Dr. Axe Wire · Study decoded · health

Weekly Drug Injection Nearly Stops Kidney Decline in IgA Nephropathy Trial

A phase 3 trial found an injected drug nearly stopped kidney function loss over two years compared with placebo in adults with IgA nephropathy.

By Dr. Josh Axe · October 31, 2026 · 1 source · Understand

Photo: Pexels

A phase 3 trial published October 22, 2026 in the New England Journal of Medicine found that weekly injections of the drug atacicept nearly halted the decline in kidney function in adults with IgA nephropathy, a kidney disease in which an abnormal antibody damages the kidney's filtering units.

428adults, 2-year trial

5.58mL/min higher eGFR

5.1% vs 17.8%progressed

7% vs 15.4%serious events

The trial, published October 22, 2026 in the New England Journal of Medicine, randomly assigned 431 adults with biopsy-confirmed IgA nephropathy to weekly subcutaneous atacicept at 150 mg or a placebo injection, with 428 ultimately treated (214 in each group). At week 52, kidney function measured by eGFR (estimated glomerular filtration rate, a blood test reflecting how well kidneys filter waste) had changed by -0.11 mL/min/1.73m² with atacicept versus -5.69 mL/min/1.73m² with placebo, a difference of 5.58 mL/min/1.73m². Through week 104, the yearly rate of decline was -0.60 mL/min/1.73m² per year with atacicept compared with -5.60 mL/min/1.73m² per year with placebo, a difference of 5.00 mL/min/1.73m² per year. A composite measure of kidney disease worsening occurred in 11 of 214 patients (5.1%) on atacicept versus 38 of 214 patients (17.8%) on placebo. No patients on atacicept progressed to dialysis, transplant or death, compared with 7 patients on placebo.

IgA nephropathy involves an abnormal antibody that triggers inflammation and scarring in the kidney's filtering units over years, gradually reducing how much blood they can clean. Every main kidney measure in this trial favored atacicept (P values below 0.001), and the drop of about 5.6 points a year on placebo shows how fast kidney function can fall in this disease.

Annual Kidney Function Decline: Atacicept vs Placebo Through 104 Weeks

New England Journal of Medicine, 2026, Barratt et al.

Adverse events occurred in 160 of 214 patients (74.8%) on atacicept and 167 of 214 patients (78.0%) on placebo; serious adverse events occurred in 7.0% and 15.4% of these groups, respectively, with one death reported in the placebo group. The trial compared atacicept only against placebo, not against other approved IgA nephropathy therapies, so how it stacks up against existing treatment options is not established here.

Dr. Axe’s Take

Atacicept slowed kidney decline, but it doesn't fix why the immune system attacks the kidneys in IgA nephropathy. More broadly, research links the faulty antibody behind this disease to immune tissue in the gut lining. The kidney numbers are real: function barely moved over two years on the drug and fell about 5.6 points a year on placebo. The cost is a weekly injection with no end date, from a drug that suppresses part of the immune system, so watch for infections. I'd also work on gut health, blood pressure and regular bloodwork to track your eGFR, and bring this trial to your nephrologist.

— Dr. Axe

Take the Organ Health Quiz →

Study summary

Who: 431 adults with biopsy-confirmed IgA nephropathy; 428 treated (214 atacicept, 214 placebo).
Design: Randomized, placebo-controlled phase 3 trial, final efficacy analysis through week 104.
Dose: Weekly subcutaneous atacicept, 150 mg, versus placebo.
Primary result: eGFR change at week 52: -0.11 vs -5.69 mL/min/1.73m² (difference 5.58); annualized slope through week 104: -0.60 vs -5.60 mL/min/1.73m² per year (difference 5.00).
Secondary: Kidney disease progression: 5.1% (atacicept) vs 17.8% (placebo); no atacicept patients reached dialysis, transplant or death vs 7 on placebo.
Funding / conflicts: Funded by Vera Therapeutics; ORIGIN 3 ClinicalTrials registry number, NCT04716231.
Date: Oct 22, 2026