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Clinical Study of Rituximab for the Treatment for Idiopathic Membranous Nephropathy With Nephrotic Syndrome (PRIME)

Primary Purpose

Glomerulonephritis, Membranous, Nephrotic Syndrome,Idiopathic

Status
Recruiting
Phase
Phase 3
Locations
Japan
Study Type
Interventional
Intervention
Rituximab (genetical recombination)
Placebo
Rituximab (genetical recombination)
Sponsored by
Shoichi Maruyama MD PhD
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Glomerulonephritis, Membranous

Eligibility Criteria

15 Years - undefined (Child, Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria: 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 Criteria: 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 the screening 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, or patients who are not willing to use contraceptive measures during the study period Patients who are judged to be unsuitable by the investigator or a subinvestigator

Sites / Locations

  • Anjo Kosei HospitalRecruiting
  • Kasugai Municipal HospitalRecruiting
  • Konan Kosei HospitalRecruiting
  • Fujita Health University hospitalRecruiting
  • Juntendo University Urayasu HospitalRecruiting
  • Kurume University HospialRecruiting
  • Asahikawa Medical University HospitalRecruiting
  • Kanazawa University HospitalRecruiting
  • Mie University HospialRecruiting
  • Hamamatsu University HosptialRecruiting
  • Kyushu University HospitalRecruiting
  • University Hospital,Kyoto Prefectural University of MedicineRecruiting
  • Kyoto University HospitalRecruiting
  • Osaka University Hospital

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Active Comparator

Placebo Comparator

Other

Arm Label

Rituximab group in double-blind phase

Placebo group in double-blind phase

Rituximab group in open-label phase

Arm Description

Outcomes

Primary Outcome Measures

Percentage of patients achieving ICR I
Achieving ICR I is defined as "Urine protein-creatinine ratio < 1.0 g/gCr".

Secondary Outcome Measures

Percentage of patients who are CR, ICR I, ICR II, NR or PR
CR, ICR I, ICR II, NR or PR are defied as below; CR (Complete Remission): Urine protein-creatinine ratio < 0.3 g/gCr ICR I (Incomplete Remission Type I): 0.3 g/gCr ≤ Urine protein-creatinine ratio < 1.0 g/gCr ICR II (Incomplete Remission Type II): 1.0 g/gCr ≤ Urine protein-creatinine ratio < 3.5 g/gCr NR (No Response): 3.5 g/gCr ≤ Urine protein-creatinine ratio PR (Partial Remission): Decrease in urine protein-creatinine ratio from base line ≥50%, and urine protein-creatinine ratio 0.3 to 3.5 g/gCr
Duration before achieving CR, ICR I, ICR II or PR
Duration of achieving CR, ICR I, ICR II or PR is summarized.
Urine protein-creatinine ratio
The differences of urine protein-creatinine ratio between prior to treatment and at each timepoint are summarized.
eGFR
The differences of eGFR between prior to treatment and at each timepoint are summarized.
B-cells (CD19-positive and CD20-positive cells)
B cell counts (CD19 positive and CD20 positive cell counts) at each timepoint are summarized.
Expression of HACA
The number of patients expressing HACA, and the proportion of these patients at each timepoint are summarized.
Serum rituximab (genetical recombination) concentration
Serum rituximab (genetical recombination) level at each timepoint are summarized.

Full Information

First Posted
June 13, 2023
Last Updated
July 20, 2023
Sponsor
Shoichi Maruyama MD PhD
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1. Study Identification

Unique Protocol Identification Number
NCT05914155
Brief Title
Clinical Study of Rituximab for the Treatment for Idiopathic Membranous Nephropathy With Nephrotic Syndrome
Acronym
PRIME
Official Title
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)
Study Type
Interventional

2. Study Status

Record Verification Date
July 2023
Overall Recruitment Status
Recruiting
Study Start Date
June 24, 2023 (Actual)
Primary Completion Date
December 31, 2026 (Anticipated)
Study Completion Date
December 31, 2026 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor-Investigator
Name of the Sponsor
Shoichi Maruyama MD PhD

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No

5. Study Description

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

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Glomerulonephritis, Membranous, Nephrotic Syndrome,Idiopathic

