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Primary Membranous NephropathyPhase 3MAJESTYNCT04629248

A Study Evaluating the Efficacy and Safety of Obinutuzumab in Participants With Primary Membranous Nephropathy

A Phase 3 study testing Obinutuzumab, Tacrolimus and Methylprednisolone in people with Primary Membranous Nephropathy, run by Hoffmann-La Roche at 50 sites in 11 countries.

Active, not recruiting

Under way, not looking for participants. Everyone needed has enrolled. The study is still running.

Official record
Search all trials

Trial summary

This study will evaluate the efficacy, safety, pharmacodynamics, and pharmacokinetics (PK) of obinutuzumab compared with tacrolimus in participants with primary membranous nephropathy (pMN). Read more about this study

Who is it for?
Ages 18 to 75 years
Conditions the study is for
Primary Membranous Nephropathy
What is being tested?
Obinutuzumab, Tacrolimus and Methylprednisolone
Could I receive a placebo?
No, everyone receives an active treatment
How many people
142 participants
Where
50 sitesin 11 countries
Study dates
25 Jun 2021to 21 Dec 2027
Phase
Phase 3
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 75 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Diagnosis of primary membranous nephropathy (pMN) according to renal biopsy prior to or during screening
  • Screening urinary protein-to-creatinine ratio (UPCR) >= 5 g/g from 24-hour urine collection after best supportive care for >= 3 months prior to screening or screening UPCR >= 4 g/g after best supportive care for >= 6 months prior to screening
  • eGFR >= 40 mL/min/1.73m^2 or qualified endogenous creatinine clearance >= 40 mL/min/1.73m^2 based on 24-hour urine collection during screening
  • Other inclusion criteria may apply

Who cannot join

  • Participants with a secondary cause of MN
  • Pregnancy or breastfeeding
  • Evidence of >= 50% reduction in proteinuria during the previous 6 months prior to randomization
  • Severe renal impairment, including the need for dialysis or renal replacement therapy
  • Type 1 or 2 diabetes mellitus
  • Receipt of an excluded therapy, including any anti-CD20 therapy less than 9 months prior to or during screening; or cyclophosphamide, tacrolimus, or cyclosporin less than 6 months prior to or during screening
Show all 12Show fewer
  • Significant or uncontrolled medical disease which, in the investigator's opinion, would preclude participant participation
  • Known active infection of any kind or recent major episode of infection
  • Major surgery requiring hospitalization within the 4 weeks prior to screening
  • Current active alcohol or drug abuse or history of alcohol or drug abuse within 12 months prior to screening
  • Intolerance or contraindication to study therapies
  • Other exclusion criteria may apply

Trial locations and contacts

50 sites in 11 countries.

50 sites in 11 countries

China10 sites
  • Peking University First Hospital

    Beijing, 100034

  • Sichuan Provincial People's Hospital

    Chengdu, 610072

  • The 1st Affiliated hospital of Fujian Medical University

    Fuzhou, 350005

  • Nanfang Hospital, Southern Medical University

    Guangzhou, 510515

  • Zhejiang Provincial People?s Hospital

    Hangzhou, Zhejiang, 310014

  • Ruijin Hospital, Shanghai Jiaotong University School of Medicine

    Shanghai, 200025

  • Huashan Hospital, Fudan University

    Shanghai, 200040

  • Tongji Hospital Tongji Medical College Huazhong University of Science and Technology

    Wuhan, 430030

  • The First Affiliated Hospital of Xian Jiao Tong University

    Xi'an, 710061

  • General Hospital of Ningxia Medical University

    Yinchuan, 750004

Other trials in China

United States8 sites
  • Accel Research Sites; Mid-Florida Kidney and Hypertension Care

