A weekly shot nearly stopped kidney decline in IgA nephropathy

If you or someone you love lives with IgA nephropathy, here is news worth sharing over coffee. In a large two-year trial, a weekly shot called atacicept nearly stopped the yearly loss of kidney function. Far fewer people on the drug saw their kidney disease get worse.

That is a real step forward for a disease that often begins in young adults. It is one of several new drugs changing how IgA nephropathy is treated.

How the study worked

ORIGIN 3 was a randomized, placebo-controlled trial of 428 adults with biopsy-confirmed IgA nephropathy. Half got a 150 mg atacicept injection under the skin each week and half got a placebo (214 in each group), and the results were published Oct. 22, 2026, in New England Journal of Medicine. The drug’s maker, Vera Therapeutics, paid for the trial, and it covers two years of follow-up.

What is IgA nephropathy?

It is one of the most common kidney diseases in the world. Abnormal IgA antibodies form clumps that lodge in the kidney’s tiny filters. That causes inflammation, blood and protein in the urine, and a slow loss of kidney function. Many people eventually need dialysis or a transplant.

Atacicept works on the cause. It blocks two signals, called BAFF and APRIL, that drive the production of the abnormal IgA.

What they found

Doctors track kidney health with a number called eGFR, which shows how well your kidneys filter your blood. A falling number means falling function.

After one year, people on placebo had lost about 6 points (exactly 5.69 ml per minute per 1.73 m2). People on atacicept had lost almost nothing, just 0.11. The gap between the two groups was about 6 points, or 5.58 to be exact.

The pattern held through the second year. Each year, the placebo group kept losing about 6 points (5.60), while the atacicept group lost less than 1 (0.60).

The drug also made a difference in outcomes that matter most. Kidney disease got worse in 11 people on atacicept (5.1%) and in 38 people on placebo (17.8%). No one on atacicept needed dialysis or a transplant, or died, compared with 7 people on placebo.

Side effects were about even between the groups. Some adverse event happened in 74.8% of people on atacicept and 78.0% of people on placebo. Serious ones were less common on atacicept, at 7.0% versus 15.4%. One person died during the trial, and that person was on placebo.

Why this matters

Without treatment, many people with IgA nephropathy lose kidney function year after year. A drug that nearly flattens that decline could keep people off dialysis for much longer. Other targeted drugs, such as sibeprenlimab, are also reporting strong results, so doctors are gaining several options.

What you can do today

Blood pressure control and lowering protein in the urine remain essential for IgA nephropathy, and you can help with the first one right now. Check your blood pressure at home on three days this week, at the same hour each day, and write the numbers down. Bring that list to your next kidney doctor visit, and ask about drugs that target the cause of the disease, such as atacicept, and whether they are approved or available in trials.