Kidney Week

Abstract: FR-PO889

Characterization of Patients with Active Glomerular Inflammation in IgAN: Data from the Adelphi DSP

Session Information

• IgA Nephropathy: Clinical, Outcomes, and Therapeutics
  October 25, 2024 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Glomerular Diseases

• 1402 Glomerular Diseases: Clinical, Outcomes, and Therapeutics

Authors

• Ndife, Briana C., Novartis Pharmaceuticals Corporation, East Hanover, New Jersey, United States

Briana C. Ndife, MPH

• Aldworth, Carolina A R, Novartis Pharmaceuticals Corporation, East Hanover, New Jersey, United States

Carolina A R Aldworth, MD, MS, MBA

• de Courcy, Jonathan, Adelphi Group Ltd, Bollington, United Kingdom

Jonathan de Courcy

• Chatterton, Emma, Adelphi Group Ltd, Bollington, United Kingdom

Emma Chatterton, MSc

• Garratt-Wheeldon, Jade, Adelphi Group Ltd, Bollington, United Kingdom

Jade Garratt-Wheeldon

• Lafayette, Richard A., Stanford University Department of Medicine, Stanford, California, United States

Richard A. Lafayette, MD

Background

Immunoglobulin A nephropathy (IgAN), the most common primary glomerulonephritis, is characterized by the deposition of immune complexes in the glomerular mesangium and a multitude of inflammatory responses. Active glomerular inflammation in IgAN is poorly defined. We describe active glomerular inflammation in a real-world, multi-country setting, using MEST-C scores and hematuria.

Methods

Data were drawn from the Adelphi Real World IgAN Disease Specific Programme^TM, a cross-sectional survey of IgAN-treating physicians, including retrospective data, in China, France, Germany, Italy, Japan, Spain, UK, and the USA, from June–October 2021. Physicians reported data on patient (pt) demographics, MEST-C scores, and clinical characteristics. Analyses were descriptive.
Active glomerular inflammation was defined using MEST-C scores at diagnosis of M1, E1, or C1/2 and/or hematuria persisting from diagnosis to survey.
Declining eGFR (≥40% reduction from diagnosis to survey) and proteinuria ≥1g/day at survey, despite treatment with supportive care (ACEi, ARB, or SGLT2i), were assessed within the population.

Results

Nephrologists (n=271) completed records for pts who had received supportive care for ≥3 consecutive months during their treatment history (n=1254). Mean (SD) pt age was 43 (14) years, 60% were men, and median (IQR) time since IgAN diagnosis was 2 (1–5) years (n=1201).
M1, E1, or C1/2 was reported for 59% (n=741) of pts. Within this population, mean (SD) age was 42 (14), 61% were men, and median (IQR) time since diagnosis was 2 (1–4) years. Proteinuria ≥1g/day despite treatment was noted in 32% (n=239) and declining eGFR in 4% (n=29). 30% had persistent hematuria (n=223).
M1, E1, or C1/2 and/or persistent hematuria were reported for 67% (n=837) of pts. Within this population, mean (SD) age was 42 (14), 61% were men and median (IQR) time since diagnosis was 2 (1–4) years. Proteinuria ≥1g/day despite treatment was noted in 31% (n=263), and declining eGFR in 4% (n=31).

Conclusion

IgAN pts with active glomerular inflammation can be identified from pt charts within this dataset, and many pts had multiple indicators of active glomerular inflammation. Further research is needed to improve the treatment and management of IgAN pts and further validate the active glomerular inflammatory phenotype.

Funding

• Commercial Support – Novartis Pharmaceutical Corporation