eligibility_summary
Eligible: biopsy-proven primary MN or nephrotic syndrome with positive anti‑PLA2R, high risk per KDIGO 2021, eGFR ≥40, life expectancy >24 mo, relapse after prior response if off IS: >3 mo (high‑dose steroids/CNI/MMF), >6 mo (chlorambucil/cyclophosphamide), >12 mo (rituximab). Exclude: secondary MN, ≥50% PLA2R titer drop in past year, diabetes, surgery <1 mo, need initiation of drugs affecting renal function, porcine protein allergy.
trial_source
clinical_trials.gov from Dec 2, 2025
annotation_status
ai
ai_summary
Phase 3 head-to-head study in primary membranous nephropathy tests: 1) SNP-ACTH (1-39) Gel: a peptide hormone (ACTH) given subcutaneously. Mechanism: agonist of melanocortin receptors, stimulates adrenal MC2R to increase endogenous glucocorticoids (broad immunosuppression) and activates extra-adrenal melanocortin receptors on immune cells and kidney podocytes, promoting anti-inflammatory effects and podocyte stabilization to reduce proteinuria. 2) Rituximab: chimeric anti-CD20 monoclonal antibody (IV) that depletes CD20+ B cells, lowering anti-PLA2R autoantibodies and immune complex formation. Primary targets/pathways: melanocortin signaling/HPA axis and podocytes (ACTH), CD20+ B cells and the anti-PLA2R autoantibody pathway (rituximab).