Phase 1b/2a Study Assessing the Safety and Efficacy of Felzartamab in Anti-Phospholipase A2 Receptor Autoantibody–Positive Primary Membranous Nephropathy

Introduction: Primary membranous nephropathy (PMN) is most often caused by autoantibodies to phospholipase A2 receptor (PLA2R). M-PLACE (NCT04145440) is an open-label, phase 1b/2a study that assessed the safety and efficacy of the fully human anti-CD38 monoclonal antibody felzartamab in high-risk an...

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Main Authors: Brad H. Rovin, Pierre M. Ronco, Jack F.M. Wetzels, Sharon G. Adler, Isabelle Ayoub, Philippe Zaoui, Seung Hyeok Han, Jaideep S. Dudani, Houston N. Gilbert, Uptal D. Patel, Paul T. Manser, Julia Jauch-Lembach, Nicola Faulhaber, Rainer Boxhammer, Stefan Härtle, Ben Sprangers
Format: Article
Language:English
Published: Elsevier 2024-09-01
Series:Kidney International Reports
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Online Access:http://www.sciencedirect.com/science/article/pii/S2468024924017947
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author Brad H. Rovin
Pierre M. Ronco
Jack F.M. Wetzels
Sharon G. Adler
Isabelle Ayoub
Philippe Zaoui
Seung Hyeok Han
Jaideep S. Dudani
Houston N. Gilbert
Uptal D. Patel
Paul T. Manser
Julia Jauch-Lembach
Nicola Faulhaber
Rainer Boxhammer
Stefan Härtle
Ben Sprangers
author_facet Brad H. Rovin
Pierre M. Ronco
Jack F.M. Wetzels
Sharon G. Adler
Isabelle Ayoub
Philippe Zaoui
Seung Hyeok Han
Jaideep S. Dudani
Houston N. Gilbert
Uptal D. Patel
Paul T. Manser
Julia Jauch-Lembach
Nicola Faulhaber
Rainer Boxhammer
Stefan Härtle
Ben Sprangers
author_sort Brad H. Rovin
collection DOAJ
description Introduction: Primary membranous nephropathy (PMN) is most often caused by autoantibodies to phospholipase A2 receptor (PLA2R). M-PLACE (NCT04145440) is an open-label, phase 1b/2a study that assessed the safety and efficacy of the fully human anti-CD38 monoclonal antibody felzartamab in high-risk anti-PLA2R+ PMN. Methods: Patients with newly diagnosed or relapsed PMN (cohort 1 [C1]; n = 18) or PMN refractory to immunosuppressive therapy (IST) (cohort 2 [C2]; n = 13) received 9 infusions of felzartamab 16 mg/kg in the 24-week treatment period, followed by a 28-week follow-up. The primary end point was the incidence and severity of treatment-emergent adverse events (TEAEs). Results: A total of 31 patients were enrolled and received felzartamab. Twenty-seven patients (87.1%) had TEAEs, including infusion-related reactions (IRRs) (29.0%), hypogammaglobulinemia (25.8%), peripheral edema (19.4%), and nausea (16.1%). Five patients (16.1%) had serious TEAEs that all resolved. Immunologic response (anti-PLA2R titer reduction ≥50%) was achieved by 20 of 26 efficacy-evaluable patients (76.9%) (C1, 13/15 [86.7%]; C2, 7/11 [63.6%]). Anti-PLA2R titer reductions were rapid (week 1 response, 44.0%; response 7 months after last felzartamab dose [end of study, EOS], 53.8%). Partial proteinuria remission (urine protein-to-creatinine ratio [UPCR] reduction ≥50%, UPCR <3.0 g/g, and stable estimated glomerular filtration rate [eGFR]) was achieved by 9 of 26 patients (34.6%) (C1, 7/15 [46.7%]; C2, 2/11 [18.2%]) before or at EOS (median follow-up, 366 days). Serum albumin increased from baseline to EOS in 20 of 26 patients (76.9%) (C1, 12/15 [80.0%]; C2, 8/11 [72.7%]). Conclusion: In this population with high-risk anti-PLA2R+ PMN, felzartamab was tolerated and resulted in rapid partial and complete immunologic responses and partial improvements in proteinuria and serum albumin in some patients.
