Phase
Condition
Kidney Disease
Collagen Vascular Diseases
Idiopathic Membranous Nephropathy
Treatment
Fludarabine, Cyclophosphamide
NKX019
Cyclophosphamide
Clinical Study ID
Ages 18-75 All Genders
Study Summary
Eligibility Criteria
Inclusion
General Inclusion Criteria:
Age ≥18 and ≤75
Signed informed consent form and ability to adhere to the study visit schedule andcomply with other protocol requirements
Women of childbearing potential must have negative pregnancy tests at screening andbaseline, and agree to abstinence or acceptable birth control from 2 weeks prior tothe first dose through 1 year after the last dose
Progression despite maximal tolerated doses of renin-angiotensin system (RAS)blockade agents
. For participants taking chronic corticosteroids for management of the diseaseunder study, the prednisone (or equivalent) dose must be ≤20 mg/day at 2 weeks priorto Screening and stable for ≥ 14 days before start of Screening
For participants on immunosuppressives or immunomodulators (other thancorticosteroids), all doses must be stable for ≥ 4 weeks prior to Screening
LN-specific Inclusion Criteria:
Score of 10 or more points on the American College of Rheumatology (ACR) 2019classification criteria for SLE
Active biopsy proven lupus nephritis Class III or Class IV without Class V overlapusing the 2018 International Society of Nephrology and Renal Pathology Society (ISN/RPS) criteria as evidenced on kidney biopsy during consent or within 6 monthsbefore screening. The biopsy must have at least mild to moderate activity score andno more than moderate chronicity index per NIH indices
Active renal disease as defined by urinary protein:creatinine ratio (UPCR) ≥ 1.5 g/gor proteinuria ≥1.5 g/day on a 24-hour collection and ≤ 7 g/day by either measure
One or more of the following: positive antinuclear antibodies (ANA) ≥ 1:80 atscreening OR positive anti-dsDNA OR positive anti-Smith (anti-Sm)
Refractory LN defined as having received ≥ 2 prior therapies for LN (immunosuppressant and corticosteroid/or immunomodulatory agent, and corticosteroidat therapeutic range for at least 90 days), and had an inadequate response totherapy despite being on a therapeutic dose for ≥ 90 days
pMN-specific Inclusion Criteria:
Evidence of pMN by renal biopsy during screening or within 6 months before screening
Active renal disease at screening defined by spot UPCR ≥ 3.5 g/g or proteinuria ≥ 3.5 g/day on a 24-hour collection
Presence of primary membranous nephropathy autoantibodies
Refractory or intolerant to at least 1 induction therapy for pMN (immunosuppressantand corticosteroid or immunomodulatory agent and/corticosteroid) and defined as notachieving a complete remission after 180 days, or partial remission after 90 days
Exclusion
General Exclusion Criteria:
eGFR < 45 ml/min/1.73 m^2
Currently requiring renal dialysis or expected to require dialysis during the studyperiod
Previous solid organ or hematopoietic cell transplant or planned transplant withinstudy treatment period
Congenital or acquired immunodeficiency resulting in severe infection or thosereceiving chronic immunoglobulin replacement therapy
Liver disease or dysfunction, including cirrhosis and/or aspartate aminotransferase,alanine aminotransferase, or bilirubin ≥ 3 times the upper limit of normal
Pulmonary comorbidity including chronic obstructive pulmonary disease or asthmarequiring daily oral steroids, resting hypoxemia (<92% oxygen saturation via pulseoximetry) on room air, or significant smoking history (i.e. >10 pack/year) withactive pulmonary disease
Bone marrow insufficiency unrelated to active underlying autoimmune disease withwhite blood cell count < 3,000/mm^3; hemoglobin levels < 9 gm/dL absolute neutrophilcount < 1500/mm^3; platelet count < 100,000/mm^3
Major cardiac disease, abnormalities, or interventions as defined by, but notlimited to:
Uncontrolled angina or unstable life-threatening arrhythmias
History of myocardial infarction within 12 weeks prior to the first dose ofNKX019
Any prior coronary artery bypass graft surgery
≥ Class III New York Heart Association (NYHA) congestive heart failure (CHF),significantly decreased ejection fraction (EF ≤ 40%), or severe cardiacinsufficiency.
