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NCT06962800PHASE3Recruiting

A Study to Learn More About the Effects and Safety of Felzartamab Infusions in Adults With Primary Membranous Nephropathy (PMN)

Biogen

Start Date

5/22/2025

Completion Date

3/29/2029

Summary

In this study, researchers will learn more about the use of felzartamab in participants with primary membranous nephropathy, also known as PMN. In people with PMN, autoantibodies build up in the glomeruli of the kidney. Antibodies are proteins that help the body fight off infection. An autoantibody is a type of antibody that mistakenly targets and attacks the body's own tissues. Glomeruli are the filters of the kidney that remove waste and extra fluid from the body. In PMN, the build-up of autoantibodies in the glomeruli causes damage to the kidneys. Kidney damage can lead to too much protein and blood leaking into the urine. High levels of protein in the urine, called proteinuria, are common in people with PMN. Symptoms of PMN can include swelling in the legs and body, tiredness, and high blood pressure. If left untreated, PMN can eventually lead to kidney failure. In this study, researchers will learn more about how a study drug called felzartamab affects people with PMN. Felzartamab is a monoclonal antibody, which means it is an antibody made in a laboratory. Felzartamab can target immune cells that produce autoantibodies, helping to lower their buildup in the kidneys. The main goal of this study is to compare how felzartamab works compared to a drug called tacrolimus. Tacrolimus is another drug given to people with PMN and kidney disease. The main question that researchers want to answer is: * How many participants achieve a complete response after 104 weeks of treatment? * A complete response means that their urine protein levels decrease to a low level and their kidney function remains stable. Researchers will also learn about: * How long it takes before the participants' disease gets worse * How long the participants' urine protein levels stay low * How many participants develop antibodies against felzartamab in the blood? * How many participants achieve a complete response after 76 weeks of treatment * How many participants have medical problems during the study * How felzartamab is processed by the body * How felzartamab affects participants' tiredness and overall physical health The study will be done as follows: * Participants will be screened to check if they can join the study. This may take up to 42 days. * Participants will be randomized to receive either felzartamab as intravenous (IV) infusions or tacrolimus, taken orally as tablets. * If participants have worsening kidney function or worsening proteinuria, or if their PMN relapses, or if they show no signs of improvement in their PMN, they will have a chance to receive rescue treatment. * If a participant stops treatment early, there will be follow-up visits every 12 weeks until they reach Week 104. * In total, participants will have up to 23 study visits. Participants who do not need rescue treatment will stay in the study for up to 104 weeks. Participants who need rescue treatment will stay in the study for up to 156 weeks.

Detailed Description

The primary objective of the study is to assess the efficacy of felzartamab compared to tacrolimus in participants with PMN in achieving complete remission (CR) of proteinuria. The secondary objectives of the study are to evaluate the efficacy of felzartamab through additional clinical endpoints and timepoints, to assess the impact of felzartamab on serum anti-phospholipase A2 receptor (PLA2R) antibodies and patient-reported outcomes, and to assess the safety, pharmacokinetics (PK) and immunogenicity of felzartamab.

