Fabhalta (iptacopan) for IgA nephropathy
What the FDA decided
The FDA approved Novartis's sBLA for Fabhalta (iptacopan) in IgA nephropathy. Conversion from accelerated to traditional approval under priority review, based on 24-month APPLAUSE-IgAN data showing a 48% slower decline in kidney function. Most IgAN drugs are approved on proteinuria reduction alone; this one now carries a kidney-function claim.
Who this decision matters to
IgA nephropathy is the most common primary glomerulonephritis worldwide, caused by abnormal IgA1 antibodies depositing in the kidney's mesangium, activating complement pathways and triggering inflammation that progressively damages the kidneys. While some patients have a benign course, up to 40% progress to end-stage kidney disease within 20 years of diagnosis. Six disease-specific therapies targeting complement, endothelin, and the APRIL/BAFF pathway have reached FDA approval since 2021, most recently Trutakna (atacicept) in July 2026.
Prevalence: Incidence is about 1 in 100,000 people per year in the U.S. (IgA Nephropathy Foundation); cumulative U.S. prevalence is estimated at roughly 130,000 to 150,000 cases. Significantly more common in East Asian and Pacific Islander populations, with reported incidence up to 4 times higher.. See our full IgA Nephropathy page for current treatments, recruiting trials, and community resources.
About the drug
Fabhalta: selective oral inhibitor of complement factor B, preventing activation of the alternative complement pathway that amplifies kidney inflammation. Our full Fabhalta profile covers how it works, side effects in plain language, and its trial history.
Where IgA Nephropathy treatment stands today
IgA nephropathy treatment has transformed dramatically, with six disease-specific FDA-approved therapies now available: targeted-release budesonide (Tarpeyo), the endothelin blockers Filspari (sparsentan, which also blocks angiotensin) and Vanrafia (atrasentan), the complement inhibitor Fabhalta (iptacopan), the APRIL inhibitor Voyxact (sibeprenlimab), and — newest, approved in July 2026 — Trutakna (atacicept), the first dual BAFF/APRIL inhibitor. Beyond the approved options, active trials include Biohaven's BHV-1400, a first-in-class degrader that selectively removes the pathogenic Gd-IgA1 antibody and whose pivotal trial is expected to start in the second half of 2026, plus late-stage programs like felzartamab, zigakibart, povetacicept, and sefaxersen. These targeted options represent a genuine shift from generic immunosuppression toward addressing the specific mechanisms of kidney damage. The IgA Nephropathy Foundation and NephCure maintain current trial databases. If you have persistent protein in your urine above 0.5-1 gram per day despite maximum supportive therapy, you may qualify for trials of emerging therapies — and with multiple approved drugs now available, discussing the full treatment sequence with your nephrologist matters more than ever. A kidney biopsy is essential for diagnosis and helps predict your individual risk of progression.
Meanwhile, 96 IgA Nephropathy trials are recruiting
Whatever the FDA decides here, research on IgA Nephropathy does not stop. A few currently enrolling studies, US sites first:
Other drugs Trial Friend tracks for IgA Nephropathy
Get notified when new iga-nephropathy trials open or existing trials change status, add sites, or update eligibility.
Our coverage
Frequently asked questions
When will the FDA decide on Fabhalta?
The FDA has already decided: the application was approved. See the outcome details above.
What is Fabhalta being reviewed for?
Novartis submitted a sBLA for Fabhalta in IgA nephropathy. Conversion from accelerated to traditional approval under priority review, based on 24-month APPLAUSE-IgAN data showing a 48% slower decline in kidney function. Most IgAN drugs are approved on proteinuria reduction alone; this one now carries a kidney-function claim.
What happens after the Fabhalta decision?
If approved, availability is not immediate: specialty pharmacy setup, insurance review, and patient assistance typically take weeks even when everything goes right. If the FDA issues a complete response letter, the application was not approved in its current form; CRLs are often about manufacturing or data presentation rather than efficacy, and sponsors frequently resubmit. This page updates with the outcome either way.
Where this date comes from
The FDA does not publish PDUFA dates; companies disclose them. This one comes from Novartis press release. Dates can move, and the FDA can act early or late. This page rechecks against our calendar, which is re-verified daily.