IgA NEPHROPATHY TREATMENT EXPLORATION

Advancement is needed in the treatment of IgA nephropathy

A better understanding of the pathophysiology of IgA nephropathy and relevant clinical endpoints may help provide targets for future treatment exploration.
Identifying surrogate and functional endpoints is key to evaluating new therapeutic options for IgA nephropathy.5,21,22
kidney iga nephropathy treatment

eGFR

A functional endpoint that denotes deteriorating kidney function23

eGFR is considered the most useful overall measure of kidney function5,23

A reduction in eGFR is associated directly with a worse renal prognosis in patients with IgA nephropathy23,24

proteinuira test iga nephropathy

Proteinuria

A surrogate endpoint that serves as a sign of kidney injury21

While proteinuria levels are variable and can fluctuate episodically, they are a useful indicator in IgA nephropathy21,25

There is a strong and consistent relationship between the level and duration of proteinuria and loss of kidney function in patients with IgA nephropathy21,25

IgA=immunoglobulin A; IgAN=immunoglobulin A nephropathy; MOD=mechanism of disease.

References

1. Barratt J, Rovin BH, Cattran D, et al. Kidney Int Rep. 2020;5(20):1620-1624. doi:10.1016/j.ekir.2020.08.009

2. Hastings MC, Bursac Z, Julian BA, et al. Kidney Int Rep. 2017;3(1):99-104. doi:10.1016/j.ekir.2017.08.008

3. Schena FP. Am J Med. 1990;89(2):209-215. doi:10.1016/0002-9343(90)90300-3

4. Barratt J, Feehally J. Semin Nephrol. 2011;31(4):349-360. doi:10.1016/j.semnephrol.2011.06.006

5. Kidney Disease: Improving Global Outcomes (KDIGO) Glomerulonephritis Work Group. KDIGO Clinical Practice Guideline for Glomerulonephritis. Kidney Int. 2012;2(suppl 2):259-274.

6. IgA Nephropathy Foundation of America, Inc. The Voice of the Patient: Externally Led Patient-Focused Drug Development Meeting on IgA Nephropathy. https://nkf.egnyte.com/dl/aHGCS6tPNM/?. Accessed August 18, 2021.

7. Penfold RS, Prendecki M, McAdoo S, Tam FWK. Int J Nephrol Renovasc Dis. 2018;11:137-148. doi:10.2147/IJNRD.S129227

8. Arroyo AH, Bomback AS, Butler B, et al. Clin Nephrol. 2015;84(3):145-155. doi:10.5414/CN108556

9.Rauen T, Wied S, Fitzner C, et al; for the STOP-IgAN Investigators. Kidney Int Supp.2020;98(4):1044-1052. doi:10.1016/j.kint.2020.04.046

10. Lafayette RA, Kelepouris E. Am J Nephrol. 2018;47(suppl 1):43-52. doi:10.1159/000481636

11. United States Renal Data System (USRDS). 2018 USRDS Annual Data Report. Vol 2. 2018; chap 9. Accessed April 7, 2021. https://usrds.org/media/1734/v2_c09_esrd_costs_18_usrds.pdf.

12. Golestaneh L, Alvarez PJ, Reaven N, et al. Am J Manag Care. 2017;23(10 Suppl):S163-S172.

13. Knoop T, Vikse BE, Svarstad E, Leh S, Reisæter AV, Bjørneklett R. Am J Kidney Dis. 2013;62(5):883-890. doi:10.1053/j.ajkd.2013.04.019

14. Ponticelli C, Glassock RJ. Clin J Am Soc Nephrol. 2010;5(12):2363-2372. doi:10.2215/CJN.06720810

15. Ponticelli C, Traversi L, Banfi G. Pediatr Transplantat. 2004:8(4):334-338. doi:10.1111/j.1399-3046.2004.00177.x

16. He J-W, Zhou X-J, Lv J-C, Zhang H. Theranostics. 2020;10(25):11462-11478. doi:10.7150/thno.49778

17. Cheung CK, Barratt J. 2020. Accessed April 7, 2021. https://www.uptodate.com/contents/pathogenesis-of-iga-nephropathy?search=pathogenesis%20of%20iga%20nephropathy&source=search_result&selectedTitle=1~126&usage_type=default&display_rank=1.

18. Reinholdt J, Husby S. In: Morteau O, ed. Oral Tolerance: The Response of the Intestinal Mucosa to Dietary Antigens. Landes Bioscience; 2003.

19. Floege J. J Am Soc Nephrol. 2019;30(7):1139-1141. doi:10.1681/ASN.2019040373

20. Wehbi B, Oblet C, Boyer F, et al. J Am Soc Nephrol. 2019;30(7):1238-1249. doi:10.1681/ASN.2018111089

21. Thompson A, Carroll K, Inker LA, et al. Clin J Am Soc Nephrol. 2019;14(3):469-481. doi:10.2215/CJN.08600718

22. Ibrahim A, Garg AX, Knoll GA, Akbari A, White CA. Am J Transplant. 2013;13(3):708-713. doi:10.1111/ajt.12050

23. Levey AS, Gansevoort RT, Coresh J, et al. Am J Kidney Dis. 2020;75(1):84-104. doi:10.1053/j.ajkd.2019.06.009

24. Goto M, Wakai K, Kawamura T, Ando M, Endoh M, Tomino Y. Nephrol Dial Transplant. 2009;24(10):3068-3074. doi:10.1093/ndt/gfp273

25. Brantsma AH, Atthobari J, Bakker SJ, de Zeeuw D, de Jong PE, Gansevoort RT. J Am Soc Nephrol. 2007;18(2):637-645. doi:10.1681/ASN.2006070738