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Kidney Week

Abstract: SA-PO905

From Famine to Feast in IgA Nephropathy: New Treatments Present New Opportunities for Patients

Session Information

Category: Glomerular Diseases

  • 1402 Glomerular Diseases: Clinical, Outcomes, and Trials

Authors

  • Dudzenski, Chris, Spherix Global Insights, Exton, Pennsylvania, United States
  • Weiss, Meghan, Spherix Global Insights, Exton, Pennsylvania, United States
  • Regan, Stephen, Spherix Global Insights, Exton, Pennsylvania, United States
Background

As of only a few years ago, IgA nephropathy (IgAN), a common form of glomerulonephritis worldwide, had few treatment options beyond RAAS inhibitors and corticosteroids. The approval of SGLT2 inhibitors to treat non-diabetic CKD patients, along with accelerated approvals for targeted budesonide and sparsentan over the past three years have created new options. This analysis explores the evolution of IgAN treatment in the US.

Methods

Data from 1,359 patient charts were collected in partnership with 496 US nephrologists via HIPAA compliant online surveys annually from 2021 to 2023. Additionally, launch metrics have been collected on a monthly basis via an online survey of ~75 nephrologists each wave, beginning with the launch of targeted budesonide in February 2022.

Results

Audited chart data reveals US nephrologists are embracing new options, with exponential growth in the use of SGLT2is in IgAN patients (6% in 2021, 21% in 2022, and 43% in 2023) and steady growth in the adoption of newly approved agents. Correspondingly, as use of targeted budesonide grew from 2022 to 2023, corticosteroid use in IgAN patients dropped (14% in 2021 and 2022 to 7% in 2023).

As of May 2023, 53% of US nephrologists reported they had prescribed targeted budesonide, having grown from 18% six months post-launch and 39% after 12 months on the market. In May 2023, after only a few months on the market, 87% of US nephrologists were aware of sparsentan’s approval and 43% considered it an advance over other treatment options; a minority of physicians had written a prescription for the agent (21%). Sparsentan’s REMs monitoring requirements may impact overall use as the product continues its launch.

Despite newer options, 66% of nephrologists still perceive there to be a high unmet need for new IgAN treatments. The pipeline of potential disease-targeting mechanisms is robust, including complement inhibitors, anti-APRIL agents, and anti-BLyS agents. Notably, 68% of nephrologists believe the complement system plays an active role in the pathogenesis of IgAN as they seek non-immunosuppressive options that target the cause of the disease.

Conclusion

Within a short timeframe, nephrologists have gone from few treatment options for IgAN patients to having a more substantial arsenal. As more disease-targeting agents potentially come to market, care for IgAN patients is likely to continue to evolve.