IgA nephropathy (Berger's disease) is the most common cause of kidney inflammation worldwide. A faulty form of the IgA antibody forms clumps that lodge in the kidney filters, and up to 1 in 3 people reach kidney failure within 20 years, often in their 40s or 50s. Until recently, treatment was blood-pressure pills and sometimes steroids. Since 2023 a wave of approvals has arrived, from kidney-protecting pills to drugs that target the immune cause.
- 94studies open or running
- 19phase 3 trials
- 822papers published this year
- 23NIH-funded projects
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Now
Nov 2026
Slower loss of kidney functionHappened 21.4% kidney failure or major decline
Iptacopan halved the yearly decline in kidney function; kidney failure or major decline 21.4% vs 33.5%.
21.4%: reached kidney failure or major decline, vs 33.5% with placebo.
Drugs that target the causeHappened 51.2% lower urine protein
Sibeprenlimab (approved November 2025) cut urine protein 51.2% vs placebo; atacicept (approved July 2026) cut it 45.7%.
51.2%: lower urine protein than placebo at 9 months.
A kidney-protecting pillHappened 36.1 points more protein reduction
Atrasentan reduced urine protein 36.1 percentage points more than placebo.
36.1: percentage-point greater drop in urine protein than placebo.
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6 months
by May 2027
Two more FDA decisionsLikely
Povetacicept (target date November 30, 2026) and ravulizumab (fourth quarter 2026) await FDA decisions.
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12 months
by Nov 2027
Another anti-APRIL antibodyPossible
Novartis' zigakibart phase 3 (383 people) finishes August 2027.
Proof that atacicept preserves kidney functionPossible 45.7% drop in urine protein
Full ORIGIN 3 results on kidney function will decide whether accelerated approval becomes full approval.
45.7%: drop in urine protein at 36 weeks, vs 6.8% with placebo.
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3 years
by late 2029
Antisense and anti-CD38 approachesPossible
Roche's sefaxersen (459 people, due May 2028) and Takeda's mezagitamab (347 people, due September 2028) are in phase 3.
Combining drug typesPossible
LUMINA IgAN (340 people) tests zigakibart plus atrasentan together; due September 2028.
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5 years
by late 2031
Longer-acting and new-mechanism drugsLong shot
Jade's JADE101 (480 people, due June 2029) and Biohaven's IgA degrader BHV-1400 (420 people) aim at less frequent dosing and new targets.
The research paths
APRIL and BAFF blockers
51.2% lower urine proteinDetails and 5 trialsHide
Drugs that cut production of the faulty IgA at its source.
WatchPovetacicept decision; zigakibart; JADE101.
- Zigakibart (anti-APRIL) vs placebo (BEYOND)Novartis · 383 people · fully enrolled Aug 2027
- JADE101 (anti-APRIL, long-acting)Jade Biosciences · 480 people · enrolling Jun 2029
- Zigakibart plus atrasentan (LUMINA IgAN)Novartis · 340 people · not yet open Sep 2028
- Mezagitamab (anti-CD38) vs placeboTakeda · 347 people · enrolling Sep 2028
- BHV-1400 (IgA degrader)Biohaven · 420 people · not yet open Sep 2028
Complement blockers
21.4% kidney failure or major declineDetails and 1 trialsHide
Iptacopan, ravulizumab and sefaxersen block the immune attack on kidney filters.
WatchRavulizumab decision; IMAGINATION.
Kidney-protecting pills
36.1 points more protein reductionDetails and 2 trialsHide
Endothelin blockers, SGLT2 inhibitors and blood-pressure drugs as the foundation.
WatchALIGN final kidney-function results.
Borrowed from other conditions
From Paroxysmal nocturnal hemoglobinuria
Iptacopan
Approved
A complement factor B pill first approved for a rare blood disease.
From PNH and myasthenia gravis
Ravulizumab
Under FDA review
A long-acting complement C5 antibody, under FDA review for IgA nephropathy.
From Multiple myeloma research
Mezagitamab
Phase 3
An anti-CD38 antibody that depletes the plasma cells making faulty IgA.
Open to join now
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IgA nephropathy
Mezagitamab
Locations and eligibility → -
IgA nephropathy
JADE101
Locations and eligibility → -
IgA nephropathy
Hydroxychloroquine
Locations and eligibility → -
IgA nephropathy
PS-002
Locations and eligibility →
See every recruiting IgA nephropathy trial →
When the trials finish
Completion dates the trials registered. Results usually follow 3 to 12 months later.
- Heating up
- Maturing
- Early
- Cooling
- Fully enrolled, waiting on results
- Still enrolling
What just happened
FDA approves atacicept
ORIGIN 3.
Iptacopan halves kidney function loss
APPLAUSE-IgAN, NEJM.
FDA approves sibeprenlimab
VISIONARY, NEJM.
Standard treatment today
- Low urine protein, normal kidney functionBlood-pressure control and monitoring.
- Persistent urine proteinACE inhibitor or ARB, SGLT2 inhibitor; sparsentan or atrasentan.
- High risk of progressionAdd an immune-targeting drug: sibeprenlimab, atacicept, iptacopan or targeted-release budesonide.
- Kidney failureDialysis or kidney transplant; the disease can recur in the transplant.
How to read this page, and sourcesHow to read this page, and sources
- Most recent approvals are accelerated, based on lower urine protein; confirmation that they preserve kidney function is still coming.
- Forecasts are editorial judgments by Find a Trial, not predictions from sponsors or regulators.
See IgA nephropathy trials recruiting now →