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Abstract: SA-PO0774

Real-World (RW) Clinical Considerations for IgAN Treatment Decisions: Survey of Health Care Providers (HCPs) in the United States (US)

Session Information

Category: Glomerular Diseases

  • 1402 Glomerular Diseases: Clinical, Outcomes, and Therapeutics

Authors

  • Ndife, Briana C., Novartis Pharmaceuticals Corporation, East Hanover, New Jersey, United States
  • Trenz, Helen, Novartis Pharmaceuticals Corporation, East Hanover, New Jersey, United States
  • Srinivas, Titte, Novartis Pharmaceuticals Corporation, East Hanover, New Jersey, United States
  • Haile-Meskale, Ruth, Novartis Pharmaceuticals Corporation, East Hanover, New Jersey, United States
  • Pivneva, Irina, Analysis Group Inc Boston, Boston, Massachusetts, United States
  • Edwards, Marie Louise, Analysis Group Inc Boston, Boston, Massachusetts, United States
  • Anderson, Annika, Analysis Group Inc Boston, Boston, Massachusetts, United States
  • Easson, Kaitlyn, Analysis Group Inc Boston, Boston, Massachusetts, United States
  • Signorovitch, James, Analysis Group Inc Boston, Boston, Massachusetts, United States
  • Rastogi, Anjay, University of California Los Angeles, Los Angeles, California, United States
Background

IgAN is the most common form of primary glomerulonephritis worldwide with heterogeneous clinical presentation and variable disease progression. Given the rapidly evolving therapeutic landscape for IgAN, there is a need to understand how treatment decisions are made in everyday practice. This survey explored how US HCPs decide on the treatment of patients (pts) with IgAN in RW community and academic practices.

Methods

US HCPs, who were board certified physicians, physician assistants, or nurse practitioners with nephrology specialty, and responsible for the treatment of ≥1 pt with IgAN within ≤12 months, were invited to complete an online survey (Feb–Mar 2025). The objective was to describe treatment decisions made by HCPs for pts with IgAN who had high proteinuria despite receiving standard of care. Data collected included clinical decision-making on treatment approaches, understanding of IgAN-related terms, and availability of clinical data; no pt-level data were collected. Data were summarized descriptively.

Results

Overall, 150 HCPs were included, with a mean ± SD practice duration of 19.8 ± 8.6 years; most (54.7%) practiced in community settings. In the past year, HCPs cared for a mean of 29 adults with IgAN. The most common treatments HCPs had ever prescribed for IgAN were renin-angiotensin-aldosterone system inhibitors (RAASi; 99.3% of HCPs), sodium-glucose cotransporter-2 inhibitors (92.7%), and systemic glucocorticoids (80.0%). Most HCPs (91.3%) included proteinuria reduction in their definition of successful treatment response. The most common persistent proteinuria definitions included a threshold of >0.5 g/g, for ≥90 days, in 2 samples. For pts with persistent proteinuria, most HCPs (98.7%) said they would escalate therapy beyond supportive care (RAASi). Additionally, HCPs recognized the heterogeneity of pts: clinical considerations varied among the different classes of IgAN therapies.

Conclusion

HCPs with extensive experience managing pts with IgAN recognize both the importance of escalating therapy beyond supportive care in pts with persistent proteinuria and the need for multifactorial assessment when considering treatment escalation.

Funding

  • Commercial Support – Novartis Pharmaceutical Corporation

Digital Object Identifier (DOI)