Phase 2 Study of ALXN2030 in Patients With Antibody-Mediated Rejection After Kidney Transplantation

Inclusion Criteria:

• Kidney transplant received ≥ 6 months

• Active or chronic active AMR according to Banff 2022 classification, based onScreening kidney biopsy

• HLA-DSA (preformed and/or de novo DSA)

• MVI score ≥ 2 (g ≥ 1 and ptc ≥ 1)

• eGFR ≥ 30 mL/min/1.73 m2

• Must be vaccinated for S pneumoniae prior to randomization

• Must be vaccinated for H influenzae type B (where available) prior to randomization

Exclusion Criteria:

• Biopsy-based diagnosis of any of the following at Screening:

• TCMR, according to the Banff grade ≥ 1

• Polyoma virus nephropathy

• Severe thrombotic microangiopathy

• Glomerulonephritis

• ABO-incompatible transplant

• uACR > 2200 mg/g indicating nephrotic range proteinuria

• Hemoglobin < 8 g/dL

• Platelets < 100 × 109/L

• Leucocytes < 3 × 109/L

• Neutrophils < 1.5 × 109/L

• Multiorgan transplant recipient (except for previous multiple kidney transplants) orcell transplant (islet, bone marrow, stem cell) recipient

• Active systemic bacterial, viral, or fungal infection within 14 days prior torandomization

• Participants with history of HIV who are not on anti-retroviral therapy or if ontherapy have a known detectable viral load within 1 year of Screening

• Evidence of hepatitis B or hepatitis C infections

• Congenital immunodeficiency

• History of unexplained, recurrent infection

• Pregnant, breastfeeding, or intending to conceive within 6 months after the lastdose of study intervention

• ALT or AST > 2.0 × ULN

• Total bilirubin > 2 × ULN (participants with Gilbert's syndrome can be included withtotal bilirubin > 2 × ULN as long as direct bilirubin is ≤ 1.5 × ULN)

• Current or chronic history of liver disease that is considered clinicallysignificant by the Investigator

• Planned or recent treatments, < 3 months prior to the Screening Visit, for AcuteRejection, AMR (including plasmapheresis, plasma exchange, IVIg, B-cell depletingtherapy, IL inhibitors, proteasome inhibitors, high-dose corticosteroids [except fortapering]), TCMR (including T-cell depleting therapy), excluding the SoC treatmentwhich will be allowed and should be stable during the entire treatment