Kidney function recovery in immunoglobulin A nephropathy patient following bimekizumab therapy

Immunoglobulin A nephropathy (IgAN) is one of the most common causes of primary glomerulonephritis and follows a 'four hit' model of pathogenesis. Novel treatments show promise in treating either the early insults described by this model or the subsequent inflammatory reaction. This case report describes a man in his 50s who received bimekizumab for his HLA B27-positive spondylarthritis in the setting of IgAN. His background history includes bilateral enthesitis of the ankles, bilateral Achilles tendonitis, peripheral arteritis and anterior uveitis. 6 months after starting on bimekizumab, his renal parameters improved with a reduction in his albuminuria and an increase in his estimated glomerular filtration rate (eGFR). This improvement may be explained by bimekizumab's dual blockade of IL-17 A and F, blunting the inflammatory pathways relevant to IgAN although causality cannot be inferred from a single case.