RecruitingPhase 3NCT05914155

Clinical Study of Rituximab for the Treatment for Idiopathic Membranous Nephropathy with Nephrotic Syndrome

The Multi-center, Randomized, Double-blind, Placebo-controlled Study to Evaluate the Efficacy and Safety of Rituximab (Genetical Recombination) for the Treatment for Idiopathic Membranous Nephropathy with Nephrotic Syndrome (PRIME Study)


Sponsor

Shoichi Maruyama MD PhD

Enrollment

88 participants

Start Date

Jun 24, 2023

Study Type

INTERVENTIONAL

Conditions

Summary

To confirm the efficacy and safety of rituximab (genetical recombination) intravenously administered to idiopathic membranous nephropathy with nephrotic syndrome.


Eligibility

Min Age: 15 Years

Inclusion Criteria6

  • Patients who undergo kidney biopsy and are diagnosed as having idiopathic membranous nephropathy prior to the obtainment of informed consent
  • Patients who are diagnosed as having nephrotic syndrome prior to the obtainment of informed consent and receive no steroids or immunosuppressants within 12 weeks prior to the obtainment of informed consent
  • Patients with urine protein-creatinine ratio ≥ 3.5 g/gCr at the screening
  • Patients with hypoalbuminemia (serum albumin ≤ 3.0 g/dL) at the screening
  • Patients aged 15 years or older at informed consent
  • Patients who give voluntary written consent after having received adequate information on this study (legally acceptable representatives should also give consent for underage patients, and informed assent should be obtained from children)

Exclusion Criteria14

  • Patients with primary nephrotic syndrome other than membranous nephropathy (IgA nephropathy, minimal change disease, focal segmental glomerulosclerosis and so forth), and patients with secondary nephrotic syndrome (autoimmune disease, metabolic disease, infection, allergic/hypersensitive disease, tumor, and drug-induced disease)
  • Patients with the renal function lowered (eGFR \<30 mL/min/1.73 m2 based on CKD-EPIcr formula) at the screening
  • Patients who have used anti-CD20 antibody including rituximab (genetical recombination) prior to the informed consent for idiopathic membranous nephropathy
  • Patients who have participated in another clinical study within 12 weeks prior to the informed consent (enrollment is allowed for those participating in a clinical study in the range of 'Indications' or 'Dosage and Administration' in Japan) or patients who are participating in another study
  • Patients with history of renal transplant
  • Patients with poorly controlled diabetes (HbA1c of 8.0% or higher)
  • Patients who have or are suspected to have active infection (infection requiring treatment with systemic antimicrobial, antifungal, or antiviral agents) at the time of informed consent
  • Patients tested positive for HBs antigen, HBs antibody, HBc antibody, and/or HCV antibody (patients with positive HBs antibody and/or HBc antibody can be enrolled only when HBV-DNA test is negative \[less than the detection limit\]), or patients with positive HIV antibody or HTLV-1 antibody at the time of the screening
  • Patients with leukopenia (less than 2,000 /mm3), neutropenia (less than 1,000 /mm3), or lymphopenia (less than 500 /mm3) at the time of the screening
  • Patients with history of serious hypersensitivity or anaphylactic reaction to one of the ingredients in the investigational drug or murine protein-containing products
  • Patients who are judged to be life-threatening nephrotic syndrome by the investigator or a subinvestigator
  • Patients with serious comorbidity (e.g., hepatic, renal (excluding idiopathic membranous nephropathy with nephrotic syndrome), cardiac, lung, hematologic, or brain disease)
  • Female patients who are pregnant, lactating, or potentially pregnant, patients who are not willing to use contraceptive measures during the study period, or female patients not willing to use contraceptive measures until 12 months after the last dose of study drug (except for female patients who are unale to pregnant)
  • Patients who are judged to be unsuitable by the investigator or a subinvestigator

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Interventions

DRUGRituximab (genetical recombination)

Administer 1,000 mg of rituximab (genetical recombination) IV infusion every two weeks for two doses in double-blind phase.

DRUGPlacebo

Administer placebo IV infusion every two weeks for two doses in double-blind phase.

DRUGRituximab (genetical recombination)

Patients who remain to be ICR II (Incomplete Remission Type II) or NR (No Response) until Week 26 in the double-blind phase, if the patients wish to move to the open-label phase and the investigator or a subinvestigator considers the move necessary, the patient will move to the open-label phase and receive 1,000 mg of rituximab (genetical recombination) IV infusion every two weeks for two doses after the readministration criteria are confirmed to be met.


Locations(18)

Anjo Kosei Hospital

Anjo, Aichi-ken, Japan

Kasugai Municipal Hospital

Kasugai, Aichi-ken, Japan

Konan Kosei Hospital

Kōnan, Aichi-ken, Japan

Nagoya University Hospital

Nagoya, Aichi-ken, Japan

Fujita Health University hospital

Toyoake, Aichi-ken, Japan

Juntendo University Urayasu Hospital

Urayasu, Chiba, Japan

Kyushu University Hospital

Fukuoka, Fukuoka, Japan

Kurume University Hospial

Kurume, Fukuoka, Japan

Asahikawa Medical University Hospital

Asahikawa, Hokkaido, Japan

Kanazawa University Hospital

Kanazawa, Ishikawa-ken, Japan

Kumamoto University Hospital

Kumamoto, Kumamoto, Japan

University Hospital,Kyoto Prefectural University of Medicine

Kyoto, Kyoto, Japan

Kyoto University Hospital

Kyoto, Kyoto, Japan

Mie University Hospial

Tsu, Mie-ken, Japan

Tohoku University Hospital

Sendai, Miyagi, Japan

Tazuke Kofukai, Medical Research Institute, Kitano Hospital

Osaka, Osaka, Japan

Osaka University Hospital

Osaka, Osaka, Japan

Hamamatsu University Hosptial

Hamamatsu, Shizuoka, Japan

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NCT05914155


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