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Hemolytic-Uremic SyndromeCOMPRareNCT05985122

New Analytic Tools for aHUS and C3G Diagnosis

A study testing C3NEF assay in people with Hemolytic-Uremic Syndrome and Membranoproliferative Glomerulonephritis, run by Mario Negri Institute for Pharmacological Research at 1 site in Italy.

Active, not recruiting

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

Official record
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Trial summary

This protocol is part of a larger project, COMPRare (COMPlement-mediated Rare kidney diseases), which has been financed on behalf of the EJP RD (European Joint Programme on Rare Diseases) program of EU and is leaded by a scientific consortium from 7 European countries. The partners (P) of the consortium are: P1. Read more about this study

Who is it for?
Any ageHealthy volunteers can take part
What is being tested?
C3NEF assay
Could I receive a placebo?
No, everyone receives an active treatment
How many people
180 participants
Where
1 siteItaly
Study dates
1 Jul 2023to Oct 2026
Phase
Interventional
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 Any age
  • All sexes
  • Healthy volunteers accepted
  • Child, Adult, Older adult

Who may be able to join

  • Male and female patients (children and adults) with C3G diagnosis
  • Biobank written informed consent
  • Aim 2 Inclusion criteria
  • Male and female patients (children and adults) with aHUS diagnosis in acute phase (before any treatment), or in remission either untreated or undergoing anti-C5 treatment at standard dosing
  • Written informed consent Exclusion criteria
  • Stx-associated HUS
  • TTP (ADAMTS13<10%)
  • Plasma therapy within 2 weeks from blood sampling

Who cannot join

None listed.

Trial locations and contacts

1 site in 1 country.

Italy1 site
  • Centro di Ricerche Cliniche per le Malattie Rare "Aldo e Cele Daccò"

    Ranica, BG, 24020

Other trials in Italy

About this study

Official title: Towards the Most Accurate Diagnosis and Monitoring of Complement-mediated Rare Kidney Diseases

This protocol is part of a larger project, COMPRare (COMPlement-mediated Rare kidney diseases), which has been financed on behalf of the EJP RD (European Joint Programme on Rare Diseases) program of EU and is leaded by a scientific consortium from 7 European countries.

The partners (P) of the consortium are:

Read more

P1. Radboudumc Amalia Children's Hospital (The Netherlands) P2. Semmelweis University (Hungary) P3. Cordeliers Research Center (France) P4. Max Delbruck Center for Molecular Medicine (Germany) P5. Istituto di Ricerche Farmacologiche Mario Negri (Italy) P6. Lund University (Sweden) P7. Lille University (France)

The general aim of the project is to define new diagnostic tools for complement activation in order to improve patients stratification and follow-up, thereby affecting time and choice of treatment in patients with aHUS and C3G.

Particularly, the specific objectives of the COMPRare are:

  • To develop new standardized analytic assays thereby identifying specific complement prognostic biomarkers for early diagnosis, classification, improved monitoring and treatment of patients with aHUS and C3G;
  • To in-depth characterize patients' complement abnormalities in blood, in patient-derived cells and in kidney biopsies;
  • To identify strategies to classify VUS/LPV
  • To find new pathophysiological pathways involved in aHUS and C3G for further improving disease diagnosis, monitoring and treatment.

The results of these studies will form the basis of personalized treatment with existing and upcoming complement inhibitory drugs for these rare complement-mediated kidney diseases.

Read the detailed description

Atypical Hemolytic Uremic Syndrome (aHUS) and C3 Glomerulopathies (C3G) are ultra-rare conditions in which an uncontrolled complement activation results in renal inflammation with thrombotic microangiopathy (TMA) in aHUS and extensive deposition of complement fragments in the kidneys in C3G. In both conditions, these alterations lead to acute and chronic kidney damage and, ultimately, end-stage renal failure. The prevalence of genetic and acquired complement abnormalities varies between the two diseases, but covers mostly the same complement proteins. Blocking the complement system is the treatment of choice in aHUS and may have considerable potential in C3G, as evident from the increasing number of phase 3 trials with complement inhibitory drugs. Timely and accurate diagnosis is still challenging for clinicians, both for aHUS, to differentiate it from other forms of TMA, and for C3G, to distinguish it from other forms of glomerulonephritis (GN). In C3G, kidney biopsy is the diagnostic gold standard but it is not sufficient. Therefore, for both aHUS and C3G, there is an unmet need for accurate testing of genetic and acquired complement abnormalities. Moreover, interlaboratory complement-assays, in particular the tests for the C3 Nephritic Factors (C3NeFs; heterogeneous autoantibodies that stabilize the C3 convertase), vary considerably and, consequently, their standardization is a great necessity. Furthermore, the interpretation of genetic results in aHUS and C3G is not always conclusive.

