Immunoglobulin A nephropathy (IgAN) remains the most common cause of primary glomerular disease worldwide, says a 2022 study published in the American Journal of the Medical Sciences. Often a progressive disease with no established specific treatment, current management focuses on optimal supportive care. Even with management, up to 30% of patients develop kidney failure within 20 years of diagnosis. A more recent report published in the Clinical Journal of the American Society of Nephrology suggests that few patients avoid kidney failure in their lifetime.
The presence of active inflammation and kidney scarring can indicate a worse prognosis for patients with IgAN compared to individuals with complement 3 glomerulopathy (C3G) despite C3G having a variable risk of disease progression.
Despite the grim prognosis of rare kidney disease, new developments in understanding the process of IgAN as an immune-mediated disease have resulted in a rapid expansion of clinical trials. Here are some promising scientific discoveries to consider.
IgAN Scientific Advancements
Rare kidney disease clinical trials aim to test new therapeutic strategies to target the sets of proteins linked with the disease.
For example, a team of researchers presented a study during the 2024 National Kidney Foundation Spring Clinical Meetings. This study shared findings about the long-term nephroprotective effects of sparsentan compared to MT-IRB in IgAN patients. Their findings highlighted the potential of MT-IRB and sparsentan in slowing the progression of kidney function decline—offering promising insights for improved treatment strategies and care.
In February 2024, the U.S. Food and Drug Administration (FDA) designated sibeprenlimab as a special breakthrough therapy for treating IgAN. Sibeprenlimab is a humanized monoclonal antibody that blocks the action of the B-cell growth factor.
The special designation of the medication resulted from a Phase 2 trial published in The New England Journal of Medicine. The trial followed 155 patients who underwent randomization.
- 38 received sibeprenlimab at a dose of 2 mg per kilogram;
- 41 received sibeprenlimab at a dose of 4 mg per kilogram;
- 38 received sibeprenlimab at a dose of 8 mg per kilogram; and
- 38 received a placebo.
Researchers found that after 12 months of treatments with sibeprenlimab, proteinuria (protein in urine) decreased in patients with IgA nephropathy compared to those who received a placebo.
Additionally, in December 2023, the FDA granted full approval of Tarpeyo to address the root cause of the IgAN disease cascade. Based on the assumption of action, Tarpeyo is thought to target the pathogenesis of IgA nephropathy early on. Experts are hopeful this will empower disease control and decrease further risk to the kidneys.
Advancements continue with the SPOTLIGHT Study, focused on understanding and treating IgAN, Lupus Nephritis (LN), or C3G. The SPOTLIGHT Study aims to reduce protein excretion in the urine and reduce kidney function loss. The study drug, ADX-097 is designed to target the inflamed tissue to inhibit part of the immune system called the complement system and reduce the activity of the alternative pathway (AP). This is anticipated to lessen kidney damage and kidney function loss—reducing the risk of side effects of common kidney disease-related medications and the need for frequent, high-dose treatments.
Living Healthy with IgAN
Until specific treatments are mainstream, managing IgAN and C3G is focused on controlling symptoms, managing blood pressure, and slowing the kidney disease process.
In addition to prescription medications, the National Kidney Foundation recommends lifestyle changes to help manage your IgAN and lower your risk of worsening chronic kidney disease.
- Avoid smoking. Smoking can speed up the kidney disease process and increase your risk of kidney failure.
- Maintain a healthy weight and exercise regularly. Eating a balanced diet and getting adequate exercise improves overall health and well-being.
- Limit sodium intake. A high salt diet alters your sodium balance. This imbalance strains the kidneys, increasing your risk of high blood pressure and kidney disease.
Alternative Treatment for IgAN
A 2022 study published in PubMed Central examined the use of Traditional Chinese Medicine (TCM) as an effective alternative treatment for IgAN. The study followed Professor Yan-Qin Zou, a nephropathy expert who explored the long history of TCM in treating kidney diseases in Eastern Asia as it relates to IgAN.
Initially, Zou distinguished between deficiency and excess syndromes. The deficiency and excess syndromes in TCM refer to imbalances in the body's vital substances (macro- and micronutrients) including compounds such as vitamins, trace elements (like iron or zinc), minerals, amino, and fatty acids. During the study, Zou focused on treatment measures that tonified the kidney and spleen, purged turbidity and cleared dampness, promoted blood circulation, and removed blood stasis.
The findings showed that natural medicines can reduce proteinuria and serum creatinine (SCr) and improve symptoms like back pain in a long-term regimen.
