Abstract: SA-PO0852
Real-World Treatment Patterns of Patients (Pts) with Glomerular Inflammation in IgAN
Session Information
- Glomerular Management: Real-World Lessons and Emerging Therapies
November 08, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Glomerular Diseases
- 1402 Glomerular Diseases: Clinical, Outcomes, and Therapeutics
Authors
- Trenz, Helen, Novartis Pharmaceuticals Corporation, East Hanover, New Jersey, United States
- Ndife, Briana C., Novartis Pharmaceuticals Corporation, East Hanover, New Jersey, United States
- Shao, Anran, Genesis Research Group LLC, Hoboken, New Jersey, United States
- Nagelhout, Elizabeth, Genesis Research Group LLC, Hoboken, 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
- Helmuth, Margaret, University of Michigan, Ann Arbor, Michigan, United States
- Mariani, Laura H., University of Michigan, Ann Arbor, Michigan, United States
Background
IgAN is the leading primary glomerulonephritis globally, with an evolving treatment landscape, but pts with glomerular inflammation remain poorly defined. We describe treatment patterns in US pts with IgAN and glomerular inflammation.
Methods
This retrospective study included adults with biopsy-confirmed IgAN from Jul 1, 2016–Feb 6, 2024 (index date), who had kidney biopsy data in the Diaceutics proprietary DXRX database and linked pharmacy and medical claims data in the Komodo Healthcare Map™ database. Pts had ≥6 months (mo) pre-index and ≥12 mo (follow-up) post-index continuous enrollment in medical/pharmacy claims. Glomerular inflammation was defined using diagnostic biopsy characteristics (MEST-C score of M1, E1, or C1/2). Outcomes included proportion on IgAN therapies (renin–angiotensin–aldosterone system inhibitors [RAASi], sodium-glucose cotransporter-2 inhibitors [SGLT2i], immunosuppressants [IS, corticosteroids/glucocorticoids/MMF], targeted-release budesonide [TRB], and sparsentan [SPAR]); treatment sequencing (lines of therapy [LOTs]); and steroid-related adverse events (AEs) in pts with ≥1 IS/TRB claim. LOTs were considered discontinued at disenrollment, study end, or treatment discontinuation, switch, reinitiation, or augmentation.
Results
Of 5681 pts with IgAN, 4877 (85.8%) had glomerular inflammation (M1: 58.7%; E1: 52.7%; C1/C2: 49.3%/5.9%). Among these, mean age was 59.4 years; 53.3% were male. Mean ± SD follow-up was 45.8 ± 25.4 mo, during which 2983 (85.7%) had ≥1 IgAN treatment. Treated pts received RAASi (92.3%), SGLT2i (21.3%), IS (14.4%), TRB (6.1%), and SPAR (2.2%). Among first LOTs, 87.7%, 7.8%, 7.9%, 2.0%, and 0.5% received RAASi, SGLT2i, IS, TRB, and SPAR, respectively; first LOTs were discontinued by 82.4% after a median of 9.7 mo. In total, 1544 (51.8%) and 665 (43.1%) received second and third LOTs, discontinued by 45.4% and 19.4%, respectively. Of 590 pts who received IS/TRB, 22.5% and 33.1% had a steroid-related AE within 6 and 12 mo of treatment, respectively.
Conclusion
In this real-world study, many pts with IgAN had glomerular inflammation. In this population, steroid-related AEs and high LOT discontinuation rates highlight the need for additional therapies and better matching of pts to treatments.
Funding
- Commercial Support – Novartis Pharmaceutical Corporation