Variants of Unknown Significance (VUS)/Likely Pathogenic Variant (LPV) in complement genes are often found in aHUS and C3G and require further characterization. A rapid and functional VUS/LPV determination and interpretation could help to better understand the disease pathophysiology and might influence diagnosis and treatment options.

Currently, aHUS patients are effectively treated with the complement C5 inhibiting monoclonal antibodies Eculizumab and Ravulizumab. However, the duration and optimal dose of treatment are debated, particularly in view of the high costs of the drug. Even if recent studies showed that restrictive use of eculizumab is feasible, there is a clear need for biomarkers identification and protocols for monitoring and predicting disease activity in aHUS and C3G patients.

In summary, new analytic tools for further defining the disease profile in blood, (patients) cells and kidney biopsies are needed.

Being tested
C3NEF assay
Keywords
Complement-mediated kidney diseases, Blood and tissue biomarkers, Assay standardization, Glycocalyx, Characterization of variants of unknown significance
Medical subject headings
Hemolytic-Uremic Syndrome, Glomerulonephritis, Membranoproliferative

What participants receive

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

  • C3NEF assayDiagnostic test

    This assay will consist of a dual test, detecting C3 convertase binding C3NEF autoantibodies and measuring the functional consequence by complement alternative pathway (AP) activity using two distinct ELISA designs: C3NEF detection assay and AP activity assay.

Study groups in NCT05985122
Study groupRoleWhat they receive
PatientsExperimentalPatients diagnosed with C3G (15 positive and 15 negative for C3NEF) at Centro Daccò, will be identified between those who provided consent to store their samples in the certified biobank (UNI EN ISO 9001:2015; certification n° 6121) of "Centro Daccò" (Centro di Risorse Biologiche Mario Negri - Biobanca Malattie Rare e Renali) and to share them with external laboratories.
Receives: Diagnostic Test: C3NEF assay
Healthy controlsActive comparatorHealthy donors will be identified between those who provided consent to store their samples in the certified biobank (UNI EN ISO 9001:2015; certification n° 6121) of "Centro Daccò" (Centro di Risorse Biologiche Mario Negri - Biobanca Malattie Rare e Renali). Subject that meet the inclusion/exclusion criteria and for which there is no enough material stored in our biobank, will be recontacted by the investigators of "Centro Daccò" and, if agree, will be asked for serum sampling after informed consent signature.
Receives: Diagnostic Test: C3NEF assay

What is being measured

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

  1. Determination of assay sensitivity and specificity

    We estimate that 38 VUS/LPV carrying pedigrees should be enough to demonstrate the sensitivity and specificity of the assay for classifying VUS/LPV.

    Measured: At day 0

Timeline

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

  1. First posted14 Aug 2023
  2. Study start1 Jul 2023
  3. Primary completionOct 2026 (estimated)
  4. Study completionOct 2026 (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 N/A
Primary purpose
Diagnosis
Allocation
Non-randomised
Intervention model
Parallel groups
Model description
The samples (healthy volunteers and HUS or MPGN patients) for the study will be identified between those of patients and healthy controls who provided consent to store their samples in the certified biobank of "Centro Daccò" (Centro di Risorse Biologiche Mario Negri - Biobanca Malattie Rare e Renali) for two previousely approved studies.
Masking
None (open label)
Enrolment
180 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05985122
Sponsor's protocol ID
COMPRare-IRFMN
Acronym
COMPRare
Status last verified
Mar 2026
First submitted
2 Aug 2023
Last updated
23 Mar 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Noris M, Galbusera M, Gastoldi S, Macor P, Banterla F, Bresin E, Tripodo C, Bettoni S, Donadelli R, Valoti E, Tedesco F, Amore A, Coppo R, Ruggenenti P, Gotti E, Remuzzi G. Dynamics of complement activation in aHUS and how to monitor eculizumab therapy. Blood. 2014 Sep 11;124(11):1715-26. doi: 10.1182/blood-2014-02-558296. Epub 2014 Jul 18.