Eligibility Criteria

Age Range: 18 years to 80 years

Key Inclusion Criteria: * Diagnosed with PMN in need of IST according to the Investigator's clinical judgment. The diagnosis of PMN must be documented with the presence of nephrotic syndrome, and hypoalbuminemia, and confirmed with a kidney biopsy either during Screening or within 5 years of signing the informed consent form (ICF) \[see kidney biopsy exception below for participants positive for anti-PLA2R antibodies\]. For these participants, the biopsy report with redacted protected health information must be available to be reviewed by the Sponsor or an independent nephropathologist. If the participant requires a kidney biopsy during Screening, medical monitor approval must be obtained and all other eligibility criteria should be reviewed to ensure that the participant is otherwise eligible prior to performing the kidney biopsy. a. Kidney biopsy exception for anti-PLA2R antibody positive participants: Participants who are positive for anti-PLA2R antibodies and have not had a kidney biopsy performed within 5 years of signing the ICF, may be eligible for the study without undergoing a kidney biopsy based on medical monitor review confirming normal estimated glomerular filtration rate (eGFR), presence of nephrotic syndrome, hypoalbuminemia, positive anti-PLA2R antibody test (defined as an anti-PLA2R antibody titer \> 20 RU/mL), and documentation provided by the Investigator that the work-up for secondary causes of membranous nephropathy (MN) was negative with no identifiable secondary causes. * Meets one of the following: 1. Newly diagnosed PMN, defined as having never received IST for PMN in the past. 2. Relapsed PMN, defined as documented achievement of CR or partial remission (PR) after treatment with an IST for PMN followed by reappearance of nephrotic range proteinuria (urine protein to creatinine ratio \[UPCR\] ≥ 3.0 gram per gram \[g/g\] from a 24-hour urine collection or proteinuria ≥ 3.5 gram per 24 hour \[g/24 h\]). * Participants must be on the maximally approved dose or maximally tolerated dose of angiotensin-converting enzyme inhibitor (ACEI) or angiotensin receptor blocker (ARB) for at least 3 months prior to Screening. Participants not on the maximally approved dose of renin-angiotensin-aldosterone system (RAAS) inhibition may be enrolled provided there is documented intolerance to maximal RAAS inhibition (e.g., angioedema, development of postural hypotension, lightheadedness, hyperkalemia, etc). * A UPCR of ≥ 3.0 g/g (as determined by a 24-hour urine collection) or total proteinuria ≥ 3.5 g/24 h (as determined by a 24-hour urine collection) at Screening after best supportive care for at least 3 months prior to signing the ICF. Key Exclusion Criteria: * Secondary cause of MN (e.g., malignancies, medications, systemic lupus erythematosus \[SLE\], hepatitis B, hepatitis C, etc). * Severe renal impairment defined as an eGFR ≤ 30 mL/min/1.73m\^2 at Screening or including the need for dialysis or renal replacement therapy. Note: Other protocol-defined Inclusion/Exclusion criteria may apply.

