Atacicept in IgA nephropathy.

Immunoglobulin A (IgA) nephropathy is a common kidney disease. The cytokines B-cell Activating Factor (BAFF) and A Proliferation-Inducing Ligand (APRIL) have key roles in the pathophysiology of IgA nephropathy. Atacicept is an antibody to BAFF and APRIL. An interim analysis of atacicept in a phase 3 trial in IgA nephropathy, has shown it reduces proteinuria with a good safety profile. This is a very promising finding, and long-term results with atacicept, and a similarly promising BAFF and APRIL inhibitors, telitacicept and povetacicept in nephropathy are eagerly awaited. Of particular interest is whether long-term suppression of immunoglobulins with these inhibitors has adverse effects. Further trials will be needed to determine the respective roles of these inhibitors with angiotensin converting enzyme inhibitors (ACEi) and/or angiotensin receptor blockers (ARBs) and/or sodium-glucose cotransporter 2 (SGLT 2) inhibitors in IgA nephropathy.