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A Study to Evaluate the Efficacy and Safety of RO7434656 in Participants With Primary Immunoglobulin A (IgA) Nephropathy at High Risk of Progression (IMAGINATION)

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Know the risks and potential benefits of clinical studies and talk to your health care provider before participating. Read our disclaimer for details. Identifier: NCT05797610
Recruitment Status : Recruiting
First Posted : April 4, 2023
Last Update Posted : November 3, 2023
Information provided by (Responsible Party):
Hoffmann-La Roche

Brief Summary:
The purpose of this study is to evaluate the efficacy, safety, and pharmacokinetics of RO7434656, a novel Antisense Oligonucleotide (ASO) therapy in participants with primary IgA nephropathy (IgAN) who are at high risk of progressive kidney disease despite optimized supportive care.

Condition or disease Intervention/treatment Phase
Primary IgA Nephropathy Drug: RO7434656 Drug: Placebo Phase 3

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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 428 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Primary Purpose: Treatment
Official Title: A Phase III, Multicenter, Randomized, Double-Blind, Placebo-Controlled Study to Evaluate the Efficacy and Safety of RO7434656, an Antisense Inhibitor of Complement Factor B, in Patients With Primary IgA Nephropathy at High Risk of Progression
Actual Study Start Date : August 8, 2023
Estimated Primary Completion Date : September 30, 2026
Estimated Study Completion Date : September 30, 2030

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Kidney Diseases

Arm Intervention/treatment
Experimental: RO7434656
Participants will receive subcutaneous (SC) doses of RO7434656 on Days 1, 15, and 29 followed by once every 4 weeks until Week 105. After Week 105, participants may continue blinded treatment or enter open-label treatment up to 1 year after the date at which the last participant completes the Week 105 assessment, withdraws, or is discontinued from the study.
Drug: RO7434656
RO7434656 will be administered subcutaneously per schedule as specified.

Placebo Comparator: Placebo
Participants will receive SC doses of RO7434656 matching placebo on Days 1, 15, and 29 followed by once every 4 weeks until Week 105. After Week 105, participants may continue blinded treatment or enter open-label treatment up to 1 year after the date at which the last participant completes the Week 105 assessment, withdraws, or is discontinued from the study.
Drug: Placebo
Matching placebo will be administered subcutaneously per schedule as specified.

Primary Outcome Measures :
  1. Change From Baseline in the Urine Protein-to-Creatinine Ratio (UPCR) at Week 37 [ Time Frame: Baseline, Week 37 ]
    UPCR will be assessed in urine sampled over 24 hours.

Secondary Outcome Measures :
  1. Estimated Glomerular Filtration Rate (eGFR) Slope at Week 105 from Baseline [ Time Frame: Baseline, Week 105 ]
    eGFR will be calculated using the 2021 Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) creatinine equation.

  2. Time to the Composite Kidney Failure Endpoint [ Time Frame: Up to approximately 7 years ]
    Time to the composite kidney failure endpoint is defined as receipt of kidney transplantation, need for kidney replacement therapy, or a sustained decline in eGFR of ≥ 30% (requires two consecutive central laboratory eGFR values meeting criteria ≥ 4 weeks apart), whichever occurs first, without the receipt of other immunosuppressive or background therapies for the treatment of IgAN.

  3. Change From Baseline in Fatigue at Week 105 [ Time Frame: Baseline, Week 105 ]
    Fatigue will be assessed with the Functional Assessment of Chronic Illness Therapy-Fatigue subscale (FACIT-F). The FACIT-F Scale is a 13-item scale used to measure self-reported fatigue. Items are assessed on a 5-point Likert scale, with responses ranging from 0 for "not at all" to 4 for "very much". The total raw score is the sum of the values of each scored question and ranges from 0 to 52. A higher score indicates less fatigue.

  4. Change From Baseline in Symptoms and Health-Related Quality of Life at Week 105 as Assessed Using the Kidney Disease and Quality of Life 36-Item (KDQOL-36) Short Form [ Time Frame: Baseline, Week 105 ]
    The KDQOL-36 is an abbreviated questionnaire that combines generic and disease-specific components to assess participant's health-related quality of life. This 36-item questionnaire includes the Short Form 12 (SF-12), Version 1 (12 items) and 3 disease-related domains, symptoms/problems (12 items), burden of kidney disease (4 items), and effects of kidney disease (8 items). It uses a recall of 4 weeks, and items are assessed on 3- to 5-point Likert scales or with a dichotomous response option. Higher score indicates better health. The raw scores are transformed linearly to a range of 0 to 100, with higher scores indicating better health.

  5. Percentage of Participants with Treatment-Emergent Adverse Events (TEAEs) [ Time Frame: Up to approximately 7 years ]
  6. Plasma Concentration of RO7434656 [ Time Frame: Up to approximately 7 years ]

Information from the National Library of Medicine

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.

