A Study of SNP-ACTH (1-39) Gel in Patients With Primary Membranous Nephropathy

Inclusion Criteria:

• Biopsy-proven membranous glomerulonephritis or a diagnosis of MN in patients withNephrotic Syndrome and a positive anti PLA2R antibody test.
• Patients classified to be at a High Risk for progressive loss of kidney function, asdefined by Kidney Disease Improving Global Outcomes (KDIGO) 2021-Glomerular DiseasesGuideline.
• eGFR by Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) formula ≥40mL/min/1.73 m^2
• Patients who have had CR or PR in response to immunosuppressive therapy, but thenrelapsed can participate in the study if it has been more than 3 months since theirlast dose of high dose glucocorticoids, calcineurin inhibitors or mycophenolatemofetil
• Patients who have had CR or PR in response to IS therapy, but then relapsed canparticipate in the study if it has been more than 6 months since their last dose ofchlorambucil or cyclophosphamide
• Patients who have had CR or PR in response to immunosuppressive therapy, but thenrelapsed can participate in the study if it has been more than 12 months since theirlast dose of rituximab.
• Life expectancy > 24 months.
• Other inclusion criteria may apply.

Exclusion Criteria:

• Secondary membranous nephropathy as defined by history, physical exam, kidney biopsyresults or serologies.
• Patients who have had a ≥ 50% reduction in serum titers of PLA2R auto-antibody within 1 year before screening.
• Type 1 or 2 diabetes mellitus
• Patients who must be initiated on drugs likely to affect renal function if notproperly dosed.
• Surgery within 1 month of study entry
• History of sensitivity to proteins of porcine origin.
• Other exclusion criteria may apply.