A shot every four weeks kept kidney function stable in IgA nephropathy for two years
IgA nephropathyPart of a story we are following · 3 articles · See every update
Sibeprenlimab kept kidney function stable over 24 months in IgA nephropathy while it fell on placebo, and kidney events occurred in 0.4% vs. 11.2%, in the final analysis of a phase 3 trial published Oct. 22, 2026, in New England Journal of Medicine. It joins a wave of new IgA nephropathy drugs.
IgA nephropathy is a kidney disease that slowly wears down kidney function, often starting in young adulthood.
What is IgA nephropathy?
It’s one of the most common kidney diseases worldwide and often affects young adults. Abnormal IgA antibodies form clumps that lodge in the kidney’s filters, causing inflammation, blood and protein in the urine, and a slow loss of kidney function. Many people eventually need dialysis or a transplant.
What did the trial test?
510 adults with IgA nephropathy were assigned by chance to sibeprenlimab 400 mg or placebo, injected under the skin every 4 weeks. Sibeprenlimab blocks APRIL, a signal that drives the production of the abnormal IgA. The key measure was how fast kidney function (eGFR) changed over 24 months.
What did the study find about IgA nephropathy?
The difference in eGFR at 24 months was 9.2 units in favor of sibeprenlimab. No deaths were reported.
Why does this matter?
Stopping the steady loss of kidney function is the main goal in IgA nephropathy, because it can delay or prevent dialysis. Several drugs that target the disease’s cause are now showing strong results, and this one acts on a key upstream signal.
How solid is this evidence?
It’s strong. Mongevity rates it A on our A-to-E scale: a large randomized placebo-controlled phase 3 trial with clear differences in kidney function and kidney events. Limits: it was funded by the maker, Otsuka, and two years is still short for a lifelong disease.
What does this mean for you?
If you or someone close to you has IgA nephropathy, ask the nephrologist about new targeted treatments, including drugs that block APRIL, and whether they’re approved or available through trials. Keep controlling blood pressure and protein in the urine.
How do I explain this at dinner?
In some people, the kidneys’ filters get clogged by a faulty antibody and slowly wear out. A new shot blocks the signal that makes the faulty antibody, and kept the kidneys working steady for two years. A good question for the table: why is it better to stop a problem at its source?
In one sentence: sibeprenlimab kept kidney function stable for two years and sharply cut kidney events in IgA nephropathy.
Questions and answers
- What is sibeprenlimab?
- An antibody injected every 4 weeks that blocks APRIL, a signal that drives the abnormal IgA behind IgA nephropathy.
- How well did it protect the kidneys?
- Kidney function stayed stable (+0.3 per year) vs. falling 4.2 per year with placebo, and kidney events were 0.4% vs. 11.2%.
- Is it safe?
- Serious adverse events (8.1% vs. 12.7%) and serious infections (1.9% vs. 4.0%) were less frequent than with placebo, and no deaths occurred.
