What’s New and What’s Next in Glomerular Disease Care, with Sayna Norouzi, MD

The first quarter of 2025 saw significant advancements in nephrology, especially for glomerular diseases, whose treatment landscape is rapidly evolving and has already seen several therapeutic milestones so far this year.

“I feel like our field is exploding,” Sayna Norouzi, MD, an assistant professor of medicine, clinical nephrologist, and founder and director of the glomerular disease and polycystic kidney disease clinics at Loma Linda University Medical Center, said to HCPLive. “We had so many newly FDA-approved medications last year and we have 2 new medications that got approved for glomerular diseases this year as well.”

Specifically, Norouzi references the FDA approvals of atrasentan (Vanrafia) for IgA nephropathy (IgAN) and iptacopan (Fabhalta) for C3 glomerulopathy (C3G).1,2 She describes how for many years, treatment options for these patients were limited. Now, when she diagnoses someone with a glomerular disease, she has options to discuss with them.

“I think the future is really bright for our patients and the nephrology community,” Norouzi said. “Nothing makes me happier when I hear about another new option for my patients.”

For many patients living with glomerular diseases, Norouzi describes how finding community, support, or even reliable information can be both challenging and isolating. Unlike more common conditions such as hypertension or diabetes—where patients can often turn to friends, family, or a well-established online community—those with rare kidney diseases often rely solely on their nephrologist for guidance and updates, especially as it pertains to the treatment options available to them.

Looking ahead, Norouzi highlights several pipeline developments she believes hold the most promise to shape the rest of 2025. For C3G, she points to pegcetacoplan, a complement inhibitor evaluated in the VALIANT trial, as another potential key player in this space.3

In IgAN, she says the next wave of treatments may come from B-cell modulators, APRIL inhibitors, and dual APRIL/BAFF inhibitors, with several of these agents already showing significant reductions in proteinuria in clinical trials. Additionally, she calls attention to several complement inhibitors being studied in IgAN, suggesting this class may also hold potential for reshaping the IgAN treatment landscape.

“There are so many other mechanisms of action and other medications in ongoing clinical trials that are in earlier stages,” Norouzi said. “Hopefully in the next few years, we're going to see good results from these clinical trials, which can translate into more options for our patients in the near future.”

Editors’ note: Norouzi has relevant disclosures with Calliditas, Novartis, Otsuka, and Boehringer Ingelheim.

References

1. Campbell P. Atrasentan (Vanrafia) Receives Accelerated Approval in IgA Nephropathy. HCPLive. April 2, 2025. Accessed April 25, 2025. https://www.hcplive.com/view/atrasentan-vanrafia-receives-accelerated-approval-in-igan

2. Campbell P. FDA Approves Oral Iptacopan (Fabhalta) as First C3 Glomerulopathy Therapy. HCPLive. March 20, 2025. Accessed April 25, 2025. https://www.hcplive.com/view/fda-approves-oral-iptacopan-fabhalta-as-first-c3-glomerulopathy-therapy

3. Brooks A. FDA Accepts Pegcetacoplan (Empaveli) sNDA for C3G, IC-MPGN. HCPLive. April 1, 2025. Accessed April 25, 2025. https://www.hcplive.com/view/fda-accepts-pegcetacoplan-empaveli-snda-c3g-ic-mpgn