Abstract: SA-PO0840
Therapies for IgAN in the Cure Glomerulonephropathy Network (CureGN)
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
- Madison, Terri, Calliditas Na Enterprises Inc, New York, New York, United States
- Ngai, Christopher, Calliditas Na Enterprises Inc, New York, New York, United States
- Helmuth, Margaret, University of Michigan, Ann Arbor, Michigan, United States
- Smerdon, Caroline, University of Michigan, Ann Arbor, Michigan, United States
- Bomback, Andrew S., Columbia University, New York, New York, United States
- Reich, Heather N., University of Toronto, Toronto, Ontario, Canada
- Mariani, Laura H., University of Michigan, Ann Arbor, Michigan, United States
- Khalid, Myda, Indiana University School of Medicine, Indianapolis, Indiana, United States
Background
There is sparse literature on real-world use and impact of novel emerging therapies approved to treat IgAN and current trends in immunosuppressive therapy (IST) use. In North American adults with IgAN enrolled in CureGN within 6 months of their diagnostic kidney biopsy, we report treatment patterns and associated disease trajectories.
Methods
CureGN is a prospective registry of participants with glomerular disease. Descriptive statistics estimated frequency of IgAN treatments, number of IST classes used, and time from biopsy to first IST/systemic corticosteroid (SCS). Cox proportional hazard models assessed risk of a composite 40% decline/kidney failure by IST and SCS use.
Results
152 adults with incident IgAN were followed for a median of 6.8 years (interquartile range [IQR]: 2.4, 8.1). A majority were male (64%), white (74%), and non-Hispanic (84%). IST were the most frequently used IgAN medications and 61% specifically used SCS. Post-enrollment, the most common IgAN medications were renin-angiotensin system (RAS) inhibitors, other ISTs, and sodium glucose cotransporter-2 inhibitors (SGLT2i), with 29% of participants receiving 2+ IST classes. Few participants (n=5) received newer IgAN therapies (eg, sparsentan, targeted delayed-release budesonide). (Table 1) Compared with participants with estimated glomerular filtration rate (eGFR) ≥60 at biopsy, those with eGFR <60 were more likely to have received 2+ IST classes during follow-up (37.1% vs 16.3%, p=0.03). Urine protein:creatinine ratio (UPCR) at biopsy was not associated with number of IST classes used or time to first IST. Adjusting for eGFR and UPCR at enrollment, IST use was not associated with a decreased risk of progression to kidney failure (Table 2).
Conclusion
The impact of traditional IST on long term kidney function requires further exploration. Despite availability of novel IgAN therapies, conservative management (RAS inhibition, SGLT2i) and traditional IST remain most used.
Funding
- Commercial Support – Calliditas NA Enterprises Inc.