    Altamonte Springs, Florida, 32701

  • University of Colorado in Denver-Anschutz Medical Campus

    Aurora, Colorado, 80045

  • Nephrotex Research Group

    Dallas, Texas, 75231

  • Henry Ford Hospital

    Detroit, Michigan, 48202

  • University of Iowa

    Iowa City, Iowa, 52242

  • Columbia University Medical Center

    New York, New York, 10032

  • Mayo Clinic

    Rochester, Minnesota, 55902

  • Kaiser Permanente - San Francisco Medical Center

    San Francisco, California, 94118

Other trials in United States

Italy5 sites
  • Policlinico di Bari

    Bari, Apulia, 70124

  • A.O. Spedali Civili Di Brescia-P.O. Spedali Civili

    Brescia, Lombardy, 25123

  • ASST Monza - Ospedale San Gerardo

    Monza, Lombardy, 20900

  • A.O. U. Federico II

    Naples, Campania, 80131

  • Ospedale San Giovanni Bosco

    Turin, Piedmont, 10154

Other trials in Italy

Poland5 sites
  • Uniwersytecki Szpital Kliniczny nr 1 im. N. Barlickiego

    ?ód?, 90-153

  • Uniwersytecki Szpital Kliniczny im WAM CSW

    ?ód?, 92-213

  • Uniwersytecki Szpital Kliniczny w Bialymstoku

    Bia?ystok, 15-276

  • Szpital Uniwersytecki im.dr.A.Jurasza w Bydgoszczy

    Bydgoszcz, 85-094

  • Uniwersytecki Szpital Kliniczny im. Jana Mikulicza-Radeckiego we Wroclawiu

    Wroc?aw, 50-556

Other trials in Poland

Spain5 sites
  • Hospital Universitari Vall d'Hebron

    Barcelona, 08035

  • Hospital Clinic i Provincial

    Barcelona, 08036

  • Hospital Universitari de Bellvitge

    L'Hospitalet de Llobregat, Barcelona, 08907

  • Hospital Universitario 12 de Octubre

    Madrid, 28041

  • Hospital Universitario Virgen del Rocío

    Seville, 41013

Other trials in Spain

Brazil4 sites
  • Ser Servicos Especializados Em Reumatologia

    Salvador, Estado de Bahia, 40150-150

  • Hospital de Base de Sao Jose do Rio Preto

    São José do Rio Preto, São Paulo, 15090-000

  • Hospital do Rim e Hipertensão - Fundação Oswaldo Ramos

    São Paulo, São Paulo, 04038-002

  • Hospital das Clinicas - FMUSP

    São Paulo, São Paulo, 05403-000

Other trials in Brazil

Argentina3 sites
  • Organizacion Medica de Investigacion

    Buenos Aires, C1015ABO

  • CINME

    Buenos Aires, C1056ABI

  • Hospital Britanico Buenos Aires

    Buenos Aires, C1280AEB

Other trials in Argentina

France3 sites
  • Hopital Henri Mondor

    Créteil, 94010

  • Hopital Tenon

    Paris, 75020

  • Hopital Rangueil

    Toulouse, 31059

Other trials in France

Russia3 sites
  • First Moscow State Medical University n.a. I.M. Sechenov

    Moscow, Moscow Oblast, 119021

  • Rostov State Medical Uni

    Rostov-on-Don, Rostov Oblast, 344022

  • German clinic

    Saint Petersburg, Sankt-Peterburg, 196070

Other trials in Russia

Turkey (Türkiye)3 sites
  • Hacettepe Uni School of Medicine

    Ankara, 06100

  • Akdeniz University Medical Faculty

    Antalya, 07059

  • Ege Uni School of Medicine

    Izmir, 35100

Other trials in Turkey (Türkiye)

Israel1 site
  • Sheba MC

    Ramat Gan, 52621

Other trials in Israel

About this study

Official title: A Phase III Randomized, Open-Label Active Comparator-Controlled Multicenter Study to Evaluate Efficacy and Safety of Obinutuzumab in Patients With Primary Membranous Nephropathy

This study will evaluate the efficacy, safety, pharmacodynamics, and pharmacokinetics (PK) of obinutuzumab compared with tacrolimus in participants with primary membranous nephropathy (pMN).

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • ObinutuzumabDrug

    Also called Gazyva

    Open Label: An intravenous (IV) infusion of 1000 milligram (mg) of obinutuzumab will be administered at Week 0, Week 2, Week 24, and Week 26. Participants who relapse during the open-label treatment period may be eligible for further treatment.

  • TacrolimusDrug

    Open Label: Participants will receive tacrolimus at a starting oral dose (PO) of 0.05 mg/kilogram (kg) (participant dry weight) per day divided into two equal doses given at 12-hour intervals, titrated to serum trough level 5-7 Nanograms per millilitre (ng/mL). Optimized tacrolimus dose will be maintained for a maximum 52 weeks dependent on response and then tapered over 8 weeks. Participants who relapse during the open-label treatment period will have their dose of tacrolimus tapered over 8 weeks and may be eligible for further treatment.

  • MethylprednisoloneDrug

    Premedication: Methylprednisolone 80 mg IV will be administered between 30 and 60 minutes prior to the obinutuzumab infusion in all study periods.

  • AcetaminophenDrug

    Premedication: Acetaminophen (650-1000 mg, or equivalent dose of a similar agent) PO or IV will be administered between 30 and 60 minutes prior to the obinutuzumab infusion in all study periods.

  • DiphenhydramineDrug

    Premedication: Diphenhydramine (50 mg, or equivalent dose of a similar agent) PO or IV will be administered between 30 and 60 minutes prior to the obinutuzumab infusion in all study periods.

