Foundational Therapies in IgA Nephropathy

This is a video synopsis/summary of a panel discussion involving Jonathan Barratt, PhD, FRCP, and Brad Rovin, MD.

In this transcript, Dr Brad Rovin discusses the pathogenic cascade of IGA nephropathy and highlights multiple intervention points for clinicians. Emphasizing the significance of understanding how these points interact, he underscores the importance of combining therapies to achieve desired outcomes. Dr Rovin notes the current stage of therapy development, indicating promising results in various clinical trials. He categorizes therapeutic agents based on their interaction with the multiple-hit hypothesis in damaging the kidney.

The longstanding focus has been on inhibiting the renal and angiotensin aldosterone system (RAS) to address IGA nephropathy. This involves ACE inhibitors or ARBs, known to improve glomerular hemodynamics and reduce proteinuria. Acknowledging the role of immune aggregates in triggering pathways, he describes these RAS inhibitors as renal protective therapies directly targeting kidney mechanisms.

Dr Rovin introduces a timely development – the approval of a drug targeting the endothelial system in combination with RAS. This drug has demonstrated accelerated approval and significant improvement in reducing proteinuria compared to using an Angiotensin Receptor Blocker alone. Phase three trial results show a preservation of kidney function over a two-year period, with a notable decline in estimated glomerular filtration rate (EGFR).

Overall, the discussion emphasizes the evolving landscape of IGA nephropathy therapy, with a focus on combining renal protective agents and addressing multiple pathways to enhance treatment efficacy.

Video synopsis is AI-generated and reviewed by HCPLive editorial staff.