| E.1 Medical condition or disease under investigation | 
| E.1.1 | Medical condition(s) being investigated  | 
| Generalized Myasthenia Gravis | 
 
 
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| E.1.1.1 | Medical condition in easily understood language  | 
 | 
| E.1.1.2 | Therapeutic area  | Diseases [C] - Nervous System Diseases [C10] | 
| MedDRA Classification | 
| E.1.2 Medical condition or disease under investigation | 
| E.1.2 | Version  | 17.0 | 
 
| E.1.2 | Level  | HLT | 
 
| E.1.2 | Classification code  | 10071942 | 
 
| E.1.2 | Term  | Myasthenia gravis and related conditions | 
 
| E.1.2 | System Organ Class  | 100000004859 | 
 
 
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| E.1.3 | Condition being studied is a rare disease  |  Yes  | 
| E.2 Objective of the trial | 
| E.2.1 | Main objective of the trial  | 
| Assess the efficacy of eculizumab as compared with placebo in the treatment of refractory gMG based on the improvement in the MG-specific Activities of Daily Living profile (MG-ADL). | 
 
 
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| E.2.2 | Secondary objectives of the trial  | 
- Safety and tolerability of eculizumab as compared with placebo in gMG subjects
 - Efficacy of eculizumab compared with placebo
 - Describe the pharmacokinetics (PK) and pharmacodynamics (PD) of eculizumab
 - Characterize the effect of eculizumab as compared with placebo on Quality of Life measures | 
 
 
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| E.2.3 | Trial contains a sub-study  |  No  | 
| E.3 | Principal inclusion criteria  | 
- Male or female subjects ≥18 years old
 - Diagnosis of MG
 - MGFA Clinical Classification Class II to IV at screening
 - MG-ADL total score must be ≥6 at screening and randomization | 
 
 
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| E.4 | Principal exclusion criteria | 
- History of thymoma or other neoplasms of thymus
 - History of thymectomy within 12 months prior to screening
 - Weakness only affecting ocular or peri-ocular muscles (MGFA Class I)
 - MG crisis at screening (MGFA Class V)
 - Pregnancy or lactation
 - Unresolved meningococcal infection | 
 
 
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| E.5 End points | 
| E.5.1 | Primary end point(s) | 
| - change from baseline in the MG-ADL total score for eculizumab as compared with placebo | 
 
 
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| E.5.1.1 | Timepoint(s) of evaluation of this end point | 
 | 
| E.5.2 | Secondary end point(s) | 
- Change from baseline in QMG total score 
 - Proportion of subjects with at least a 3-point reduction in the MG-ADL total score and with no rescue therapy
 - Proportion of subjects with at least a 5 point reduction in the QMG total score
 - Change from baseline in the Myasthenia Gravis Composite (MGC) scale total score
 - Change from baseline in MG-QOL-15 | 
 
 
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| E.5.2.1 | Timepoint(s) of evaluation of this end point | 
 | 
| E.6 and E.7 Scope of the trial | 
| E.6 | Scope of the trial | 
| E.6.1 | Diagnosis |  No  | 
| E.6.2 | Prophylaxis |  No  | 
| E.6.3 | Therapy |  Yes  | 
| E.6.4 | Safety |  Yes  | 
| E.6.5 | Efficacy |  Yes  | 
| E.6.6 | Pharmacokinetic |  Yes  | 
| E.6.7 | Pharmacodynamic |  Yes  | 
| E.6.8 | Bioequivalence |  No  | 
| E.6.9 | Dose response |  No  | 
| E.6.10 | Pharmacogenetic |  No  | 
| E.6.11 | Pharmacogenomic |  No  | 
| E.6.12 | Pharmacoeconomic |  No  | 
| E.6.13 | Others |  No  | 
| E.7 | Trial type and phase | 
| E.7.1 | Human pharmacology (Phase I) |  No  | 
| E.7.1.1 | First administration to humans |  No  | 
| E.7.1.2 | Bioequivalence study |  No  | 
| E.7.1.3 | Other |  No  | 
| E.7.1.3.1 | Other trial type description |  | 
| E.7.2 | Therapeutic exploratory (Phase II) |  No  | 
| E.7.3 | Therapeutic confirmatory (Phase III) |  Yes  | 
| E.7.4 | Therapeutic use (Phase IV) |  No  | 
| E.8 Design of the trial | 
| E.8.1 | Controlled |  Yes  | 
| E.8.1.1 | Randomised |  Yes  | 
| E.8.1.2 | Open |  No  | 
| E.8.1.3 | Single blind |  No  | 
| E.8.1.4 | Double blind  |  Yes  | 
| E.8.1.5 | Parallel group |  Yes  | 
| E.8.1.6 | Cross over  |  No  | 
| E.8.1.7 | Other |  No  | 
| E.8.2 |  Comparator of controlled trial | 
| E.8.2.1 | Other medicinal product(s) |  No  | 
| E.8.2.2 | Placebo  |  Yes  | 
| E.8.2.3 | Other |  No  | 
| E.8.2.4 | Number of treatment arms in the trial | 2 | 
| E.8.3 | 
                                The trial involves single site in the Member State concerned
                             |  No  | 
| E.8.4 |  The trial involves multiple sites in the Member State concerned  |  Yes  | 
| E.8.4.1 | Number of sites anticipated in Member State concerned | 6 | 
| E.8.5 | The trial involves multiple Member States |  Yes  | 
| E.8.5.1 | Number of sites anticipated in the EEA | 44 | 
| E.8.6 Trial involving sites outside the EEA | 
| E.8.6.1 | Trial being conducted both within and outside the EEA |  Yes  | 
| E.8.6.2 | Trial being conducted completely outside of the EEA |  No  | 
| E.8.6.3 | If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned | 
| Argentina | 
 
| Australia | 
 
| Austria | 
 
| Belgium | 
 
| Brazil | 
 
| Canada | 
 
| Denmark | 
 
| Finland | 
 
| France | 
 
| Germany | 
 
| Greece | 
 
| Ireland | 
 
| Italy | 
 
| Japan | 
 
| Netherlands | 
 
| Norway | 
 
| Spain | 
 
| Sweden | 
 
| Switzerland | 
 
| Turkey | 
 
| United Kingdom | 
 
| United States | 
 
 
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| E.8.7 | Trial has a data monitoring committee |  No  | 
| E.8.8 | 
                        Definition of the end of the trial and justification where it is not the last
                        visit of the last subject undergoing the trial
                     | 
| Last visit of the last patient | 
 
 
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| E.8.9 Initial estimate of the duration of the trial | 
| E.8.9.1 | In the Member State concerned years | 3 | 
| E.8.9.1 | In the Member State concerned months |  | 
| E.8.9.1 | In the Member State concerned days |  | 
| E.8.9.2 | In all countries concerned by the trial years | 3 |