Keyword: Targeted Therapy

ABSTRACT: Background: Immunoglobulin A nephropathy is among the most commonly observed glomerular disorders. Its development is associated with immune dysfunction, which initiates a cascade of pathological changes within the glomeruli. The clinical course can range from minimal urinary abnormalities to progressive renal impairment, potentially culminating in end-stage kidney disease. Despite considerable advances in understanding its pathogenesis, optimal therapeutic strategies remain an active focus of scientific investigation.
Aim: To assess current and emerging therapeutic strategies for IgA nephropathy, with an emphasis on efficacy, safety, and the potential of targeted agents addressing key pathogenic pathways.
Methods: We conducted a narrative review of recent literature in PubMed, Scopus, Web of Science, and eLIBRARY databases, focusing on publications from the last decade. Studies published in English and Russian that reported results from clinical trials or meta-analyses on therapeutic interventions for IgA nephropathy were included. Search terms included «IgA nephropathy», «treatment», «targeted therapy», «new therapies», «immunosuppressants», and «clinical trials». Priority was given to randomized controlled trials and studies with high-quality evidence, though relevant observational data were also considered.
Results: Key studies identified included 52 publications, among which 20 were randomized clinical trials and a systematic review. Corticosteroid therapy remains a cornerstone of treatment but is limited by significant adverse effects. Recent therapeutic developments in IgA nephropathy have focused on interventions that selectively target inflammatory and immune pathways involved in disease progression. Certain novel agents aimed at modulating immune signaling or addressing pathogenic plasma cells have shown potential to reduce proteinuria and stabilize renal function. Early-phase clinical investigations indicate promising efficacy and manageable safety profiles, suggesting these approaches may represent important advances in disease management.
Conclusions: Recent progress in targeted and immunomodulatory therapies offers new perspectives for personalized treatment of IgA nephropathy. Comprehensive, large-scale randomized studies with extended follow-up are warranted to thoroughly assess the therapeutic potential, safety profile, and optimal positioning of these interventions within future clinical management strategies.

ABSTRACT: The advent of targeted complement inhibitors represents a paradigm shift in managing complement-mediated nephropathies. Integrating these therapies into healthcare systems, particularly in resource-variable settings, requires strategic planning.
A national council of experts was convened in October 2024 with the purpose of obtaining a clinical expert opinion to develop practical recommendations for improving the organization and optimization of medical care for patients with C3 glomerulopathy (C3G) and IgA nephropathy (IgAN) in Kazakhstan.
The council identified critical systemic gaps, including inconsistent use of renal biopsy, lack of specialized nephropathology, absence of treatment algorithms, and fragmented patient care. A consensus was reached on key recommendations for a new national clinical protocol. These include mandating pathological confirmation, creating detailed treatment and monitoring algorithms, establishing a national registry and coordination center, and investing in specialized training for healthcare professionals.
The systematic framework proposed by the council provides an actionable roadmap to overcome barriers to care. This model ensures equitable patient access to novel therapies and may serve as a blueprint for other nations navigating the integration of advanced treatments into clinical practice.