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
88 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Rituximab group in double-blind phase
Arm Type
Active Comparator
Arm Title
Placebo group in double-blind phase
Arm Type
Placebo Comparator
Arm Title
Rituximab group in open-label phase
Arm Type
Other
Intervention Type
Drug
Intervention Name(s)
Rituximab (genetical recombination)
Intervention Description
Administer 1,000 mg of rituximab (genetical recombination) IV infusion every two weeks for two doses in double-blind phase.
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Administer placebo IV infusion every two weeks for two doses in double-blind phase.
Intervention Type
Drug
Intervention Name(s)
Rituximab (genetical recombination)
Intervention Description
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.
Primary Outcome Measure Information:
Title
Percentage of patients achieving ICR I
Description
Achieving ICR I is defined as "Urine protein-creatinine ratio < 1.0 g/gCr".
Time Frame
up to 26 weeks
Secondary Outcome Measure Information:
Title
Percentage of patients who are CR, ICR I, ICR II, NR or PR
Description
CR, ICR I, ICR II, NR or PR are defied as below; CR (Complete Remission): Urine protein-creatinine ratio < 0.3 g/gCr ICR I (Incomplete Remission Type I): 0.3 g/gCr ≤ Urine protein-creatinine ratio < 1.0 g/gCr ICR II (Incomplete Remission Type II): 1.0 g/gCr ≤ Urine protein-creatinine ratio < 3.5 g/gCr NR (No Response): 3.5 g/gCr ≤ Urine protein-creatinine ratio PR (Partial Remission): Decrease in urine protein-creatinine ratio from base line ≥50%, and urine protein-creatinine ratio 0.3 to 3.5 g/gCr
Time Frame
up to 26 weeks
Title
Duration before achieving CR, ICR I, ICR II or PR
Description
Duration of achieving CR, ICR I, ICR II or PR is summarized.
Time Frame
up to 26 weeks
Title
Urine protein-creatinine ratio
Description
The differences of urine protein-creatinine ratio between prior to treatment and at each timepoint are summarized.
Time Frame
up to 26 weeks
Title
eGFR
Description
The differences of eGFR between prior to treatment and at each timepoint are summarized.
Time Frame
up to 26 weeks
Title
B-cells (CD19-positive and CD20-positive cells)
Description
B cell counts (CD19 positive and CD20 positive cell counts) at each timepoint are summarized.
Time Frame
up to 26 weeks
Title
Expression of HACA
Description
The number of patients expressing HACA, and the proportion of these patients at each timepoint are summarized.
Time Frame
up to 26 weeks
Title
Serum rituximab (genetical recombination) concentration
Description
Serum rituximab (genetical recombination) level at each timepoint are summarized.
Time Frame
up to 26 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
15 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: 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 Criteria: 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 the screening 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, or patients who are not willing to use contraceptive measures during the study period Patients who are judged to be unsuitable by the investigator or a subinvestigator
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Shoichi Maruyama, PhD, MD
Phone
+81527442192
Email
marus@med.nagoya-u.ac.jp
First Name & Middle Initial & Last Name or Official Title & Degree
Shinobu Shimizu, PhD
Phone
+81527442942
Email
s-shimizu@med.nagoya-u.ac.jp
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Shoichi Shoichi, PhD, MD
Organizational Affiliation
Nagoya University Hospital
Official's Role
Principal Investigator
Facility Information:
Facility Name
Anjo Kosei Hospital
City
Anjo
State/Province
Aichi
ZIP/Postal Code
4468602
Country
Japan
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Nobuhide Endo, PhD, MD
Phone
+81566752111
Email
ennob08@yahoo.co.jp
Facility Name
Kasugai Municipal Hospital
City
Kasugai
State/Province
Aichi
ZIP/Postal Code
486-8510
Country
Japan
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Yosuke Saka, PhD, MD
