Efficacy and Safety of Nefecon on Prevention of Relapse of IgA Nephropathy (NeFRIN)

Efficacy and Safety of Nefecon on Prevention of Relapse of IgA Nephropathy: a Randomized, Double-blinded, Placebo-Controlled Trial

IgA nephropathy (IgAN) is a chronic progressive kidney disease, and long-term control of proteinuria and prevention of relapse are crucial for delaying disease progression. Patients with IgAN who achieve proteinuria remission after receiving Nefecon for 9 months or longer still face the risk of proteinuria relapse after treatment discontinuation. This study is to evaluate the efficacy and safety of Nefecon 8 mg treatment for 15 months as a maintenance therapy to reduce the risk of IgAN relapse in proteinuria-remitted patients.

Study Overview

Status

Recruiting

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Estimated)

288

Phase

  • Phase 4

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Locations

    • Guangdong
      • Guangzhou, Guangdong, China, 510515
        • Recruiting
        • Nanfang Hospital, Southern Medical University
        • Contact:

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Diagnosed primary IgAN with biopsy verification;
  • Female or male participants ≥18 years of age;
  • Completion of ≥9 months of Nefecon 16 mg QD at the baseline visit;
  • Proteinuria ≥ 1g/d prior to initiation of Nefecon;
  • Proteinuria<0.5 g/day (or UPCR <0.5 g/g) at screening and randomization visit;
  • eGFR ≥30 ml/min/1.73m² at screening;
  • On stable treatment with supportive treatment (including RAASi, SGLT2i, ERA) for at least 1 month prior to the baseline visit;

Exclusion Criteria:

  • Systemic diseases that may cause mesangial immunoglobulin A deposition, including but not limited to IgA vasculitis nephritis, systemic lupus erythematosus, dermatitis herpetiformis, ankylosing spondylitis, and others;
  • Type 1 or type 2 diabetes mellitus;
  • Presence of primary or secondary glomerulopathies (e.g., membranous nephropathy, focal segmental glomerulosclerosis, C3 glomerulopathy and others);
  • Active infection, severe hepatic impairment (Child-Pugh Class C), congestive heart failure, and malignant tumor within the past 5 years;
  • On current or planned dialysis or kidney transplantation;
  • Participants who have been treated with systemic glucocorticoids and immunosuppressive agents within the past 3 months, including mycophenolate mofetil, hydroxychloroquine, cyclophosphamide, azathioprine, leflunomide, calcineurin inhibitors, and Chinese traditional medicines with immunosuppressive effects (such as Tripterygium wilfordii, Sinomenium acutum, Tripterygium Glycosides Tablets, Kunxian Capsules, Kunming Shanhaitang Tablets, etc.); treatment with B-cell targeted biological agents (such as telitacicept and sibeprenlimab, etc.); complement pathway inhibitors, etc.;
  • Poorly controlled hypertension (resting systolic blood pressure ≥160 mmHg or diastolic blood pressure ≥100 mmHg);
  • Participants taking potent inhibitors of cytochrome P450 (CYP) 3A4 within the past 1 month, such as ketoconazole, itraconazole, ritonavir, indinavir, saquinavir, erythromycin, or cyclosporine;
  • Females who are pregnant, breastfeeding, or planning to become pregnant in the trial period.
  • Any other conditions that, in the investigator's judgment, make the patient ineligible for this clinical study.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Quadruple

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Placebo Comparator: Control
Placebo
Placebo oral capsule once daily by mouth for 15 months
Experimental: Treatment arm
NEFECON
NEFECON 8mg once daily by mouth for 15 months

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Time to first composite disease relapse
Time Frame: 15 months
either a ≥100% increase in UPCR and an absolute UPCR ≥0.5 g/g, or a ≥30% decline in eGFR from randomization
15 months

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
eGFR slope
Time Frame: 15 months
eGFR slope from baseline to Month 15
15 months
Changes in UPCR and 24-hour urinary protein
Time Frame: 3, 6, 9, 12, and 15 Months
Changes in UPCR and 24-hour urinary protein from baseline to Months 3, 6, 9, 12, and 15
3, 6, 9, 12, and 15 Months
Major adverse kidney events
Time Frame: 15 months
The proportion of patients with the first occurrence of major adverse kidney events within 15 months, defined as the occurrence of any one of the following: eGFR ≤15 ml/min/1.73m², maintenance dialysis, kidney transplantation, ≥30% decrease in eGFR, or kidney-related death
15 months
The proportion of patients with UPCR ≥0.5 g/g
Time Frame: 15 months
The proportion of patients with sustained UPCR ≥0.5 g/g
15 months
The proportion of patients with UPCR ≥1 g/g
Time Frame: 15 months
The proportion of patients with sustained UPCR ≥1 g/g
15 months
All-cause mortality
Time Frame: 15 months
All-cause mortality
15 months

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

June 23, 2026

Primary Completion (Estimated)

December 1, 2028

Study Completion (Estimated)

December 31, 2028

Study Registration Dates

First Submitted

May 18, 2026

First Submitted That Met QC Criteria

May 18, 2026

First Posted (Actual)

May 22, 2026

Study Record Updates

Last Update Posted (Actual)

September 2, 2026

Last Update Submitted That Met QC Criteria

August 30, 2026

Last Verified

August 1, 2026

More Information

Terms related to this study

Other Study ID Numbers

  • NFEC-2026-268

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

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