Which clinical characteristics would prompt you to consider an oral factor B inhibitor such as iptacopan in the treatment of IgA nephropathy?  

Great question—some of the parameters I would think about iptacopan before or even at the same time as Tarpeyo are patients with endocapillary proliferation, crescents, along with 2-3+ complement deposition on the biopsy. These patients have increased inflammation in the glomerulus and need a ...

A strict reading of the literature requires that the answer reflect the characteristics of patients studied and shown to benefit from iptacopan in the seminal phase 3 APPLAUSE-IgAN study published in NEJM in Oct 2024. Key inclusion criteria were eGFR of ≥45 and biopsied within 5 years, or eGFR &g...

I think iptacopan may be a useful choice in patients with a more active, aggressive lesion on biopsy, declining GFR, or heavy proteinuria. It perhaps makes intuitive sense to favor iptacopan if there is strong C3 staining on biopsy as well. We still do not know which among iptacopan, sustained-relea...