Abstract: TH-PO0467
Real-World Use of Iptacopan in IgAN: A Retrospective Longitudinal Study in a Single Center
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
- Aryal, Prabesh, University of Wisconsin-Madison, Madison, Wisconsin, United States
- Singh, Tripti, University of Wisconsin-Madison, Madison, Wisconsin, United States
Background
IgA nephropathy (IgAN) is a leading cause of glomerular disease causing ESKD. Iptacopan, an oral factor B inhibitor targeting the alternative complement pathway, has emerged as a novel therapeutic option for IgAN. Real-world data regarding its use remains limited.
Methods
We performed a retrospective longitudinal study of 10 patients with biopsy-proven IgAN treated with Iptacopan at our center. Clinical data was from electronic health record which included age, Oxford MEST-C score, serum creatinine, hematuria, and urine protein-to-creatinine ratio (UPCR) at diagnosis, before and after Iptacopan initiation and supportive therapy including RAAS inhibitors and SGLT-2 inhibitors.
Results
The mean age was 33 years, and median duration of Iptacopan therapy was 4.5 months (2-7 months). All the patients were receiving background supportive therapy when tolerated. 3 out of 10 patients had skin involvement, and 2 out of 10 patients also had IBD.
Median UPCR decreased from 1.4 before Iptacopan to 0.45 g/g corresponding to an approximate 81% median reduction. Median eGFR improved from 75 to 78 mL/min/1.73 m2. Microscopic hematuria improved in most patients. No treatment-limiting adverse events were identified. The median time from ordering Iptacopan to its availability to patients was 27.5 days.
Conclusion
In this study, Iptacopan use in IgAN was associated with substantial proteinuria reduction, improvement in hematuria, and stable kidney function over short-term follow-up though long term is needed to assess durability of response.
Treatment response to Iptacopan
| Variable | Pre-treatment | Post-treatment | Change | % Change |
| UPCR g/g (median) | 1.4 (1.0 - 4.3) | 0.45 (0.1 – 1.7) | -0.7 (-2.2 to 0) | - 81% ( -90%-0%) |
| eGFR (mL/min/1.73 m2) (median) | 75 (44-108) | 78 (36-108) | - | - |
| Hematuria RBC/HPF | >20-50 | < 0-5 | - | - |