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IgA nephropathy management: what does the future hold?
Sydney C W Tang1, Heather N Reich2,3
1Division of Nephrology, Department of Medicine, School of Clinical Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong, China.
Kidney International Supplements
|July 22, 2026
Summary
New treatments for IgA nephropathy (IgAN) are emerging, including approved medications like Nefecon and sparsentan. Future management may involve combination therapies targeting multiple disease pathways for IgAN.
Area of Science:
- Nephrology
- Immunology
- Pharmacology
Background:
- IgA nephropathy (IgAN) pathogenesis understanding has advanced, driving development of targeted therapies.
- Surrogate markers for early treatment efficacy have aided regulatory approval of novel IgAN treatments.
- Recent IgAN clinical trial data prompted revisions to Kidney Disease: Improving Global Outcomes guidelines.
Purpose of the Study:
- To review the current landscape of IgA nephropathy (IgAN) treatments.
- To discuss the implications of newly approved and conditionally approved therapies for IgAN management.
- To explore future directions in IgAN treatment, including combination therapies and biomarker research.
Main Methods:
- Review of recent clinical trial data for IgA nephropathy (IgAN) therapies.
- Analysis of approved and conditionally approved IgAN medications (Nefecon, sparsentan, iptacopan, atrasentan).
- Discussion of emerging treatment strategies and the need for noninvasive biomarkers.
Main Results:
- Two agents, Nefecon and sparsentan, are approved in some regions for IgAN.
- Iptacopan and atrasentan have conditional approval based on proteinuria, pending kidney function data.
- A dual approach addressing IgAN pathogenesis and supportive care is likely future management.
- Combination therapies targeting distinct pathogenic mechanisms are expected to become standard care for chronic kidney disease.
Conclusions:
- The IgAN treatment landscape is rapidly evolving with new targeted therapies.
- Combination therapies are anticipated to be the future standard of care for IgAN.
- Further research into noninvasive biomarkers is crucial for personalized IgAN patient care.
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