Phone
+81568570057
Email
yosukesaka@hospital.kasugai.aichi.jp
First Name & Middle Initial & Last Name & Degree
Toshiaki Sawada
Phone
+81568570057
Email
chikenjimukyoku@hospital.kasugai.aichi.jp
Facility Name
Konan Kosei Hospital
City
Kōnan
State/Province
Aichi
ZIP/Postal Code
4838704
Country
Japan
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Hiroshi Kojima, PhD, MD
Phone
+81587513333
Email
h-kojima@konan.jaaikosei.or.jp
Facility Name
Fujita Health University hospital
City
Toyoake
State/Province
Aichi
ZIP/Postal Code
4701192
Country
Japan
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Naotake Tsuboi, PhD, MD
Phone
+81562932111
Email
nao-take@fujita-hu.ac.jp
First Name & Middle Initial & Last Name & Degree
Michiko Nakano
Phone
+81562932139
Email
nakanom@fujita-hu.ac.jp
Facility Name
Juntendo University Urayasu Hospital
City
Urayasu
State/Province
Chiba
ZIP/Postal Code
2790021
Country
Japan
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Hitoshi Suzuki, PhD, MD
Phone
+81473533111
Email
shitoshi@juntendo.ac.jp
Facility Name
Kurume University Hospial
City
Kurume
State/Province
Fukuoka
ZIP/Postal Code
8300011
Country
Japan
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Kei Fukami, PhD, MD
Phone
+81942317002
Email
fukami@kurume-u.ac.jp
First Name & Middle Initial & Last Name & Degree
Yusuke Kaida, PhD, MD
Phone
+81942317002
Email
kaida_yuusuke@kurume-u.ac.jp
Facility Name
Asahikawa Medical University Hospital
City
Asahikawa
State/Province
Hokkaido
ZIP/Postal Code
0788510
Country
Japan
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Naoki Nakagawa, PhD, MD
Phone
+81166682442
Email
naka-nao@asahikawa-med.ac.jp
Facility Name
Kanazawa University Hospital
City
Kanazawa
State/Province
Ishikawa
ZIP/Postal Code
9208641
Country
Japan
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Yasunori Iwata, PhD, MD
Phone
+81762652499
Email
iwatay@staff.kanazawa-u.ac.jp
Facility Name
Mie University Hospial
City
Tsu
State/Province
Mie
ZIP/Postal Code
5148507
Country
Japan
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Kan Katayama, PhD, MD
Phone
+81592321111
Email
katayamk@med.mie-u.ac.jp
First Name & Middle Initial & Last Name & Degree
Tomoko Sugiura
Phone
+81592315403
Email
renal@med.mie-u.ac.jp
Facility Name
Hamamatsu University Hosptial
City
Hamamatsu
State/Province
Shizuoka
ZIP/Postal Code
4313129
Country
Japan
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Hideo Yasuda, PhD, MD
Phone
+81534352261
Email
ysdh@hama-med.ac.jp
Facility Name
Kyushu University Hospital
City
Fukuoka
ZIP/Postal Code
8128582
Country
Japan
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Toshiaki Nakano, PhD, MD
Phone
+81926425256
Email
nakano.toshiaki.455@m.kyushu-u.ac.jp
First Name & Middle Initial & Last Name & Degree
Kenji Ueki, PhD, MD
Phone
+81926425256
Email
ueki.kenji.982@m.kyushu-u.ac.jp
Facility Name
University Hospital,Kyoto Prefectural University of Medicine
City
Kyoto
ZIP/Postal Code
6028566
Country
Japan
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Tetsuro Kusaba, PhD, MD
Phone
+81752515111
Email
kusaba@koto.kpu-m.ac.jp
Facility Name
Kyoto University Hospital
City
Kyoto
ZIP/Postal Code
6068507
Country
Japan
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Kaoru Sakai, PhD, MD
Phone
+81757513111
Facility Name
Osaka University Hospital
City
Osaka
ZIP/Postal Code
5650871
Country
Japan
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Yoshitaka Isaka, PhD, MD
Phone
+81668795111

12. IPD Sharing Statement

Plan to Share IPD
Yes
IPD Sharing Plan Description
If the principal investigator, clinical trial office, main stakeholder conclude that secondary use of individual data obtained in this clinical trial is beneficial for additional analysis, the secondary use of data excluding personal information will be acceptable after publication of results.

Learn more about this trial

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

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