Biologics and Non-Biologics Immunosuppressive Treatments for IgA Nephropathy in Both Adults and Children

Immunoglobulin A nephropathy represents the most prevalent cause of glomerulonephritis worldwide and may lead to renal failure in a relevant number of cases in both paediatric and adult subjects. Although their pathogenesis is still largely unclear, evidence of immune abnormalities provides the back...

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Published inJournal of clinical medicine Vol. 13; no. 9; p. 2465
Main Authors Chiarenza, Decimo Silvio, Verrina, Enrico Eugenio, La Porta, Edoardo, Caridi, Gianluca, Ghiggeri, Gian Marco, Mortari, Gabriele, Lugani, Francesca, Angeletti, Andrea, Bigatti, Carolina
Format Journal Article
LanguageEnglish
Published Switzerland MDPI AG 01.05.2024
Subjects
Adults
Biological products
Biopsy
Care and treatment
Demographic aspects
Diagnosis
Dosage and administration
Hypotheses
IgA glomerulonephritis
Immunosuppressive agents
Kidney diseases
Kidney transplants
Pathogenesis
Pediatrics
Safety and security measures
Steroids
Testing
Italy
BAFF
IgA nephropathy
biologics
iptacopan
BAFF/APRIL inhibitors
paediatric nephrology
complement cascade
rituximab
sibeprenlimab
APRIL
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Abstract Immunoglobulin A nephropathy represents the most prevalent cause of glomerulonephritis worldwide and may lead to renal failure in a relevant number of cases in both paediatric and adult subjects. Although their pathogenesis is still largely unclear, evidence of immune abnormalities provides the background for the use of immunosuppressive drugs, such as corticosteroids, calcineurin inhibitors, and antiproliferative and alkylating agents. Unfortunately, these treatments fail to achieve a sustained remission in a significant percentage of affected patients and are burdened by significant toxicities. Recent developments of new biologics, including anti-BAFF/APRIL inhibitors and molecules targeting complement components, offered the opportunity to selectively target immune cell subsets or activation pathways, leading to more effective and safer hypothesis-driven treatments. However, studies testing new biologic agents in IgAN should also consider paediatric populations to address the unique needs of children and close the therapeutic gap between adult and paediatric care.
AbstractList Immunoglobulin A nephropathy represents the most prevalent cause of glomerulonephritis worldwide and may lead to renal failure in a relevant number of cases in both paediatric and adult subjects. Although their pathogenesis is still largely unclear, evidence of immune abnormalities provides the background for the use of immunosuppressive drugs, such as corticosteroids, calcineurin inhibitors, and antiproliferative and alkylating agents. Unfortunately, these treatments fail to achieve a sustained remission in a significant percentage of affected patients and are burdened by significant toxicities. Recent developments of new biologics, including anti-BAFF/APRIL inhibitors and molecules targeting complement components, offered the opportunity to selectively target immune cell subsets or activation pathways, leading to more effective and safer hypothesis-driven treatments. However, studies testing new biologic agents in IgAN should also consider paediatric populations to address the unique needs of children and close the therapeutic gap between adult and paediatric care.
Immunoglobulin A nephropathy represents the most prevalent cause of glomerulonephritis worldwide and may lead to renal failure in a relevant number of cases in both paediatric and adult subjects. Although their pathogenesis is still largely unclear, evidence of immune abnormalities provides the background for the use of immunosuppressive drugs, such as corticosteroids, calcineurin inhibitors, and antiproliferative and alkylating agents. Unfortunately, these treatments fail to achieve a sustained remission in a significant percentage of affected patients and are burdened by significant toxicities. Recent developments of new biologics, including anti-BAFF/APRIL inhibitors and molecules targeting complement components, offered the opportunity to selectively target immune cell subsets or activation pathways, leading to more effective and safer hypothesis-driven treatments. However, studies testing new biologic agents in IgAN should also consider paediatric populations to address the unique needs of children and close the therapeutic gap between adult and paediatric care.Immunoglobulin A nephropathy represents the most prevalent cause of glomerulonephritis worldwide and may lead to renal failure in a relevant number of cases in both paediatric and adult subjects. Although their pathogenesis is still largely unclear, evidence of immune abnormalities provides the background for the use of immunosuppressive drugs, such as corticosteroids, calcineurin inhibitors, and antiproliferative and alkylating agents. Unfortunately, these treatments fail to achieve a sustained remission in a significant percentage of affected patients and are burdened by significant toxicities. Recent developments of new biologics, including anti-BAFF/APRIL inhibitors and molecules targeting complement components, offered the opportunity to selectively target immune cell subsets or activation pathways, leading to more effective and safer hypothesis-driven treatments. However, studies testing new biologic agents in IgAN should also consider paediatric populations to address the unique needs of children and close the therapeutic gap between adult and paediatric care.
Audience Academic
Author Angeletti, Andrea
Lugani, Francesca
La Porta, Edoardo
Chiarenza, Decimo Silvio
Bigatti, Carolina
Verrina, Enrico Eugenio
Caridi, Gianluca
Mortari, Gabriele
Ghiggeri, Gian Marco
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Keywords BAFF
IgA nephropathy
biologics
iptacopan
BAFF/APRIL inhibitors
paediatric nephrology
complement cascade
rituximab
sibeprenlimab
APRIL
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Snippet Immunoglobulin A nephropathy represents the most prevalent cause of glomerulonephritis worldwide and may lead to renal failure in a relevant number of cases in...
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SubjectTerms Adults
Biological products
Biopsy
Care and treatment
Demographic aspects
Diagnosis
Dosage and administration
Hypotheses
IgA glomerulonephritis
Immunosuppressive agents
Kidney diseases
Kidney transplants
Pathogenesis
Pediatrics
Safety and security measures
Steroids
Testing
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Title Biologics and Non-Biologics Immunosuppressive Treatments for IgA Nephropathy in Both Adults and Children
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