Oral Factor B Inhibition for IgA Nephropathy

The FDA approved iptacopan in 2024 for patients with IgA nephropathy who were at risk of rapid disease progression. A complement factor B inhibitor, iptacopan is thought to reduce glomerular injury in IgA nephropathy by suppressing activation of the alternative complement pathway. Approval was based on interim analysis of a phase 3, industry-funded, placebo-controlled trial, which showed a reduction in proteinuria at 9 months. Now, researchers report outcomes of this trial at 24 months. All 500 patients had biopsy-proven IgA nephropathy, an estimated glomerular filtration rate (eGFR) of at least 30 ml/min/1.73 m², and a 24-hour urinary protein-to-creatinine ratio (UPCR) of 1 or higher.