Interventions

DRUG

Felzartamab

DRUG

Tacrolimus

DRUG

Standard of Care IST

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Conditions

Primary Membranous Nephropathy

Locations

Apogee Clinical Research, LLC

Huntsville, Alabama 35805-4104

United States

The Nephrology Group, Inc. - Fresno

Fresno, California 93720-2989

United States

Academic Medical Research Institute

Los Angeles, California 90022

United States

UCLA Health Connie Frank Kidney Transplant Center and General Nephrology

Los Angeles, California 90095-8344

United States

UCSF Medical Center

San Francisco, California 94143-2205

United States

Stanford University

Stanford, California 94305-2200

United States

Henry Ford Hospital- A-Basement Research Pharmacy

Detroit, Michigan 48202-2608

United States

Elixia Health - Michigan Kidney Consultants, LLC - Elixia - PPDS

Pontiac, Michigan 48341

United States

James J Peters Veterans Administration Medical Center - NAVREF - PPDS

The Bronx, New York 10468

United States

ECU Physicians Nephrology and Hypertension

Greenville, North Carolina 27834

United States

University Hospitals Cleveland Medical Center

Cleveland, Ohio 44106-1716

United States

Knoxville Kidney Center, PLLC

Knoxville, Tennessee 37923-3624

United States

Vanderbilt University Medical Center

Nashville, Tennessee 37204-3609

United States

Nephrotex Research Group

Dallas, Texas 75231-0929

United States

University of Texas Medical Branch

League City, Texas 77573

United States

University of Wisconsin School of Medicine and Public Health

Madison, Wisconsin 53792-0001

United States

Organización Médica de Investigación

Buenos Aires, C1015ABO

Argentina

CINME S.A. - Centro de Investigaciones Metabólicas

Buenos Aires, C1056ABI

Argentina

Hospital Italiano de Buenos Aires

Buenos Aires, C1199ABB

Argentina

Centro Medico Dra. Laura Maffei- Investigacion Clinica Aplicada

Buenos Aires, C1425

Argentina

Clínica Privada Vélez Sarsfield

Córdoba, X5016KET

Argentina

Concord Hospital

Concord, New South Wales 2138

Australia

St George Hospital

Kogarah, New South Wales 2217

Australia

Liverpool Hospital

Liverpool, New South Wales 2170

Australia

Westmead Hospital

Westmead, New South Wales 2145

Australia

Townsville Hospital

Douglas, Queensland 4814

Australia

Royal Brisbane and Women s Hospital

Herston, Queensland 4006

Australia

Gold Coast University Hospital

Southport, Queensland 4215

Australia

Griffith University Clinical Trial Unit

Southport, Queensland 4215

Australia

Monash Health

Clayton, Victoria 3168

Australia

Sunshine Hospital - Australia

St Albans, Victoria 3021

Australia

Santa Casa de Misericórdia de Belo Horizonte

Belo Horizonte, Minas Gerais 30150-221

Brazil

Hospital de Clinicas de Porto Alegre

Porto Alegre, Rio Grande do Sul 90560-030

Brazil

Hospital Sao Lucas Da Pontificia Universidade Catolica Do Rio Grande Do Sul (PUCRS)

Porto Alegre, Rio Grande do Sul 90610-001

Brazil

Hospital das Clinicas da Faculdade de Medicina de Ribeirao Preto da Universidade de Sao Paulo

Ribeirão Preto, São Paulo 14051-140

Brazil

Fundacao Faculdade Regional de Medicina de Sao Jose Do Rio Preto Hospital de Base - PPDS

São José do Rio Preto, São Paulo 15090-000

Brazil

Centro de Pesquisa Clínica de Nefrologia do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo

São Paulo, 05304-000

Brazil

London Health Sciences Centre - Victoria Hospital

London, Ontario N6A 5W9

Canada

Fu Yang People's Hospital - South Campus

Fuyang, Anhui 236006

China

Beijing Tsinghua Changgung Hospital

Beijing, Beijing Municipality 102218

China

Peking University First Hospital - Changqiao Campus

Xichengqu Beijing, Beijing Municipality 100034

China

Zhongshan Hospital Xiamen University

Xiamen, Fujian 361004

China

Gansu Provincial Hospital

Lanzhou, Gansu 730000

China

Lanzhou University Second Hospital

Lanzhou, Gansu 730030

China

Zhujiang Hospital of Southern Medical University

Guangzhou, Guangdong 510280

China

Peking University Shenzhen Hospital

Shenzhen, Guangdong 518036

China

The First Affiliated Hospital of Guangxi Medical University

Nanning, Guangxi 530021

China

The People's Hospital of Guangxi Zhuang Autonomous Region

Nanning, Guangxi 530021

China

The Affiliated Hospital of Guizhou Medical University

Guiyang, Guizhou 550004

China

The Second Hospital of Hebei Medical University - Main

Shijiazhuang, Hebei 50000

China

The First Hospital of Hebei Medical University

Shijiazhuang, Hebei 50031

China

Daqing Oilfield General Hospital

Daqing, Heilongjiang 163001

China

The First Affiliated Hospital of Henan Science and Technology University - Jinghua Campus

Luoyang, Henan 471003

China

The Second Xiangya Hospital of Central South University

Changsha, Hunan 410011

China

Yueyang People Hospital

Yueyang, Hunan 414000

China

The Second Affiliated Hospital of Xian Jiaotong University

Xi'an, Shaanxi 710004

China

The First Affiliated Hospital of Xian Jiaotong University

Xi'an, Shaanxi 710061

China

Qilu Hospital of Shandong University

Jinan, Shandong 250012

China

The Second Hospital of Shandong University

Jinan, Shandong 250033

China

The Affiliated Hospital of Qingdao University - Xihaian Campus

Qingdao, Shandong 266555

China

Yantai Yuhuangding Hospital

Yantai, Shandong 264000

China

Huashan Hospital Fudan University

Shanghai, Shanghai Municipality 200040

China

The Second Affiliated Hospital, Zhejiang University School of Medicine

Hangzhou, Zhejiang 310009

China

Sir Run Run Shaw Hospital Zhejiang University School of Medicine - Qingchun Campus

