| 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  | 
| Generalized Myasthenia Gravis | 
 
 
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| 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  | 20.0 | 
 
| 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  | 
| To assess the efficacy of ravulizumab compared with placebo in the treatment of gMG based on the improvement in the Myasthenia Gravis-Activities of Daily Living (MG-ADL) profile. | 
 
 
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| E.2.2 | Secondary objectives of the trial  | 
• To assess the efficacy of ravulizumab compared with placebo in the treatment of gMG based on the improvement in the Quantitative Myasthenia Gravis (QMG) total score.
 • To assess the efficacy of ravulizumab compared with placebo in the treatment of gMG based on the improvement in quality of life measures.
 • To assess the efficacy of ravulizumab compared with placebo in the treatment of gMG based on other efficacy endpoints. | 
 
 
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| E.2.3 | Trial contains a sub-study  |  No  | 
| E.3 | Principal inclusion criteria  | 
• Male and female patients ≥ 18 years of age
 • Diagnosed with MG at least 6 months (180 days) prior to the date of the Screening Visit
 • Myasthenia Gravis Foundation of America Clinical Classification Class II to IV at screening
 • MG-ADL profile must be ≥ 6 at screening and randomization (Day 1)
 • Vaccinated against meningococcal infections within 3 years prior to, or at the time of, initiating study drug to reduce the risk of meningococcal infection (N meningitidis).
 •  Body weight ≥ 40 kg at the time of screening
 • Patients of childbearing potential and patients with partners of childbearing potential must follow protocol-specified contraception guidance for avoiding pregnancy while on treatment and for 8 months after last dose of study drug
 
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| E.4 | Principal exclusion criteria | 
Medical Conditions:
 • Any active or untreated thymoma. History of thymic carcinoma or thymic malignancy 
 • History of thymectomy, thymomectomy, or any thymic surgery within the 12 months prior to screening
 • History of N meningitidis infection
 • Human immunodeficiency virus (HIV) infection 
 • History of hospitalization for ≥ 24 hours, for any reason, within the 4 weeks (28 days) prior to screening
 • Females who plan to become pregnant during the study, or are currently pregnant or breastfeeding, or who have a positive pregnancy test result at screening or on Day 1
 • History of unexplained infections
 • Active systemic bacterial, viral, or fungal infection within 14 days prior to study drug administration on Day 1
 • Presence of fever ≥ 38°C (100.4°F) within 7 days prior to study drug administration on Day 1
 
 Prior/Concomitant Therapy
 •Use of the following within the time period specified below:
    - IVIg within the 4 weeks (28 days) prior to randomization (Day 1)
    - Use of PE within the 4 weeks (28 days) prior to randomization (Day 1)
    - Use of rituximab within the 6 months (180 days) prior to screening
 • Patients who have received previous treatment with complement-inhibitors (eg, eculizumab)
 
 
 
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| E.5 End points | 
| E.5.1 | Primary end point(s) | 
| Change from Baseline in MG-ADL total score  | 
 
 
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| E.5.1.1 | Timepoint(s) of evaluation of this end point | 
| At Week 26 of the Randomized-Controlled Period. | 
 
 
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| E.5.2 | Secondary end point(s) | 
• Change from Baseline in QMG total score
 • Change from Baseline in the Revised 15-Component Myasthenia Gravis Quality of Life (MG-QOL15r) score 
 • Change from Baseline in Neuro-QOL Fatigue score
 • Improvement from Baseline of at least 3 points in the MG-ADL total score
 • Improvement from Baseline of at least 5 points in the QMG total score | 
 
 
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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 | 2 | 
| E.8.5 | The trial involves multiple Member States |  Yes  | 
| E.8.5.1 | Number of sites anticipated in the EEA | 63 | 
| 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 | 
| Austria | 
 
| Belgium | 
 
| Canada | 
 
| Czech Republic | 
 
| Denmark | 
 
| France | 
 
| Germany | 
 
| Israel | 
 
| Italy | 
 
| Japan | 
 
| Korea, Republic of | 
 
| Netherlands | 
 
| Portugal | 
 
| Russian Federation | 
 
| Spain | 
 
| Switzerland | 
 
| 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
                     | 
| LVLS in the study or last scheduled procedure shown in the Schedule of Activities for the last patient in the study globally | 
 
 
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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 | 0 | 
| E.8.9.1 | In the Member State concerned days | 0 | 
| E.8.9.2 | In all countries concerned by the trial years | 4 | 
| E.8.9.2 | In all countries concerned by the trial months | 0 | 
| E.8.9.2 | In all countries concerned by the trial days | 0 |