# Emerging Therapies in IgA Nephropathy: From A Proliferation-Inducing Ligand (APRIL) and B-cell Activating Factor (BAFF) Inhibitors to Precision Medicine

## TL;DR

This review discusses new treatments for IgA nephropathy, a common kidney disease, including targeted therapies and precision medicine approaches to improve patient outcomes.

## Contribution

The paper provides an updated synthesis of emerging therapies and precision medicine strategies for IgA nephropathy.

## Key findings

- APRIL and BAFF inhibitors show promise in targeting specific immune pathways in IgA nephropathy.
- Complement pathway modulators and novel agents like felzartamab and sparsentan are being explored for disease modification.
- Precision medicine strategies, including biomarker-guided therapy, are advancing personalized treatment approaches.

## Abstract

IgA nephropathy (IgAN) is the most prevalent primary glomerular disease worldwide and a significant contributor to end-stage kidney disease (ESKD). Traditional management has centered on supportive care and non-specific immunosuppression, but recent advances in the understanding of pathogenic pathways have catalyzed the development of targeted therapies. This review synthesizes current evidence on evolving treatments, with a focus on A Proliferation-Inducing Ligand (APRIL) and B-cell Activating Factor (BAFF) (e.g., sibeprenlimab, atacicept, povetacicept, telitacicept), complement pathway modulators (e.g., iptacopan, cemdisiran, ravulizumab), and novel agents such as felzartamab and sparsentan. It also explores precision medicine strategies, including biomarker-guided therapy, individualized risk stratification, and combination regimens. Supported by high-quality recent clinical trial data and the latest kidney disease outcome guidelines, these innovations represent a paradigm shift toward personalized, disease-modifying treatment in IgAN, offering a new horizon for improved renal outcomes and long-term disease control.