Abstract: SA-PO0665
Evolving IgAN Landscape: Persistent Unmet Need Despite Expanding Therapeutic Options
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
- 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
IgA nephropathy (IgAN) is a progressive glomerular disease with historically limited treatment options. The relatively recent approvals of five targeted therapies have transformed the treatment landscape; however, optimal disease control remains difficult to achieve. This research evaluates current management patterns, remaining unmet needs, and nephrologist perspectives on emerging pipeline mechanisms of action (MOAs).
Methods
Data were collected from 105 U.S. nephrologists via an online survey conducted in February 2026, with trended comparisons to a similar cohort of 105 nephrologists surveyed in February 2025 and 105 nephrologists surveyed in February 2024.
Results
Nephrologists report improved ability to treat IgAN following recent approvals of targeted therapies, with 87% agreeing that new agents have enhanced management (vs. 80% in Q1’24); however, only 44% of patients are estimated to have ever achieved complete proteinuria remission (<0.3g/d), similar to the 47% measured one year earlier in Q1'25. Additionally, nephrologists estimate that more than one-third of their IgAN patients remain sub-optimally managed (37% in Q1’26 vs. 36% in Q1'25 and Q1’24).
Nearly three-quarters of nephrologists (72%) continue to identify unmet need for additional therapies. Pipeline interest is strong, particularly for therapies targeting the underlying disease mechanism. Dual APRIL/BAFF inhibitors (e.g., atacicept, povetacicept) are viewed as highly promising, while nephrologists also consider complement inhibitors (ravulizumab, sefaxersen) and plasma-cell–targeting therapies (felzartamab, mezagitamab) as also offering potential. Across pipeline agents, nephrologists increasingly prioritize durable eGFR data over proteinuria reduction alone when evaluating clinical value.
Conclusion
Despite rapid therapeutic innovation and increasing adoption of targeted agents, IgAN remains characterized by continued unmet need, with many patients failing to achieve proteinuria targets or optimal disease control. Evolving treatment strategies and diverse pipeline mechanisms are expected to play a critical role in improving long-term renal outcomes.