Products such as Tarpeyo (Calliditas), Filspari (Travere) and now Novartis’ Fabhalta and Venrafia provide physicians more options than ever before.
Exton, PA, May 8, 2025 – With multiple targeted therapies now available and SGLT2 inhibitors broadly embraced, nephrologists across the globe are redefining how they manage IgA Nephropathy (IgAN) patients. Data from Spherix Global Insights’ comprehensive Patient Chart Dynamix™ services—spanning over 2,300 patient charts across the US, EU5, Japan, and China—demonstrate the magnitude of this shift, highlighting differences in treatment patterns, product adoption, and future intent across markets.
As standard treatment practice increasingly incorporates SGLT2 inhibitors—initially reserved for diabetes and then diabetic kidney disease—nephrologists are initiating these agents earlier in the treatment algorithm, citing emerging data supporting their protective effects in CKD, including IgAN. Adoption has grown substantially year-over-year in all surveyed markets. While regional differences exist, the early use of SGLT2 inhibitors, in combination with RAASi, is now widely accepted as foundational care for non-dialysis IgAN patients.
Overlaying this supportive care are newly launched agents designed specifically for IgAN. Calliditas’ Tarpeyo® (budesonide) and Travere’s Filspari® (sparsentan) have quickly gained traction in the US, with prescribing steadily moving upstream in the treatment paradigm. Indeed, nearly one in five US IgAN patients are currently managed with Tarpeyo, and Filspari’s use has nearly doubled in the past year alone. Across Europe, Kinpeygo—Tarpeyo’s EU label—has seen notable growth, especially in Germany and the UK. Filspari’s limited availability at the time of fielding across many regions somewhat constrained its uptake, though future use intentions are high as access expands. In China, Nefecon (budesonide) has rapidly secured a foothold, with many patients already initiated on therapy.
Despite different access landscapes, nephrologists are aligned on one key goal: reducing proteinuria to below 0.5g/day. Yet, many patients remain above this threshold despite therapy, underscoring the need for additional, more effective options. Enter Novartis, with Fabhalta® (iptacopan), recently approved in the US and garnering early interest for use in later lines of therapy. Vanrafia®, also from Novartis, has just received its first approval and is poised to further expand the treatment armamentarium. Together, these products—alongside pipeline agents targeting the complement system, APRIL/BAFF pathways, and other novel MOAs—represent a new chapter in IgAN care focused on underlying disease pathophysiology.
Importantly, Spherix’s data highlight regional nuances in how nephrologists view and sequence these therapies. In Japan, tonsillectomy remains a widely accepted option and is often paired with systemic corticosteroids. In contrast, physicians in the US and China are increasingly moving away from broad immunosuppression in favor of targeted mechanisms with improved safety profiles. While there is general agreement on first-line strategies, subsequent lines of therapy are in flux, shaped by clinical experience, product availability, and evolving guideline recommendations.
Physicians continue to prioritize clinical data demonstrating both proteinuria reduction and eGFR preservation when evaluating new options, though safety warnings remain a barrier to adoption for some. Even so, enthusiasm for therapies with novel mechanisms continues to grow, particularly in markets where patients remain difficult to manage despite standard therapies.
With over five years of continuous tracking, Spherix Global Insights has established the most robust and consistent global dataset on IgAN, offering the industry’s most comprehensive view of how real-world treatment decisions have evolved and how emerging therapies are being integrated into clinical practice. By continuing to track real-world patient management trends and comparing data across markets, Spherix delivers actionable insights that support strategic decision-making for stakeholders across the nephrology landscape.
Patient Chart Dynamix™ is an independent, data-driven service unveiling real patient management patterns through rigorous analysis of large-scale patient chart audits. Insights reveal the “why” behind treatment decisions, include year over year trending to quantify key aspects of market evolution, and integrate specialists’ attitudinal & demographic data to highlight differences between stated and actual treatment patterns.
About Spherix Global Insights
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Spherix Global Insights Contacts
Tucker Hurtado, Nephrology Franchise Head
Tucker.Hurtado@SpherixGlobalInsights.com
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