Abstract: SA-PO0663
Real-World Adherence to Oral Therapies in IgA Nephropathy
Session Information
- Glomerular Diseases: Clinical, Outcomes, and Therapeutics Research - Other
October 24, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Glomerular Diseases
- 1402 Glomerular Diseases: Clinical, Outcomes, and Therapeutics
Authors
- Wang, Yan, Alexion, AstraZeneca Rare Disease, Boston, Massachusetts, United States
- Konstantinidis, Menelaos, Alexion, AstraZeneca Rare Disease, Boston, Massachusetts, United States
- Joshi, Preeti, Alexion, AstraZeneca Rare Disease, Boston, Massachusetts, United States
Background
IgA nephropathy (IgAN) is a rare and progressive inflammatory disease, associated with nephron loss, increased risk of kidney failure, impaired quality of life, and higher healthcare resource utilization (HCRU). Approved oral IgAN therapies require long-term daily dosing, which may affect treatment adherence. Real-world adherence data for these therapies remain limited. This study evaluated adherence to 5 oral therapies for IgAN and examined the association between adherence and HCRU.
Methods
This retrospective, longitudinal cohort study was conducted using the Komodo US claims dataset (Jan 2015–Jan 2026). Five non-mutually exclusive cohorts were defined by oral therapy class: Budesonide, Sparsentan, Iptacopan, ACEi/ARBs, and SGLT2is. For each cohort, the index date was the first paid claim for the respective therapy class. Key eligibility criteria included adults aged ≥18 years with ≥1 IgAN diagnosis and continuous enrollment for 6 months pre-index and 12 months post-index (9 months for Budesonide). Adherence was measured using proportion of days covered (PDC) and medication possession ratio (MPR) at 12 months (9 months for Budesonide), and PDC ≥80% was considered adherent (reported as %). Poisson regression models examined the association between PDC and inpatient admission and emergency department (ED) visits for each cohort, adjusting for baseline demographics and comorbidities.
Results
Overall, the 5 cohorts were Budesonide (N=1,276), Sparsentan (N=993), Iptacopan (N=35), ACEi/ARBs (N=22,585), and SGLT2i (N=10,211). At baseline, the mean age across cohorts ranged from 41 to 55 years, 55%-61% were male, 48%-79% had CKD, and 54%-67% had hypertension. Mean PDC ranged from 0.63 to 0.67 and 44% to 54% of patients achieved PDC ≥80% across cohorts and mean MPR ranged from 0.72 to 0.80. Each 0.10 decrease in PDC was associated with a 9.5% to 12.3% increase in inpatient admission rates and a 6.9% to 8.9% increase in ED visit rates (both p<0.001).
Conclusion
Medication adherence to oral therapies in IgAN was suboptimal in real-world settings, approximately half the patients met the adherence threshold. Lower adherence was associated with higher HCRU, highlighting an unmet need for alternative options to improve adherence.
Funding
- Commercial Support – Alexion, AstraZeneca Rare Disease.