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spelling doaj-art-c88b107cd5c848e89b3a51428462e26c2025-08-20T03:47:02ZengElsevierKidney International Reports2468-02492024-09-01992635264710.1016/j.ekir.2024.06.018Phase 1b/2a Study Assessing the Safety and Efficacy of Felzartamab in Anti-Phospholipase A2 Receptor Autoantibody–Positive Primary Membranous NephropathyBrad H. Rovin0Pierre M. Ronco1Jack F.M. Wetzels2Sharon G. Adler3Isabelle Ayoub4Philippe Zaoui5Seung Hyeok Han6Jaideep S. Dudani7Houston N. Gilbert8Uptal D. Patel9Paul T. Manser10Julia Jauch-Lembach11Nicola Faulhaber12Rainer Boxhammer13Stefan Härtle14Ben Sprangers15Department of Medicine and Division of Nephrology, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA; Correspondence: Brad H. Rovin, Division of Nephrology, The Ohio State University Wexner Medical Center, 1644 Neil Avenue, 4th Floor, Columbus, Ohio 43210, USA.Sorbonne Université and INSERM UMRS 1155, Paris France; Centre Hospitalier Le Mans, Le Mans, FranceDepartment of Nephrology, Radboud University Medical Center, Nijmegen, The NetherlandsLundquist Research Institute at Harbor UCLA, Torrance, California, USADepartment of Medicine and Division of Nephrology, The Ohio State University Wexner Medical Center, Columbus, Ohio, USACentre Hospitalier Universitaire Grenoble Alpes, Grenoble, FranceYonsei University College of Medicine, Seoul, South KoreaHuman Immunology Biosciences, Inc., South San Francisco, California, USAHuman Immunology Biosciences, Inc., South San Francisco, California, USAHuman Immunology Biosciences, Inc., South San Francisco, California, USAHuman Immunology Biosciences, Inc., South San Francisco, California, USAMorphoSys AG, Planegg, GermanyMorphoSys AG, Planegg, GermanyMorphoSys AG, Planegg, GermanyMorphoSys AG, Planegg, GermanyKatholieke Universiteit Leuven, Leuven, Belgium; Zlekenhuis Oost Limburg Genk, Genk, BelgiumIntroduction: Primary membranous nephropathy (PMN) is most often caused by autoantibodies to phospholipase A2 receptor (PLA2R). M-PLACE (NCT04145440) is an open-label, phase 1b/2a study that assessed the safety and efficacy of the fully human anti-CD38 monoclonal antibody felzartamab in high-risk anti-PLA2R+ PMN. Methods: Patients with newly diagnosed or relapsed PMN (cohort 1 [C1]; n = 18) or PMN refractory to immunosuppressive therapy (IST) (cohort 2 [C2]; n = 13) received 9 infusions of felzartamab 16 mg/kg in the 24-week treatment period, followed by a 28-week follow-up. The primary end point was the incidence and severity of treatment-emergent adverse events (TEAEs). Results: A total of 31 patients were enrolled and received felzartamab. Twenty-seven patients (87.1%) had TEAEs, including infusion-related reactions (IRRs) (29.0%), hypogammaglobulinemia (25.8%), peripheral edema (19.4%), and nausea (16.1%). Five patients (16.1%) had serious TEAEs that all resolved. Immunologic response (anti-PLA2R titer reduction ≥50%) was achieved by 20 of 26 efficacy-evaluable patients (76.9%) (C1, 13/15 [86.7%]; C2, 7/11 [63.6%]). Anti-PLA2R titer reductions were rapid (week 1 response, 44.0%; response 7 months after last felzartamab dose [end of study, EOS], 53.8%). Partial proteinuria remission (urine protein-to-creatinine ratio [UPCR] reduction ≥50%, UPCR <3.0 g/g, and stable estimated glomerular filtration rate [eGFR]) was achieved by 9 of 26 patients (34.6%) (C1, 7/15 [46.7%]; C2, 2/11 [18.2%]) before or at EOS (median follow-up, 366 days). Serum albumin increased from baseline to EOS in 20 of 26 patients (76.9%) (C1, 12/15 [80.0%]; C2, 8/11 [72.7%]). Conclusion: In this population with high-risk anti-PLA2R+ PMN, felzartamab was tolerated and resulted in rapid partial and complete immunologic responses and partial improvements in proteinuria and serum albumin in some patients.http://www.sciencedirect.com/science/article/pii/S2468024924017947clinical trialfelzartamabMOR202phase 2phospholipase A2 receptorprimary membranous nephropathy
spellingShingle Brad H. Rovin
Pierre M. Ronco
Jack F.M. Wetzels
Sharon G. Adler
Isabelle Ayoub
Philippe Zaoui
Seung Hyeok Han
Jaideep S. Dudani
Houston N. Gilbert
Uptal D. Patel
Paul T. Manser
Julia Jauch-Lembach
Nicola Faulhaber
Rainer Boxhammer
Stefan Härtle
Ben Sprangers
Phase 1b/2a Study Assessing the Safety and Efficacy of Felzartamab in Anti-Phospholipase A2 Receptor Autoantibody–Positive Primary Membranous Nephropathy
Kidney International Reports
clinical trial
felzartamab
MOR202
phase 2
phospholipase A2 receptor
primary membranous nephropathy
title Phase 1b/2a Study Assessing the Safety and Efficacy of Felzartamab in Anti-Phospholipase A2 Receptor Autoantibody–Positive Primary Membranous Nephropathy
title_full Phase 1b/2a Study Assessing the Safety and Efficacy of Felzartamab in Anti-Phospholipase A2 Receptor Autoantibody–Positive Primary Membranous Nephropathy
title_fullStr Phase 1b/2a Study Assessing the Safety and Efficacy of Felzartamab in Anti-Phospholipase A2 Receptor Autoantibody–Positive Primary Membranous Nephropathy
title_full_unstemmed Phase 1b/2a Study Assessing the Safety and Efficacy of Felzartamab in Anti-Phospholipase A2 Receptor Autoantibody–Positive Primary Membranous Nephropathy
title_short Phase 1b/2a Study Assessing the Safety and Efficacy of Felzartamab in Anti-Phospholipase A2 Receptor Autoantibody–Positive Primary Membranous Nephropathy
title_sort phase 1b 2a study assessing the safety and efficacy of felzartamab in anti phospholipase a2 receptor autoantibody positive primary membranous nephropathy
topic clinical trial
felzartamab
MOR202
phase 2
phospholipase A2 receptor
primary membranous nephropathy
url http://www.sciencedirect.com/science/article/pii/S2468024924017947
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