Hangzhou, Zhejiang 310016

China

Osmania General Hospital

Hyderabad, Andhra Pradesh 500012

India

Nizams Institute of Medical Sciences

Hyderabad, Andhra Pradesh 500082

India

Manipal Hospital Bangalore

Bangalore, Karnataka 560017

India

M.S. Ramaiah Medical College and Hospital

Bangalore, Karnataka 560054

India

Noble Hospital

Pune, Maharashtra 411013

India

Max Super Speciality Hospital - Saket

New Delhi, National Capital Territory of Delhi 110017

India

Sir Ganga Ram Hospital

New Delhi, National Capital Territory of Delhi 110060

India

Regency Health Super Specialty Hospital - Lucknow

Lucknow, Uttar Pradesh 226022

India

Galaxy Hospital - Varanasi

Varanasi, Uttar Pradesh 221010

India

Nil Ratan Sircar Medical College and Hospital

Kolkata, West Bengal 700014

India

Postgraduate Institute of Medical Education & Research (PGIMER)

Chandigarh, 160012

India

National Hospital Organization Chiba Medical Center Chibahigashi National Hospital

Chia-shi, Chiba 260-8712

Japan

Juntendo University Urayasu Hospital

Urayasu-Shi, Chiba 279-0021

Japan

Hokkaido University Hospital

Sapporo, Hokkaidô 060-8648

Japan

Kagawa University Hospital

Kita-Gun Uchiko-Cho, Kagawa-ken 761-0793

Japan

The Kitasato Institute Kitasato University Hospital

Sagamihara-Shi Minami-Ku, Kanagawa 252-0375

Japan

Yokohama City University Hospital

Yokohama, Kanagawa 236-0004

Japan

University of Miyazaki Hospital

Miyazaki, Miyazaki 889-1692

Japan

Niigata University Medical & Dental Hospital

Niigata, Niigata 951-8520

Japan

Social Medical Corporation Yuuaikai Yuuai Medical Center

Tomigusuku-Shi, Okinawa 901-0224

Japan

Saitama Medical University Hospital

Iruma-Gun Moroyama-Machi, Saitama 350-0451

Japan

Japanese Red Cross Musashino Hospital

Musashino-shi, Tokyo 180-8610

Japan

Hospital Raja Permaisuri Bainun

Perak, Pahang 30450

Malaysia

Hospital Canselor Tuanku Muhriz UKM

Cheras, WilayahPersekutuan KualaLumpur 56000

Malaysia

Prince Court Medical Centre

Kuala Lumpur, 50450

Malaysia

Ajou University Hospital

Suwon, Gyeonggido 16499

South Korea

Seoul National University Hospital

Seoul, Seoul Teugbyeolsi 3080

South Korea

Inje University Haeundae Paik Hospital

Busan, 48108

South Korea

Hanyang University Seoul Hospital

Seoul, 4763

South Korea

Chung-Ang University Hospital

Seoul, 6973

South Korea

Hualien Tzu Chi Hospital

Hualien City, Hualien 970

Taiwan

Kaohsiung Medical University Chung-Ho Memorial Hospital

Kaohsiung City, 80756

Taiwan

Kaohsiung Chang Gung Memorial Hospital

Kaohsiung City, 83301

Taiwan

China Medical University Hospital

Taichung, 40447

Taiwan

Taichung Veterans General Hospital

Taichung, 40705

Taiwan

National Cheng Kung University Hospital

Tainan, 70403

Taiwan

MacKay Memorial Hospital

Taipei, 104

Taiwan

Taipei Medical University Hospital - PPDS

Taipei, 11031

Taiwan

Taipei Municipal Wanfang Hospital

Taipei, 116

Taiwan

Chang Gung Memorial Hospital

Taoyuan, 33305

Taiwan