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Lookup NU author(s): Professor David KavanaghORCiD
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC 4.0).
© 2026 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.Plain Language Summary: What is this summary about? The phase 2 NOBLE study looked at adults with complement 3 glomerulopathy (C3G) or primary immune-complex membranoproliferative glomerulonephritis (IC-MPGN) who had already had a kidney transplant. In these rare diseases, a buildup of a specific protein (complement protein 3 [C3]) in the kidneys leads to inflammation and, eventually, permanent damage that ends with kidney failure. People with kidney failure need to be on dialysis or receive a kidney transplant, but most people continue to accumulate C3 in the kidney after transplant and develop the disease again. When kidneys are damaged, they can no longer filter blood properly. As a result, proteins leak into urine (pee) and are lost from the body, and toxins and waste products from the blood are not removed from the body. The leakage of proteins into the urine is called proteinuria. What happened in this study? Researchers gave pegcetacoplan, a medicine that blocks C3 and one of its products (C3b), to people living with C3G or primary IC-MPGN who were taking other medicines for their kidney diseases but were not getting better. People in this study had already had at least 1 kidney transplant. The goal of NOBLE was to look at how safe pegcetacoplan was and how well pegcetacoplan worked for treating C3G or primary IC-MPGN. Signs of it working well included lower amounts of C3 in the kidney, lower proteinuria levels, and kidney function that did not change. Before the study started, people in the study were randomly assigned to one of two groups. One group received pegcetacoplan for 12 weeks and the other group did not receive pegcetacoplan. People in both groups continued taking the other medicines that they were taking before the study began. What were the results? After taking pegcetacoplan for 12 weeks, people living with C3G or primary IC-MPGN had improved (decreased) amounts of C3 buildup in the kidney, improved (decreased) proteinuria, and kidney function that was stable (did not change significantly) compared with before they started taking pegcetacoplan. They had side effects during the study, but most were classified as mild or moderate, and people got better. Six side effects that were considered serious happened among people taking pegcetacoplan. None of the serious side effects were considered caused by pegcetacoplan. How to say (download PDF and double click sound icon to play sound)… Biopsy: BY-op-see Dialysis: dy-A-luh-sis Glomerular: gluh-MER-yuh-lr Glomeruli: gluh-MER-yuh-lai Glomerulopathy: glu-MER-yuh-lop-a-thee Glomerulonephritis: gluh-MER-yuh-low-nuh-FRAI-tuhs Haemophilus influenzae: HEE-mof-il-us IN-floo-en-zye Immunofluorescence: im-myoo-no-floor-EH-sents Neisseria meningitidis: nai-SEE-ree-uh meh-nuhn-JI-tuh-duhs Paroxysmal nocturnal hemoglobinuria: PAYR-ok-SIZ-mul nok-TER-nul HEE-moh-GLOH-bih-NOO-ree-uh Pegcetacoplan: peg-set-ah-COE-plan Proteinuria: prow-tee-NYUR-ee-uh Streptococcus pneumoniae: strep-tuh-KOK-us nee-oh-MOH-nee-uh Subcutaneously: sub-kyoo-TAY-nee-uss-lee Phase 2 clinical trial: A type of trial that determines if a medicine works for a small group of patients with a particular disease. Side effect: A medical issue that happens during a clinical trial or study. It may be caused by the study medicine (the treatment being studied) or by a different medical issue. Serious side effect: A side effect is considered serious when it is life threatening, requires hospitalization, or leads to disability or death. A serious side effect may not be caused by the treatment, even if it occurs during a study. This is an abstract of the Plain Language Summary of Publication article. View the full Plain Language Summary PDF of this article to read the full-text Link to original article here Trial registration:ClinicalTrials.gov identifier: NCT04572854.
Author(s): Bomback AS, Daina E, Remuzzi G, Kanellis J, Kavanagh D, Pickering MC, Sunder-Plassmann G, Walker PD, Wang Z, Fakhouri F
Publication type: Article
Publication status: Published
Journal: Future Rare Diseases
Year: 2026
Volume: 6
Issue: 1
Online publication date: 22/01/2026
Acceptance date: 17/12/2025
Date deposited: 09/02/2026
ISSN (electronic): 2399-5270
Publisher: Taylor and Francis Ltd.
URL: https://doi.org/10.1080/23995270.2025.2607959
DOI: 10.1080/23995270.2025.2607959
Data Access Statement: The NOBLE study is complete. Access to patient-level data with qualified external researchers may be available upon request for review once the data are published.
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