ASN's Mission

To create a world without kidney diseases, the ASN Alliance for Kidney Health elevates care by educating and informing, driving breakthroughs and innovation, and advocating for policies that create transformative changes in kidney medicine throughout the world.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005


The Latest on X

Kidney Week

Please note that you are viewing an archived section from 2023 and some content may be unavailable. To unlock all content for 2023, please visit the archives.

Abstract: INFO15-SA

Efficacy of Belimumab and Rituximab Compared with Rituximab Alone for the Treatment of Primary Membranous Nephropathy (REBOOT)

Session Information

  • Informational Posters - III
    November 04, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
    Abstract Time: 10:00 AM - 12:00 PM

Category: Glomerular Diseases

  • No subcategory defined


  • Nachman, Patrick H., University of Minnesota, Minneapolis, Minnesota, United States
  • Ding, Linna, National Institute of Allergy and Infectious Diseases, Bethesda, Maryland, United States

Group or Team Name

  • on behalf of the ITN080AI REBOOT Study Management Team

Background: Primary membranous nephropathy (PMN) is caused by the glomerular deposition of immune complexes. Autoantibodies against the phospholipase A2 receptor (PLA2R) are identified in ~70% of patients with PMN. In PMN, complete remission (CR) of proteinuria is associated with a low rate of relapse and excellent patient and kidney outcomes. With current therapies, rate of CR remains low.
Rationale: We hypothesize that treating patients with PMN with both rituximab (RTX, a B-cell depleting agent) and belimumab (BEL, monoclonal antibody directed against B cell activating factor) will result in greater depletion of memory B cells, limit the re-emergence of autoreactive B cells, and lead to a more sustained response.
Study design: REBOOT (NCT03949855) is a phase 2, multicenter, a prospective, double-blind, placebo-controlled trial. 104 participants will receive weekly subcutaneous BEL or placebo for 52 weeks and 2 doses of RTX at weeks 4 and 6. Participants meeting certain response criteria at week 30 will receive 2 additional doses of RTX at weeks 34 and 36. Participants will be followed until week 156 (Figure 1). Patients must be 18-75 years old with serum anti-PLA2R positive PMN and have proteinuria ≥ 4 g/day. The primary outcome is the proportion of participants in complete remission (proteinuria ≤ 0.3 g/day with stable eGFR) at week 104. The tolerance endpoint at week 156 assesses whether treatment with BEL and RTX results in a more durable remission compared to RTX alone. Planned mechanistic studies include longitudinal measurement of anti-PLA2R antibodies and functional profiling of autoreactive lymphocytes.
Summary: REBOOT is designed to explore mechanisms of reestablishing immune tolerance in patients with anti-PLA2R associated primary MN. For additional information or to refer patients, please visit

Figure 1. Study Design


  • Funding: Conducted by the Immune Tolerance Network and supported by the National Institute of Allergy and Infectious Diseases of the National Institutes of Health (UM1-AI-109565). GSK plc is providing belimumab.