Evolving Therapeutic Strategies and Real-World Application in IgAN

This episode focuses on translating clinical evidence into everyday treatment decisions. The panel emphasizes that the expanding therapeutic landscape requires individualized care, balancing disease severity, patient comorbidities, and willingness to engage in ongoing monitoring. They discuss how clinicians might choose between targeted-release budesonide, dual endothelin/angiotensin receptor blockade (e.g., sparsentan), and B-cell modulators, depending on proteinuria level, risk of progression, and tolerance profiles. Real-world considerations such as clinic workflow, infusion vs. injection preferences, and patient adherence are highlighted. The group stresses the importance of shared decision-making, noting that treatment choices are not solely algorithmic but influenced by patient goals and lifestyle. They conclude that as more agents become available, clinicians must be prepared to sequence and adjust therapy over time, rather than relying on a single long-term intervention.