    PubMed 25037630
  • Iatropoulos P, Daina E, Curreri M, Piras R, Valoti E, Mele C, Bresin E, Gamba S, Alberti M, Breno M, Perna A, Bettoni S, Sabadini E, Murer L, Vivarelli M, Noris M, Remuzzi G; Registry of Membranoproliferative Glomerulonephritis/C3 Glomerulopathy; Nastasi. Cluster Analysis Identifies Distinct Pathogenetic Patterns in C3 Glomerulopathies/Immune Complex-Mediated Membranoproliferative GN. J Am Soc Nephrol. 2018 Jan;29(1):283-294. doi: 10.1681/ASN.2017030258. Epub 2017 Oct 13.

    PubMed 29030465
  • Donadelli R, Pulieri P, Piras R, Iatropoulos P, Valoti E, Benigni A, Remuzzi G, Noris M. Unraveling the Molecular Mechanisms Underlying Complement Dysregulation by Nephritic Factors in C3G and IC-MPGN. Front Immunol. 2018 Oct 15;9:2329. doi: 10.3389/fimmu.2018.02329. eCollection 2018.

    PubMed 30487789
  • Galbusera M, Noris M, Gastoldi S, Bresin E, Mele C, Breno M, Cuccarolo P, Alberti M, Valoti E, Piras R, Donadelli R, Vivarelli M, Murer L, Pecoraro C, Ferrari E, Perna A, Benigni A, Portalupi V, Remuzzi G. An Ex Vivo Test of Complement Activation on Endothelium for Individualized Eculizumab Therapy in Hemolytic Uremic Syndrome. Am J Kidney Dis. 2019 Jul;74(1):56-72. doi: 10.1053/j.ajkd.2018.11.012. Epub 2019 Mar 7.

    PubMed 30851964
  • Piras R, Breno M, Valoti E, Alberti M, Iatropoulos P, Mele C, Bresin E, Donadelli R, Cuccarolo P, Smith RJH, Benigni A, Remuzzi G, Noris M. CFH and CFHR Copy Number Variations in C3 Glomerulopathy and Immune Complex-Mediated Membranoproliferative Glomerulonephritis. Front Genet. 2021 Jun 11;12:670727. doi: 10.3389/fgene.2021.670727. eCollection 2021.

    PubMed 34211499
  • Aiello S, Gastoldi S, Galbusera M, Ruggenenti P, Portalupi V, Rota S, Rubis N, Liguori L, Conti S, Tironi M, Gamba S, Santarsiero D, Benigni A, Remuzzi G, Noris M. C5a and C5aR1 are key drivers of microvascular platelet aggregation in clinical entities spanning from aHUS to COVID-19. Blood Adv. 2022 Jan 8;6(3):866-881. doi: 10.1182/bloodadvances.2021005246.

    PubMed 34852172
  • Piras R, Valoti E, Alberti M, Bresin E, Mele C, Breno M, Liguori L, Donadelli R, Rigoldi M, Benigni A, Remuzzi G, Noris M. CFH and CFHR structural variants in atypical Hemolytic Uremic Syndrome: Prevalence, genomic characterization and impact on outcome. Front Immunol. 2023 Jan 30;13:1011580. doi: 10.3389/fimmu.2022.1011580. eCollection 2022.

    PubMed 36793547
  • Gastoldi S, Aiello S, Galbusera M, Breno M, Alberti M, Bresin E, Mele C, Piras R, Liguori L, Santarsiero D, Benigni A, Remuzzi G, Noris M. An ex vivo test to investigate genetic factors conferring susceptibility to atypical haemolytic uremic syndrome. Front Immunol. 2023 Feb 9;14:1112257. doi: 10.3389/fimmu.2023.1112257. eCollection 2023.

    PubMed 36845135

Questions about this trial

What is this clinical trial studying?

A study testing C3NEF assay in people with Hemolytic-Uremic Syndrome and Membranoproliferative Glomerulonephritis, run by Mario Negri Institute for Pharmacological Research at 1 site in Italy.

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 8 inclusion and 0 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 23 Mar 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Italy. 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.

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?

Determination of assay sensitivity and specificity (time frame: At day 0). 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 NCT05985122, which also lists 8 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 23 Mar 2026.

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