AzTrials
AzTrials

Antibody-mediated RejectionPhase 2NCT05021484

Felzartamab in Late Antibody-Mediated Rejection

A Phase 2 study testing Felzartamab in people with Antibody-mediated Rejection, run by Farsad Eskandary at 2 sites in 2 countries.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
Search all trials

Trial summary

This prospective trial will assess the safety, tolerability, pharmacokinetics, immunogenicity, pharmacodynamics and efficacy of the fully human CD38 monoclonal antibody felzartamab in kidney transplant recipients with late active or chronic-active ABMR. Read more about this study

Who is it for?
Ages 19 to 80 years
Conditions the study is for
Antibody-mediated Rejection
What is being tested?
Felzartamab
Type of treatment
Injection or infusion
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
22 participants
Where
2 sitesin 2 countries
Study dates
6 Oct 2021to 7 Mar 2024
Phase
Phase 2
Are there results?
None posted in the registry

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 19 to 80 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Voluntary written informed consent
  • Age >18 years (maximum: 80 years)
  • Functioning living or deceased donor allograft after ≥180 days post-transplantation
  • eGFR ≥20 ml/min/1.73 m2 (CKD-EPI formula)
  • HLA class I and/or II antigen-specific antibodies (preformed and/or de novo DSA).
  • Active or chronic/active ABMR (±C4d in PTC) according to the Banff 2019 classification
  • Molecular ABMR score (MMDx) ≥0.2

Who cannot join

  • Patients actively participating in another clinical trial
  • Age ≤18 years
  • Female subject is pregnant or lactating or not on adequate contraceptive therapy
  • ABO-incompatible transplant
  • Index biopsy results:
  • T-cell-mediated rejection classified Banff grade ≥I
Show all 24Show fewer
  • De novo or recurrent severe thrombotic microangiopathy
  • Polyoma virus nephropathy
  • De novo or recurrent glomerulonephritis
  • Acute rejection treatment ≤3 month before screening
  • Previous treatment with other CD38 monoclonal antibodies (e.g. daratumumab)
  • Previous treatment with other immunomodulatory monoclonal/polyclonal antibodies (e.g. CD20 Ab rituximab, IL-6/IL-6R Ab) ≤3 months before study treatment
  • Total bilirubin >2×the upper limit of normal [ULN], alanine transaminase and aspartate aminotransferase >2·5×ULN
  • Haemoglobin <8 g/dL
  • Thrombocytopenia: Platelets <100 G/L
  • Leukopenia: Leukocytes <3 G/L
  • Neutropenia: Neutrophils < 1.5 G/L
  • Hypogammaglobulinemia: Serum IgG <400 mg/dL
  • Active viral, bacterial or fungal infection precluding intensified immunosuppression
  • Active malignant disease precluding intensified immunosuppressive therapy
  • Latent or active tuberculosis (positive QuantiFERON-TB-Gold test)
  • Administration of a live vaccine within 6 weeks of screening
  • History of alcohol or illicit substance abuse
  • Serious medical or psychiatric illness likely to interfere with participation in the study

Trial locations and contacts

2 sites in 2 countries.

2 sites in 2 countries

Austria1 site
  • Medical University of Vienna

    Vienna, 1090

Other trials in Austria

Germany1 site
  • Charité University

    Berlin, 10117

Other trials in Germany

About this study

Official title: Safety, Tolerability and Efficacy of Monoclonal CD38 Antibody Felzartamab in Late Antibody-Mediated Renal Allograft Rejection - A Phase 2 Pilot Trial

This prospective trial will assess the safety, tolerability, pharmacokinetics, immunogenicity, pharmacodynamics and efficacy of the fully human CD38 monoclonal antibody felzartamab in kidney transplant recipients with late active or chronic-active ABMR. The study is designed as a randomized, controlled, double-blind pilot phase 2 trial. Participants will be randomized to receive either felzartamab or placebo for a period of six months, and then followed for another six months. After six and twelve months, study participants will be subjected to follow-up allograft biopsies.

Read the detailed description

This prospective bi-center study (University of Vienna, Charité Universitätsmedizin Berlin; Sponsor: Medical University of Vienna, Vienna, Austria; Funder: MorphoSys AG, Planegg, Germany) is an investigator-driven pilot trial designed to assess the safety\&tolerability (primary endpoint), pharmacokinetics, immunogenicity, pharmacodynamics and efficacy (preliminary assessment) of the fully human CD38 monoclonal antibody felzartamab in kidney transplant recipients diagnosed with late active or chronic-active antibody-mediated rejection (ABMR) after kidney transplantation.

Adult renal allograft recipients with anti-HLA donor-specific antibodies (DSA) and biopsy-proven ABMR (Banff 2019 classification) ≥180 days post-transplantation will be identified and recruited at the kidney transplantation outpatient services of the two center sites.

The primary endpoint will be safety and tolerability. Participants will be randomized to receive either felzartamab (intravenous administration) or placebo (1:1 randomization stratified by study site and according to ABMR categories) for a period of 6 months (administration of felzartamab/placebo at day 0, 7, 14, 21, and thereafter in 4-weekly intervals. After six (week 24) and twelve months (week 52), study participants will be subjected to follow-up allograft biopsies.

