Current Disease-Modifying Treatment Options in IgAN

In this segment, the panel discusses how the treatment landscape for IgA nephropathy is evolving with the introduction of disease-targeted therapies. They highlight targeted-release budesonide, formulated to act in the gut-associated lymphoid tissue, where galactose-deficient IgA1 is produced. This allows reduction of pathogenic IgA at its source while avoiding the broader immunosuppression seen with systemic steroids. The discussion also includes sparsentan, a dual endothelin receptor antagonist and angiotensin receptor blocker, which has shown meaningful reductions in proteinuria compared with standard RAAS blockade alone. These agents are contrasted with SGLT2 inhibitors, which remain part of optimized supportive care but do not directly address the underlying immune mechanism. The panel notes that while these therapies represent important progress, access and reimbursement may limit uptake in real-world settings. Still, they agree that these additions mark a shift toward disease-modifying treatment strategies rather than relying solely on supportive care.