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Abstract: SA-PO713

Evolution in IgA Nephropathy Treatment: How Will SGLT2 Inhibitors, Steroid Regimens, and Experiment Therapies Change the Treatment Landscape?

Session Information

Category: Glomerular Diseases

  • 1303 Glomerular Diseases: Clinical‚ Outcomes‚ and Trials


  • Dudzenski, Chris, Spherix Global Insights, Exton, Pennsylvania, United States
  • Canetta, Pietro A., Columbia University Irving Medical Center, New York, New York, United States
  • Foy, Denise, Spherix Global Insights, Exton, Pennsylvania, United States

Treatment options for IgA nephropathy (IgAN) are evolving rapidly.The use of SGLT2 inhibitors (SGLT2i) has established efficacy.Other treatment options, including reduced-dose systemic steroid regimens, a recently launched oral targeted budesonide. Agents in development have the potential to continue to improve patient outcomes. Survey data is presented on U.S. nephrologists’ clinical practice and expectations regarding the treatment of IgAN.


907 IgAN patient records were collected in collaboration with more than 200 US nephrologists via a HIPAA-compliant, online chart review tool between Dec 20, 2020 – Feb 16, 2021 and Dec 14, 2021 – Feb 21, 2022.Launch tracking data for delayed-release budesonide capsules was captured via an online survey fielded to 77 US nephrologists from May 4–7, 2022.


SGLT2i use in IgAN patients more than tripled between 2021 and 2022 (from 6% to 21%) after dapagliflozin was approved in the U.S for non-diabetic CKD and sub-analysis data was published on its use in IgAN patients. 75% of nephrologists strongly agreed that SGLT2is may significantly help delay kidney disease progression in glomerular disease patients, and 73% expected to continue to increase their prescribing over the next six months.Despite awareness of the TESTING trial spreading among nephrologists, use of systemic steroids has remained stable at 14% of patients year-over-year.The availability of budesonide capsules has created another option, with nephrologists were predicting up to 13% of their diagnosed IgAN patients may be eligible candidates for this therapy.New agents in the pipeline for IgAN include sparsentan, atrasentan, and iptacopan.Nephologists have strong awareness of these agents in development (~60% consider themselves moderately to highly familiar with sparsentan and atrasentan, this moves to 42% for iptacopan) and indicate increasing willingness to prescribe if available.


Nephologists treating IgAN patients have significantly increased their use of SGLT2is in the past year, with utilization likely to continue to increase.However, large majority of patients remain untreated with SGLT2i.Systemic steroids, with evolving treatment regimens, continue to have a role in patient management, with the potential for more change following the recent approval of delayed-release budesonide.