Primary goals of the trial are to assess the safety, pharmacokinetics and pharmacodynamics (peripheral blood plasma cell and natural killer cell depletion) of a 6-month course of treatment over a period of 12 months. The trial will in addition provide first data on efficacy (progression/activity of rejection, blood biomarkers) and potential associations of treatment with parameters reflecting clinical progression of allograft dysfunction, including the course of estimated glomerular filtration rate.

Being tested
Felzartamab, Placebo
Keywords
CD38, Kidney transplantation

What participants receive

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

  • FelzartamabDrug

    Also called MOR202, CD38 monoclonal antibody

    Intravenous infusion in regular intervals over 6 months

  • PlaceboDrug

    Also called 0.9% Saline

    Intravenous infusion in regular intervals over 6 months

Study groups in NCT05021484
Study groupRoleWhat they receive
FelzartamabActive comparator9 doses of felzartamab as an intravenous infusion over 6 treatment cycles at 28 days each. Dosing occurs every week in cycle 1 and every four weeks in cycles 2-6.
Receives: Drug: Felzartamab
PlaceboPlacebo comparator9 doses of placebo as an intravenous infusion over 6 treatment cycles at 28 days each. Dosing occurs every week in cycle 1 and every four weeks in cycles 2-6.
Receives: Drug: Placebo

What is being measured

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

  1. Incidence of treatment-emergent adverse events

    (Serious) adverse events will be classified using the Medical Dictionary for Regulatory Activities (MedDRA). Documentation of an AE will include the assessment of its relationship with the study drug (unrelated, related) and the severity of AE will be graded on a three-point scale (mild, moderate, severe).

    Measured: 12 months

Secondary outcomes (17)
  1. Felzartamab serum concentration

    Total felzartamab serum concentration (ELISA, ng/mL)

    Measured: At day 0, week 1, 2, 3, 4, 8, 12, 16, 20, 24, 28, 32, 36, 40, 44, 44, 48 and 52

  2. Anti-Felzartamab antibodies

    Concentration of anti-felzartamab antibodies in serum (ELISA, ng/mL)

    Measured: At day 0, week 1, 2, 3, 4, 8, 12, 16, 20, 24, 28, 32, 36, 40, 44, 44, 48 and 52

  3. Morphologic ABMR categories

    Phenotyping of renal transplant biopsies: active ABMR vs. chronic active ABMR vs. chronic inactive ABMR

    Measured: At week 24 and at week 52

  4. Serum donor-specific antibody (DSA) levels

    Mean fluorescence intensity (MFI) of the immunodominant DSA (Luminex)

    Measured: Week 0, 12, 24, and 52

  5. Serum immunoglobulin levels

    Ig (sub)classes (ELISA, Nephelometry, mg/dL)

    Measured: Week 0, 12, 24, and 52

  6. Leukocyte subsets in peripheral blood

    Counts of circulating plasma cells, natural killer cells, T and B cell subpopulations (flow cytometry, cell counts)

    Measured: Week 0, 1, 4, 8, 12, 24, and 52

  7. Immunologic biomarkers

    CXCL9 and CXCL10 levels in blood and urine, BAFF levels in blood (ELISA, Luminex)

    Measured: Week 0, 12, 24, and 52

  8. Torque Teno virus

    Torque Teno virus (TTV) levels in plasma (quantitative PCR)

    Measured: Week 0, 12, 24, and 52

  9. eGFR

    Estimated GFR (CKD-EPI, mL/min/1.73m2)

    Measured: At day 0, week 4, 8, 12, 16, 20, 24, 28, 32, 36, 40, 44, 44, 48 and 52

  10. Proteinuria

    Urinary protein excretion in spot urine (protein/creatinine ratio in mg/g)

    Measured: At day 0, week 4, 8, 12, 16, 20, 24, 28, 32, 36, 40, 44, 44, 48 and 52

  11. Graft loss

    Graft failure: time (months) to event (Kaplan Meier)

    Measured: 12 months

  12. Death

    Patient death: time (months) to event (Kaplan Meier)

    Measured: 12 months

  13. Glomerulitis plus peritubular capillaritis sum score

    Grading of renal transplant biopsies using a semiquantitative score (g+ptc 0-6); higher = worse prognosis

    Measured: At week 24 and at week 52

  14. Transplant glomerulopathy score

    Grading of renal transplant biopsies using a semiquantitative score (cg 0-3); higher = worse prognosis

    Measured: At week 24 and at week 52

  15. C4d score

    Grading of renal transplant biopsies using a semiquantitative score (c4d 0-3); higher = worse prognosis

    Measured: At week 24 and at week 52

  16. Molecular ABMR score

    ABMR score (0.0-1.0, dimensionless number) assessed via the Molecular Microscope Diagnostic Platform (MMDx); higher = worse prognosis

    Measured: At week 24 and at week 52

  17. Molecular ABMR categories

    Molecular archetype analysis of rejection phenotypes using the Molecular Microscope Diagnostic Platform (MMDx). Phenotypes: early-stage ABMR; fully developed ABMR; late-stage ABMR