Prolongation of the QT interval corrected for heart rate (QTc) (Fridericia)interval of > 480 msec
Peripheral artery bypass graft surgery, pulmonary embolism, or other ≥ Grade 2thrombotic or embolic events within 12 weeks prior to the first dose of NKX019
Uncontrolled hypertension (systolic BP > 160mmHg and/or diastolic BP > 90mmHg)despite therapy
Active bleeding disorders
Any overlapping autoimmune condition for which the condition or the treatment of thecondition may affect the study assessments or outcomes (eg, anti-GBM antibodyglomerulonephritis or any condition for additional immunosuppression is indicated);clinically significant conditions that could cause a secondary nephropathy (eg,infections, liver disease, tumors or drugs); or kidney biopsy-confirmed significantrenal disease other than disease under study (eg, diabetic nephropathy, hypertensivenephropathy). Overlapping conditions for which the condition or treatment is notexpected to affect assessments or outcomes (eg, Sjögren's syndrome, rheumatoidarthritis) are not excluded
Pregnancy, breast feeding or, if of childbearing potential, not using adequatecontraceptive precautions
Current infection requiring active systemic anti-infective therapy or recent acuteinfection requiring systemic therapy within 30 days of planned LD
History of positive HIV antibody or test positive at screening, Hepatitis B or Cpositive at screening, active tuberculosis (TB) or latent TB requiring suppressivetherapy
Major surgery within 28 days prior to the first dose of NKX019 or any surgery fromwhich the participant has not recovered or has ongoing complications
Malignancy within 5 years of screening, with the exception of basal and squamouscell carcinomas treated by complete excision. Participants with cervical dysplasiathat is cervical intraepithelial neoplasia but have been treated with conization orloop electrosurgical excision procedure and have had a normal repeat Papanicolaoutest are allowed
Prior cellular therapy including mesenchymal, CAR-T or CAR-NK cells
Central nervous system (CNS) comorbidity or any autoimmune disease with CNSinvolvement within 90 days prior to the first dose of NKX019 as well as active CNSlupus within 1 year prior to screening
Any other acute or chronic medical or psychiatric condition, or known laboratoryabnormality that, in the Investigator's opinion, is expected to interfere or impactstudy participation
Current participation in another interventional clinical trial a. Potential participants can be considered for enrollment after investigationalproduct washout period of 5 half-lives or 30 days, whichever is longer
Currently taking or known need for any of the medications prohibited in the studyprotocol
Known hypersensitivity or contraindications to the study treatment including LD; orother components such as human serum albumin or dimethyl sulfoxide
LN-specific Exclusion Criteria:
- Known clinically active antiphospholipid antibody syndrome (APS); or high-risk profile
Study Design
Study Description
Connect with a study center
Nkarta Investigational Site
Parkville, Victoria 3050
AustraliaActive - Recruiting
Nkarta Investigational Site
Manati, 00674
Puerto RicoActive - Recruiting
Nkarta Investigational Site
Manatí, 00674
Puerto RicoSite Not Available
Nkarta Investigational Site
Manatí 4566137, 00674
Puerto RicoSite Not Available
Nkarta Investigational Site
Little Rock, Arkansas 72201
United StatesActive - Recruiting
University of Arkansas for Medical Sciences
Little Rock, Arkansas 72205
United StatesActive - Recruiting
Nkarta Investigational Site
Little Rock 4119403, Arkansas 4099753 72201
United StatesSite Not Available
Nkarta Investigational Site
Tustin, California 92780
United StatesActive - Recruiting
Nkarta Investigational Site
Gainesville, Florida 32610
United StatesActive - Recruiting
University of Florida Health Shands Hospital
Gainesville, Florida 32610
United StatesActive - Recruiting
Nkarta Investigational Site
Miami, Florida 33133
United StatesSite Not Available
Nkarta Investigational Site
Plantation, Florida 33317
United StatesActive - Recruiting
Nkarta Investigational Site
Tampa, Florida 33602
United StatesActive - Recruiting
Nkarta Investigational Site
Gainesville 4156404, Florida 4155751 32610
United StatesSite Not Available
Nkarta Investigational Site
Miami 4164138, Florida 4155751 33133
United StatesSite Not Available
Nkarta Investigational Site
Plantation 4168782, Florida 4155751 33317
United StatesSite Not Available
Emory University
Atlanta, Georgia 30322
United StatesActive - Recruiting
Nkarta Investigational Site
Atlanta, Georgia 30303
United StatesActive - Recruiting
Nkarta Investigational Site
Atlanta 4180439, Georgia 4197000 30303
United StatesSite Not Available
Nkarta Investigational Site
Chicago, Illinois 60612
United StatesActive - Recruiting
Nkarta Investigational Site
Chicago 4887398, Illinois 4896861 60612
United StatesSite Not Available
Nkarta Investigational Site
New Orleans, Louisiana 70112
United StatesActive - Recruiting
Nkarta Investigational Site
New Orleans 4335045, Louisiana 4331987 70112
United StatesSite Not Available
Nkarta Investigational Site
Worcester, Massachusetts 01608
United StatesActive - Recruiting
University of Massachusetts
Worcester, Massachusetts 01655
United StatesActive - Recruiting
Nkarta Investigational Site
Worcester 4956184, Massachusetts 6254926 01608
United StatesSite Not Available
Nkarta Investigational Site
Ann Arbor, Michigan 48109
United StatesActive - Recruiting
Nkarta Investigational Site
Ann Arbor 4984247, Michigan 5001836 48109
United StatesSite Not Available
Nkarta Investigational Site
Summit, New Jersey 07901
United StatesActive - Recruiting
NYU Langone Health
New York, New York 10016
United StatesActive - Recruiting
Nkarta Investigational Site
New York, New York 10007
United StatesActive - Recruiting
Nkarta Investigational Site
Stony Brook, New York 11794
United StatesActive - Recruiting
Nkarta Investigational Site
Syracuse, New York 13202
United StatesActive - Recruiting
Nkarta Investigational Site
New York 5128581, New York 5128638 10007
United StatesSite Not Available
Nkarta Investigational Site
Stony Brook 5139865, New York 5128638 11794
United StatesSite Not Available
Nkarta Investigational Site
Syracuse 5140405, New York 5128638 13202
United StatesSite Not Available
Nkarta Investigational Site
Dallas, Texas 75201
United StatesActive - Recruiting
Nkarta Investigational Site
Houston, Texas 77002
United StatesActive - Recruiting
Nkarta Investigational Site
Dallas 4684888, Texas 4736286 75201
United StatesSite Not Available
Nkarta Investigational Site
Houston 4699066, Texas 4736286 77002
United StatesSite Not Available

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