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Iptacopan significantly reduced proteinuria in IgA nephropathy patients in APPLAUSE-IgAN study, confirming clinical benefit of alternative pathway inhibition. Interim analysis showed 38.3% lower urinary protein-to-creatinine ratio (UPCR) with iptacopan than placebo by month 9. Significant changes from baseline in complement pathway biomarkers were consistent with selective alternative pathway inhibition. Iptacopan, granted accelerated FDA approval in August 2024, is the first complement inhibitor indicated to reduce proteinuria in adults with IgA nephropathy at risk of rapid progression. Further data on estimated glomerular filtration rate (eGFR) is anticipated at 2025 trial completion for ‘traditional approval