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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • Primary IgAN, as evidenced by a kidney biopsy performed within 7 years prior to or during screening, without known secondary cause
  • Treatment with maximum tolerated doses of angiotensin-converting enzyme (ACE) inhibitors or angiotensin II receptor blockers (ARBs) for at least 90 days immediately prior to screening
  • Urine Protein-to-Creatinine Ratio (UPCR) ≥ 1 gram per gram (g/g) or urine protein excretion ≥ 1 gram per day (g/day) (with UPCR ≥ 0.8 g/g), all measured from a 24-hour urine collection during screening
  • eGFR ≥ 20 mL/min/1.73 m^2, as calculated by the 2021 Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) creatinine equation (Inker et al. 2021a)
  • Female participants of childbearing potential must use adequate contraception

Exclusion Criteria:

  • Pregnancy or breastfeeding, or intention of becoming pregnant during the study or within 12 weeks after the final dose of RO7434656
  • Histopathologic or other evidence of another autoimmune glomerular disease
  • Presence of ≥ 50% crescents on kidney biopsy, sustained doubling of serum creatinine within 3 months prior to screening, or rapidly progressive glomerulonephritis in the opinion of the investigator
  • Glycated Hemoglobin (HbA1c) ≥ 6.5% or a clinical diagnosis of diabetes mellitus of any type
  • Uncontrolled blood pressure, in the investigator's assessment, for 3 months prior to screening or during screening
  • Use of endothelin receptor antagonists, except those approved for use in IgAN
  • Initiation of mineralocorticoid receptor antagonists or endothelin receptor antagonists within 90 days prior to screening or during screening
  • Previous treatment with RO7434656
  • Use of herbal therapies within 90 days prior to or during screening
  • Treatment with oral or intravenous (IV) corticosteroids with a dose equivalent to ≥ 7.5 milligrams per day (mg/day) of prednisone for 7 days or equivalent to ≥ 5 mg/day of prednisone for 14 days within 90 days prior to screening
  • Treatment with other immunomodulatory agents within 6 months of randomization including, but not limited to, complement inhibitors, alkylating agents (e.g., cyclophosphamide or chlorambucil), or mycophenolate
  • Treatment with a calcineurin inhibitor within 2 months prior to screening or during screening
  • Treatment with anti-CD20 therapy within 9 months of screening or during screening
  • Any serious medical condition or abnormality in clinical laboratory tests that precludes an individual's safe participation in and completion of the study
  • Planned major procedure or major surgery during screening or the study

Other protocol-defined inclusion/exclusion criteria may apply

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT05797610

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Contact: WA43966 888-662-6728 (U.S. Only)

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United States, Arizona
Tucson Neuroscience Research - M3 WR Recruiting
Tucson, Arizona, United States, 85710
United States, California
Southern California Medical Research Center Recruiting
La Palma, California, United States, 90623
North America Research Institute-San Dimas Recruiting
San Dimas, California, United States, 91773
United States, Florida
LCC Medical Research - Miami - ClinEdge - PPDS Recruiting
Miami, Florida, United States, 33126
United States, Georgia
Cowry Medical Group LLC Recruiting
Acworth, Georgia, United States, 30101
United States, Nevada
Sierra Nevada Nephrology Consultants Recruiting
Reno, Nevada, United States, 89511
United States, North Carolina
North Carolina Nephrology, PA Recruiting
Raleigh, North Carolina, United States, 27609
United States, Texas
Global Medical Research - M3 WR Completed
Dallas, Texas, United States, 75224
Texas Kidney Institute - Dallas Recruiting
Dallas, Texas, United States, 75231
Pioneer Research Solutions Recruiting
Houston, Texas, United States, 077099
Prolato Clinical Research Center Recruiting
Houston, Texas, United States, 77054
R & H Clinical Research Recruiting
Katy, Texas, United States, 77494-2031
United States, Virginia
Nephrology Associates of Northern Virginia Inc Recruiting
Fairfax, Virginia, United States, 22033
Sponsors and Collaborators
Hoffmann-La Roche
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Study Director: Clinical Trials Hoffmann-La Roche
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Responsible Party: Hoffmann-La Roche Identifier: NCT05797610    
Other Study ID Numbers: WA43966
2022-502102-32-00 ( Other Identifier: EU Clinical Trial Number )
First Posted: April 4, 2023    Key Record Dates
Last Update Posted: November 3, 2023
Last Verified: November 2023
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: Yes
Plan Description: Qualified researchers may request access to individual patient level data through the clinical study data request platform ( Further details on Roche's criteria for eligible studies are available here ( For further details on Roche's Global Policy on the Sharing of Clinical Information and how to request access to related clinical study documents, see here (

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Studies a U.S. FDA-regulated Drug Product: Yes
Studies a U.S. FDA-regulated Device Product: No
Additional relevant MeSH terms:
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Kidney Diseases
Glomerulonephritis, IGA
Urologic Diseases
Female Urogenital Diseases
Female Urogenital Diseases and Pregnancy Complications
Urogenital Diseases
Male Urogenital Diseases
Autoimmune Diseases
Immune System Diseases