one-month forward-looking window
The first secondary endpoint will be the ability of the model to detect changes categorized as a 2-class variable: * worsening: increased MG-ADL total score by ≥2 points * other: either decreased MG-ADL total score ≥2 points or increased or decreased in MG-ADL total score \<2 points
To describe the association between MyoSense 360 active functional tests combined measures in a model, obtained at home, without supervision and the standard reference QMG sub-items scores performed under clinical supervision at baseline.
Feasibility of using MyoSense 360 developed models to predict sustained worsening, i.e., an increase by at least 2-points in MG-ADL total score that is sustained within the next 4 weeks (no change observed in the opposite direction) will be described through performance metrics: \- Positive predictive value
To describe the association between MyoSense 360 active functional tests combined measures in a model, obtained at home, without supervision and the standard reference QMG sub-items scores performed under clinical supervision at baseline.
Feasibility of using MyoSense 360 developed models to predict sustained worsening, i.e., an increase by at least 2-points in MG-ADL total score that is sustained within the next 4 weeks (no change observed in the opposite direction) will be described through performance metrics: \- time-to-event accuracy
To describe the association between MyoSense 360 active functional tests combined measures in a model, obtained at home, without supervision and the standard reference QMG sub-items scores performed under clinical supervision at baseline.
Feasibility of using MyoSense 360 developed models to predict sustained worsening, i.e., an increase by at least 2-points in MG-ADL total score that is sustained within the next 4 weeks (no change observed in the opposite direction) will be described through performance metrics: \- Model robustness across patients.
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