    Measured: At week 24 and at week 52

Timeline

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

  1. First posted25 Aug 2021
  2. Study start6 Oct 2021
  3. Primary completion7 Mar 2024
  4. Study completion7 Mar 2024

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 2
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
22 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05021484
Sponsor's protocol ID
EK1161/2021
Other IDs
2021-000545-40
Status last verified
Apr 2024
First submitted
12 Aug 2021
Last updated
18 Apr 2024
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Doberer K, Klager J, Gualdoni GA, Mayer KA, Eskandary F, Farkash EA, Agis H, Reiter T, Reindl-Schwaighofer R, Wahrmann M, Cohen G, Haslacher H, Bond G, Simonitsch-Klupp I, Halloran PF, Bohmig GA. CD38 Antibody Daratumumab for the Treatment of Chronic Active Antibody-mediated Kidney Allograft Rejection. Transplantation. 2021 Feb 1;105(2):451-457. doi: 10.1097/TP.0000000000003247.

    PubMed 32235256
  • Raab MS, Engelhardt M, Blank A, Goldschmidt H, Agis H, Blau IW, Einsele H, Ferstl B, Schub N, Rollig C, Weisel K, Winderlich M, Griese J, Hartle S, Weirather J, Jarutat T, Peschel C, Chatterjee M. MOR202, a novel anti-CD38 monoclonal antibody, in patients with relapsed or refractory multiple myeloma: a first-in-human, multicentre, phase 1-2a trial. Lancet Haematol. 2020 May;7(5):e381-e394. doi: 10.1016/S2352-3026(19)30249-2. Epub 2020 Mar 11.

    PubMed 32171061
  • Mayer KA, Doberer K, Eskandary F, Halloran PF, Bohmig GA. New concepts in chronic antibody-mediated kidney allograft rejection: prevention and treatment. Curr Opin Organ Transplant. 2021 Feb 1;26(1):97-105. doi: 10.1097/MOT.0000000000000832.

    PubMed 33315763
  • Mayer KA, Budde K, Diebold M, Halloran PF, Bohmig GA. Targeting CD38 in Antibody-Mediated Rejection. Transpl Int. 2025 May 15;38:14343. doi: 10.3389/ti.2025.14343. eCollection 2025.

    PubMed 40444214
  • Madill-Thomsen KS, Gauthier PT, Abouljoud M, Bhati C, Bruno D, Ciszek M, Durlik M, Feng S, Foroncewicz B, Grat M, Jurczyk K, Levitsky J, McCaughan G, Maluf D, Montano-Loza A, Moonka D, Mucha K, Myslak M, Perkowska-Ptasinska A, Piecha G, Reichman T, Tronina O, Wawrzynowicz-Syczewska M, Zeair S, Halloran PF. Defining an NK Cell-enriched Rejection-like Phenotype in Liver Transplant Biopsies From the INTERLIVER Study. Transplantation. 2025 Aug 1;109(8):1367-1382. doi: 10.1097/TP.0000000000005269. Epub 2025 Jan 9.

    PubMed 39780312
  • Mayer KA, Schrezenmeier E, Diebold M, Halloran PF, Schatzl M, Schranz S, Haindl S, Kasbohm S, Kainz A, Eskandary F, Doberer K, Patel UD, Dudani JS, Regele H, Kozakowski N, Klager J, Boxhammer R, Amann K, Puchhammer-Stockl E, Vietzen H, Beck J, Schutz E, Akifova A, Firbas C, Gilbert HN, Osmanodja B, Halleck F, Jilma B, Budde K, Bohmig GA. A Randomized Phase 2 Trial of Felzartamab in Antibody-Mediated Rejection. N Engl J Med. 2024 Jul 11;391(2):122-132. doi: 10.1056/NEJMoa2400763. Epub 2024 May 25.

    PubMed 38804514
  • Mayer KA, Budde K, Halloran PF, Doberer K, Rostaing L, Eskandary F, Christamentl A, Wahrmann M, Regele H, Schranz S, Ely S, Firbas C, Schorgenhofer C, Kainz A, Loupy A, Hartle S, Boxhammer R, Jilma B, Bohmig GA. Safety, tolerability, and efficacy of monoclonal CD38 antibody felzartamab in late antibody-mediated renal allograft rejection: study protocol for a phase 2 trial. Trials. 2022 Apr 8;23(1):270. doi: 10.1186/s13063-022-06198-9.

    PubMed 35395951

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Felzartamab in people with Antibody-mediated Rejection, run by Farsad Eskandary at 2 sites in 2 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 7 inclusion and 24 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: finished, as of the sponsor's last update on 18 Apr 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 2 sites in Austria, Germany. 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. Some participants in this study may receive a placebo. 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 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

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

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

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?

Incidence of treatment-emergent adverse events (time frame: 12 months). 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 NCT05021484, which also lists 7 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 18 Apr 2024.

Free account

Log in to keep searching

You’ve used your 3 free searches. AzTrials is free: log in or create a free account to keep searching clinical trials and save the ones you want to follow.

Create a free accountLog in