How would you manage a patient with stable axial spondyloarthritis who develops newly active IgA nephropathy?

Although the data are sparse, in general, the principles of treatment of IgAN in the setting of spondyloarthritis is similar to primary IgAN.

• BP targets <120/80
• RAS inhibitors or sparsentan
• SGLT2 inhibitors
• If persistent proteinuria despite above, targeted-release budesonide or oral corticosteroids ...

Increased serum IgA levels and IgA nephropathy are known to be an extra-articular feature although uncommon within the spectrum of spondyloarthropathies, just like uveitis, apical lung fibrosis, cardiac conduction defects, aortitis, etc., especially with AS (ankylosing spondylitis). If IgA nephropat...