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Recent advancements in IgA nephropathy (IgAN) treatment have led to new FDA-approved therapies. This commentary discusses their integration into the KDIGO guideline for IgAN management.

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Area of Science:

  • Nephrology
  • Immunology
  • Pharmacology

Background:

  • The Kidney Disease: Improving Global Outcomes (KDIGO) guideline for glomerular diseases was last updated in 2021, with a specific IgA nephropathy (IgAN) update in 2025.
  • Drug development for glomerular diseases has historically been slow, but recent years have seen significant progress, particularly for IgAN.

Purpose of the Study:

  • To provide a timely commentary on the integration of newly approved IgA nephropathy (IgAN) therapies into clinical practice.
  • To address the rapid pace of IgAN treatment advancements following the 2025 KDIGO guideline update.

Main Methods:

  • Review of recent clinical trial data and U.S. Food and Drug Administration (FDA) approvals for novel IgAN therapies.
  • Analysis of the presumptive mechanisms of action for new IgAN treatments in comparison to existing therapies.

Main Results:

  • Three additional IgAN treatments received accelerated FDA approval after the 2025 KDIGO guideline revision.
  • Two of these new therapies possess distinct mechanisms of action compared to previously approved drugs.

Conclusions:

  • A commentary is necessary to guide clinicians on incorporating these novel therapies into the IgAN treatment strategy.
  • Further evidence is pending for these and other emerging IgAN therapies, necessitating a full guideline update in the future.