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TherapyArea Sentinel · BioAdvisor
ISSUE 02 · FORTNIGHTLY

IgA Nephropathy Intelligence Brief

Surveillance window: August 13 – 27, 2026 · Literature · Trials · Preprints · Regulatory
34
Relevant publications
10
Trials updated
1
Relevant preprint
0
New approvals
1
Imminent readout

What moved this fortnight: the first China-cohort interim readout of sibeprenlimab's Phase 3 VISIONARY trial (61.9% placebo-adjusted proteinuria reduction), an ISN expert consensus on complement therapeutics in C3G & IgAN, and a first head-to-head-style network meta-analysis across the BAFF/APRIL class. On the trials side, 10 IgAN programs touched their registrations, and Roche's sefaxersen Phase 3 reaches primary completion Aug 31 — the next material catalyst.

Top signals ranked by clinical materiality

1

Sibeprenlimab Ph3 VISIONARY — China-cohort interim: 61.9% placebo-adjusted proteinuria reduction

First regional interim from the pivotal program behind the recently approved anti-APRIL agent; reinforces class-leading antiproteinuric effect in an East-Asian population.
ClinicalClin Kidney J · doi:10.1093/ckj/sfag222
2

ISN Forum on Complement Therapeutics in C3G & IgAN — consensus outcomes

Expert guidance on where complement inhibitors fit in real-world practice — directly relevant to positioning and medical education planning.
ClinicalKidney Int, Aug 26 · doi:10.1016/j.kint.2026.08.007
3

BAFF/APRIL-pathway inhibitors vs placebo: systematic review + network meta-analysis (7 RCTs, n=1,590)

First cross-class ranking of telitacicept, atacicept and sibeprenlimab: consistent proteinuria reduction (SMCR −0.73), sibeprenlimab highest exploratory P-score; fewer serious AEs on active treatment.
ClinicalRecovered by recall auditBMC Nephrol, Aug 11 · doi:10.1186/s12882-026-05267-4
4

Felzartamab preserves humoral immunity and vaccine response in IgAN

Anti-CD38 safety differentiation ahead of PREVAIL Ph3 readouts — a likely talking point for B-cell-depletion comparisons.
ClinicalKidney Int Rep · doi:10.1016/j.ekir.2026.106697
5

Nefecon vs systemic corticosteroids — real-world comparative study (n=82)

Scarce direct RWE: comparable antiproteinuric efficacy, numerically fewer severe infections and steroid-related AEs with targeted-release budesonide.
ClinicalRecovered by recall auditFront Immunol · doi:10.3389/fimmu.2026.1831633

Clinical & therapy 9 further items

  • Practice variation in IgAN — editorial: the field is evolving faster than consensus; positioning context for newly approved agents. Kidney360 · doi:10.34067/KID.0000001343
  • Telitacicept meta-analysis (8 studies, 459 pts) — pooled efficacy in IgAN. Front Med · doi:10.3389/fmed.2026.1894514
  • Endothelin receptor antagonists in resistant HTN and proteinuric CKD — sparsentan/atrasentan/zibotentan positioning review. J Clin Hypertens · doi:10.1111/jch.70353
  • Finerenone in IgAN — 12-month real-world study; off-label MRA signal. Renal Failure · doi:10.1080/0886022X.2026.2681246
  • Finerenone after RASi discontinuation — multicentre retrospective cohort. Diabetes Obes Metab · doi:10.1111/dom.71225
  • Telitacicept vs glucocorticoids vs Nefecon — real-world comparative letter. Drug Des Devel Ther · doi:10.2147/DDDT.S639608
  • Nefecon US real-world case series in Asian-American patients — adherence and course-completion gaps. Clin Nephrol · doi:10.5414/CN112036
  • What constitutes disease modification in IgAN? — regulatory-relevant framing letter. Clin Kidney J · doi:10.1093/ckj/sfag265
  • C5-targeted GalNAc siRNA — sustained efficacy in NHP IgAN model; early pipeline signal. Mol Ther · doi:10.1016/j.ymthe.2026.08.022

Research radar 18 items — headlines

  • Hematuria as prognostic marker — meta-analysis (Vertex-authored) doi:10.3389/fneph.2026.1899597 · hemoglobinuria as activity marker, 441-pt cohort doi:10.1016/j.kint.2026.07.021 · urinalysis-based risk model in 18k+ patients doi:10.3389/fneph.2026.1826486
  • Complement pathway review mapped to MEST-C and drug targets doi:10.3389/fmed.2026.1896069 · NETs/cGAS-STING injury pathway doi:10.1016/j.bcp.2026.118354 · plasma-proteomics endotypes doi:10.3390/cells15151373
  • Nefecon gut-microbiota differentiation doi:10.3389/fimmu.2026.1856526 · deep-learning glomerular morphometry added to the International IgAN Prediction Tool doi:10.3389/fimmu.2026.1910367 · Crohn's–IgAN shared-genetics MR doi:10.3389/fimmu.2026.1905767
  • Urinary exosomal miRNA diagnostics — case-control, non-invasive biomarker panel (AUC > 0.8) Recovered by recall audit World J Nephrol · doi:10.5527/wjn.119882 · arginine-metabolism key genes (ARG1/ARG2) via scRNA-seq Recovered by recall audit Front Immunol · doi:10.3389/fimmu.2026.1888069
  • Plus 7 further mechanistic/biomarker items in the run record.

Trials activity 10 IgAN registrations updated in window · CT.gov

Sponsor / ProgramPhaseStatusNNote
Roche — sefaxersen NCT05797610Ph3Active, not recruiting459Primary completion Aug 31, 2026 — imminent
Takeda — mezagitamab (TAK-079) NCT06963827Ph3Recruiting347176 sites
Biogen — felzartamab PREVAIL NCT06935357Ph3Recruiting454258 sites
Otsuka — sibeprenlimab pediatric NCT07770815Ph3Not yet recruiting—Start 2026-09-30
Novartis — zigakibart OLE NCT06858319Ph3Recruiting220Open-label extension
Jade Biosciences — JADE101 JUNIPER NCT07541287Ph2Recruiting30Anti-APRIL entrant
argenx — ARGX-121 NCT07773727Ph2Not yet recruiting—Start 2026-10-15
MMF in refractory IgAN (Bangladesh) NCT07785128 · complement-severity observational (Strasbourg) NCT05234463 · Ruijin IgAN database NCT04858724Ph2/ObsInvestigator-initiated / registry activity

Preprints (1 relevant)

IgA1 hinge-region O-glycoform signatures in pediatric IgA vasculitis — medRxiv, Aug 24 · doi:10.64898/2026.08.21.26361008. Adjacent to IgAN (shared Gd-IgA1 biology); flagged for reader judgment on IgAV adjacency.

Regulatory

No new IgAN approvals in window. Recent context: sibeprenlimab (VOYXACT) accelerated approval and atacicept approval earlier in 2026 — both now anchor the practice-variation debate (see Top signal 2 and the Kidney360 editorial).