Targeting the Pathogenesis of IgA Nephropathy — A New Treatment Approach?

IgA nephropathy, first described in 1968 by Berger and Hinglais, 1 is the most common form of primary glomerulonephritis. For decades, IgA nephropathy was considered to have a relatively good prognosis, and so most patients received conservative treatment, with immunosuppressive treatment reserved for those with severe proteinuria or progressive decline in the estimated glomerular filtration rate (eGFR). Global guidelines from as late as 2021 indicated that the benefits of immunosuppression, which has known toxic effects, were uncertain. 2 However, within the past 5 years, an astonishing change in how clinicians think about and treat IgA nephropathy has occurred, with five new agents . . .