Abstract: TH-PO0476
IgAN Treatment Patterns in 2026: Real-World Insights from 2,100 Patient Charts Across the United States, the Five Major European Markets (EU5), and China
Session Information
- Glomerular Diseases: Clinical, Outcomes, and Therapeutics Research - IgAN
October 22, 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
- Lafave, Jennifer, Spherix Global Insights, Exton, Pennsylvania, United States
- Tomazin, Stephanie, Spherix Global Insights, Exton, Pennsylvania, United States
- McCarthy, Kari, Spherix Global Insights, Exton, Pennsylvania, United States
Background
The treatment landscape for IgA nephropathy (IgAN) is rapidly evolving with the introduction of targeted therapies. This study evaluates real-world treatment patterns across the United States (US), Europe (EU5), and China, with a focus on the adoption and positioning of novel IgAN therapies.
Methods
Analysis was conducted using retrospective chart audits of non-dialysis IgAN patients in the US (n=507), EU5 (n=567), and China (n=1,042). Data were collected from 865 nephrologists between January and March 2026 via an online, HIPAA-compliant survey.
Results
Across regions, treatment is anchored in renin-angiotensin-aldosterone system inhibitors (RAASi) and sodium-glucose cotransporter-2 inhibitors (SGLT2i), used in >85% of patients. However, use of targeted therapies is increasing, with 41% of US and 33% of China patients now treated with branded agents. In EU5, adoption is growing but remains constrained by access.
A structured treatment paradigm is emerging. Targeted budesonide, sparsentan, and/or atrasentan are used in earlier lines and in patients with lower disease severity, while agents such as iptacopan and sibeprenlimab are reserved for patients with more advanced or progressive disease. Targeted therapies are most commonly introduced in the second or third line but are increasingly used earlier in the disease course.
Combination therapy is becoming standard, with most patients on targeted agents alongside RAASi and SGLT2i, and a majority of nephrologists agree the simultaneous use of new targeted therapies is necessary to reach treatment goals. Concurrently, systemic corticosteroid use is declining (-10% points in the US since 2022, -10% points in China and -3% points in EU5 since 2023).
Despite treatment advances, a substantial proportion of patients remain above proteinuria targets, and nephrologists report strong interest in emerging therapies with novel mechanisms of action which are expected to further expand treatment options.
Conclusion
Treatment of IgAN is evolving toward earlier use of targeted therapies and increased use of combination regimens. While foundational therapies remain the standard of care, targeted agents are being incorporated based on disease severity and progression. Ongoing gaps in disease control highlight the need for additional treatment options.