Study groups in NCT04629248
Study groupRoleWhat they receive
Open Label Treatment: ObinutuzumabExperimentalParticipants will be randomized at a 1:1 ratio to receive open-label treatment with obinutuzumab according to region and anti-phospholipase A2 receptor (PLA2R) autoantibody titer (using Euroimmun ELISA).
Receives: Drug: Obinutuzumab; Drug: Methylprednisolone; Drug: Acetaminophen; Drug: Diphenhydramine
Open Label Treatment: TacrolimusActive comparatorParticipants will be randomized at a 1:1 ratio to receive open-label treatment with tacrolimus according to region and anti-PLA2R autoantibody titer (using Euroimmun ELISA).
Receives: Drug: Tacrolimus

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Percentage of Participants who Achieve a Complete Remission (CR) at Week 104

    Measured: Week 104

Secondary outcomes (14)
  1. Percentage of Participants who Achieve an Overall Remission at Week 104

    Measured: Week 104

  2. Percentage of Participants who Achieve CR at Week 76

    Measured: Week 76

  3. Time to Treatment Failure, Meeting Escape Criteria, or Relapse after Complete or Partial Remission

    Measured: Up to 8 years

  4. Time to a Sustained Reduction of Estimated Glomerular Filtration Rate (eGFR) >= 30% from Baseline

    Measured: Up to 8 years

  5. Mean Change in T-score from Baseline in the Patient-Reported Outcomes Measurement Information System (PROMIS) Fatigue Scale at Week 104

    Self-reported changes in fatigue will be measured using the PROMIS Fatigue Scale.

    Measured: Baseline to Week 104

  6. Duration of CR

    Measured: Up to 8 years

  7. Change in anti-PLA2R Autoantibody Titer

    Measured: Baseline to Week 52

  8. Mean Change from Baseline in the PROMIS Global Assessment of Physical Health Scale at Week 104

    Self-reported changes in physical health will be measured using the PROMIS Physical Health Scale

    Measured: Baseline to Week 104

  9. Percentage of Participants with Adverse Events (AEs)

    Severity Determined According to National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE) version 5.0

    Measured: Up to 8 years

  10. Percentage of Participants with AEs of Special Interest (AESIs)

    AESIs are required to be reported by the investigator to the Sponsor immediately

    Measured: Up to 8 years

  11. Peripheral B-cell Counts at Specified Timepoints

    Measured: Weeks 0 (baseline), 2, 4, 12, 24, 26, 36, 52, 64, 76, 88, 104, 117, 130, 156, 182, 208 and every 26 weeks thereafter

  12. Serum Concentrations of Obinutuzumab at Specified Timepoints

    Measured: Weeks 0 (baseline), 2, 4, 12, 24, 26, 36, 52, 64, 76, 88, 104, 117, 130, 143, 156, 169, 182, 195, 208, every 26 weeks thereafter

  13. Prevalence of Anti-drug Antibodies (ADAs) to Obinutuzumab at Baseline

    Measured: Open Label: Baseline; Escape Treatment: Week 0

  14. Incidence of ADAs during the study

    Measured: Weeks 2, 4, 12, 24, 26, 36, 52, 64, 76, 88, 104, 130, 156, 182, 208 and every 26 weeks thereafter

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted16 Nov 2020
  2. Study start25 Jun 2021
  3. Primary completion22 Dec 2025
  4. Study completion21 Dec 2027 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
142 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04629248
Sponsor's protocol ID
WA41937
Other IDs
2020-003233-38, 2023-506525-11-00, 2023
Acronym
MAJESTY
Status last verified
Sep 2026
First submitted
27 Oct 2020
Last updated
1 Oct 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
Yes: For eligible studies, qualified researchers may request access to individual patient level clinical data. See Roche's commitment to transparency of clinical study information here: https://go.roche.com/data\_sharing

Publications

  • Fervenza FC, Hou FF, Hao CM, Kirsztajn GM, Gesualdo L, Hryszko T, Pisani A, Roccatello D, Bomback AS, Rae J, Barmaki F, Berisha E, Schindler T, Omachi TA, Garg JP, Malvar A; MAJESTY Trial Investigators. Obinutuzumab or Tacrolimus in Primary Membranous Nephropathy. N Engl J Med. 2026 Jun 5. doi: 10.1056/NEJMoa2602678. Online ahead of print.

    PubMed 42246654
  • Dossier C, Bonneric S, Baudouin V, Kwon T, Prim B, Cambier A, Couderc A, Moreau C, Deschenes G, Hogan J. Obinutuzumab in Frequently Relapsing and Steroid-Dependent Nephrotic Syndrome in Children. Clin J Am Soc Nephrol. 2023 Dec 1;18(12):1555-1562. doi: 10.2215/CJN.0000000000000288. Epub 2023 Sep 6.

    PubMed 37678236
  • Dossier C, Hogan J. Response to Majeranowski. Pediatr Nephrol. 2021 Jun;36(6):1653. doi: 10.1007/s00467-021-04982-4. Epub 2021 Mar 10. No abstract available.

    PubMed 33693991

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing Obinutuzumab, Tacrolimus and Methylprednisolone in people with Primary Membranous Nephropathy, run by Hoffmann-La Roche at 50 sites in 11 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 4 inclusion and 12 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: under way, not looking for participants, as of the sponsor's last update on 1 Oct 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 50 sites in China, United States, Italy, Poland, Spain and 6 more countries. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Percentage of Participants who Achieve a Complete Remission (CR) at Week 104 (time frame: Week 104). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT04629248, which also lists 3 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 1 Oct 2026.

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