Monitoring Considerations with Emerging B-Cell Modulators in IgAN

In this segment, the panel discusses how monitoring strategies will need to adapt as B-cell–targeted therapies such as atacicept, sibeprenlimab, and povetacicept move into broader clinical use. They emphasize the importance of establishing a baseline immune profile, including serum IgG levels, vaccination history, and infection risk. During treatment, clinicians should monitor immunoglobulin levels periodically, watching for declines that may increase susceptibility to infection. The panel also notes that patients receiving B-cell modulators may require updated vaccination timing, ideally before therapy starts, since vaccine responses may be blunted once treatment begins. Routine kidney disease monitoring remains essential—tracking proteinuria, eGFR trends, and urine microscopy to evaluate therapeutic response. The group highlights the need for patient education, particularly around infection precaution behaviors and when to seek care. Overall, they stress that monitoring must be proactive and individualized, ensuring both safety and sustained disease control as these therapies enter practice.