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Kidney Week

Abstract: TH-PO621

Analysis of the Real-World Management of IgA Nephropathy (IgAN) Patients in Five European Countries

Session Information

Category: Glomerular Diseases

  • 1402 Glomerular Diseases: Clinical, Outcomes, and Trials

Authors

  • Csomor, Philipp, CSL Vifor, Glattbrugg, Zurich, Switzerland
  • Hurtado, Tucker Bittel, Spherix Global Insights, Exton, Pennsylvania, United States
  • Dudzenski, Chris, Spherix Global Insights, Exton, Pennsylvania, United States
  • Santos, Lucy, CSL Vifor, Glattbrugg, Zurich, Switzerland
Background

Immunoglobulin A nephropathy (IgAN) is the most common form of primary glomerulonephritis worldwide. Current treatment strategies focus on controlling blood pressure and minimising proteinuria. This study investigated the real-world management of IgAN in five European countries through a physician questionnaire and patient chart review.

Methods

From 21 Dec 2022 to 6 Feb 2023, physicians from France, Germany, Italy, Spain and the UK completed a questionnaire on IgAN management, and patient charts from their centres were analysed. Physicians had to have ≥50 CKD stage 1–4 patients under their management, including ≥4 IgAN patients not on dialysis. Patients had to be ≥12 years, diagnosed with IgAN, not be on dialysis and have an eGFR ≥15 mL/min/1.73m2.

Results

Participating physicians (N=261) each saw a mean of 30 IgAN patients in the past year. Patients audited as part of the study (N=473) were mostly male (71%), 78% were Caucasian, mean age was 47 years and 57% were in CKD stage 3. The mean time since referral to their current physician was 4.2 years. Proteinuria was >1 g/day in 66% of patients at referral and in 50% of patients at the current assessment (N=403 with both referral and current values). This was despite 92% of patients currently taking an ACE inhibitor and/or ARB, 43% taking an SGLT2 inhibitor and 16% taking a steroid. Physicians considered rate of eGFR decline to be moderate in 19% and fast in 6% of patients. However, among patients with eGFR values over 2 years (N=293), rate of eGFR decline was 3 mL/year in 12%, 4–5 mL/year in 16% and ≥6 mL/year in 19% of patients. Relapse occurred at least once in 54% of patients; steroid therapy was used to control the most recent relapse episode in 60% of patients. Most physicians (78%) agreed that they would prefer to administer therapies specifically approved for IgAN and 66% agreed that there is a lack of non-immunosuppressive treatments for IgAN.

Conclusion

Many patients with IgAN continue to have persistent proteinuria despite ACE inhibitor/ARB treatment, and progressive disease is common. Overall, this study indicates that there is a need for more effective treatment strategies to reduce proteinuria and disease progression in patients with IgAN.

Funding

  • Commercial Support – CSL Vifor