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Autoimmune & Inflammatory

IgG4-Related Disease Clinical Trials and Treatments

Also called IgG4-RD, IgG4 related disease, IgG4 disease, hyper-IgG4 disease, IgG4 sclerosing disease, IgG4 autoimmune pancreatitis

IgG4-related disease was recognized as a unified clinical entity only in 2003, when Japanese researchers linked autoimmune pancreatitis to a systemic condition with IgG4-positive tissue infiltration in multiple organs. The pathophysiology involves aberrant T follicular helper cells driving IgG4 class switching in B cells, CD4+ cytotoxic T lymphocytes that infiltrate tissues and produce profibrotic cytokines, and activated fibroblasts that deposit collagen in a characteristic whorled (storiform) pattern.

View 33 active trialsMatch me to a trial

About IgG4-Related Disease

IgG4-related disease was recognized as a unified clinical entity only in 2003, when Japanese researchers linked autoimmune pancreatitis to a systemic condition with IgG4-positive tissue infiltration in multiple organs. The pathophysiology involves aberrant T follicular helper cells driving IgG4 class switching in B cells, CD4+ cytotoxic T lymphocytes that infiltrate tissues and produce profibrotic cytokines, and activated fibroblasts that deposit collagen in a characteristic whorled (storiform) pattern.

Diagnosis requires tissue biopsy in most cases, with histopathological criteria including dense lymphoplasmacytic infiltrate, storiform fibrosis, and obliterative phlebitis. Serum IgG4 levels are elevated in about 60 to 70% of patients but are neither sensitive nor specific enough for diagnosis alone. PET-CT is increasingly used to map organ involvement and monitor treatment response.

In April 2025, inebilizumab (Uplizna), a monoclonal antibody targeting CD19-positive B cells, became the first FDA-approved treatment for IgG4-related disease. In the Phase 3 MITIGATE trial, inebilizumab dramatically reduced flares, with only 10% of treated patients experiencing a flare versus 60% on placebo. Prior to this approval, treatment relied on glucocorticoids (effective but associated with 24 to 63% relapse rates upon tapering) and off-label rituximab.

Common Symptoms of IgG4-Related Disease

Recognizing the signs of IgG4-Related Disease early can lead to faster diagnosis and better outcomes. Symptoms may vary in severity from person to person. If you or a loved one are experiencing any of the following, consider speaking with a specialist.

  • Painless swelling of salivary or lacrimal (tear) glands
  • Pancreas inflammation that can mimic pancreatic cancer on imaging
  • Kidney dysfunction from tubulointerstitial nephritis
  • Retroperitoneal fibrosis causing back pain and ureteral obstruction
  • Sclerosing cholangitis (bile duct narrowing) causing jaundice
  • Lymph node enlargement, lung nodules, or aortitis depending on organ involvement

Who IgG4-Related Disease Affects

Predominantly affects adults aged 50 to 70 years. Sex distribution varies by organ involvement: pancreatobiliary and retroperitoneal disease is more common in men, while salivary and lacrimal gland disease has a more equal or female-predominant distribution. Overall U.S. data shows a slight female majority.

Affects all ethnicities. Diagnosis is frequently delayed because the condition mimics cancer, lymphoma, or other autoimmune diseases.

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FDA-Approved Treatments for IgG4-Related Disease

There is currently 1 FDA-approved medication for IgG4-Related Disease. These therapies represent the current standard of care and may be used alongside or compared against investigational treatments in active clinical trials.

inebilizumab
Amgen (via its 2023 acquisition of Horizon Therapeutics)
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Source: openFDA drug labeling data. This list may not include all treatments. Always consult your doctor.

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Help Paying for IgG4-Related Disease Treatment

Charity funds and drugmaker programs for IgG4-Related Disease, checked at the source. Pick your insurance to see what fits.

Your insurance
Charity funds
  • From a charity · NORD RareCare
    IgG4-RD Medical Assistance fund
    Open

    Pays for: Medical and medication costs.

    The foundation says: “Accepting Applications”
  • From a charity · NORD RareCare
    IgG4-RD Premium Copay Assistance fund
    Open

    Pays for: Insurance premiums and copays.

    The foundation says: “Accepting Applications”
  • From a charity · The Assistance Fund
    Immunoglobulin G4-Related Disease (IgG4-RD) fund
    Open

    Pays for: Copays, coinsurance, deductibles and other health-related expenses.

    The foundation says: “OPEN — Accepting New Patients. TAF is currently accepting new patient enrollments for this program.”
Status as each foundation showed it on September 28, 2026.
Drugmaker programs
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Side Effect Explorer

Real-world side effect reports from the FDA Adverse Event Reporting System (FAERS). Includes both FDA-approved drugs and investigational therapies from active clinical trials. Click any drug to see what patients reported.

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Genetic Testing

Genetic testing can confirm a diagnosis, guide treatment decisions, and identify family members who may be at risk.

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Trusted IgG4-Related Disease Resources

Reputable organizations and medical references for learning more about IgG4-Related Disease, including disease registries, foundation resources, and clinical guidelines.

FDA decision ahead
The FDA is due to decide on Obexelimab (Zenas BioPharma) for IgG4-related disease by May 27, 2027. Self-injected antibody that dials down B cells without depleting them. In the Phase 3 INDIGO trial it cut the risk of IgG4-RD flare by 56% over 52 weeks, with 73% of treated patients flare-free versus 45% on placebo, and reduced steroid use. Zenas disclosed the acceptance and date in its August 13, 2026 quarterly update.
See all upcoming rare disease FDA decisions →

Active Clinical Trials for IgG4-Related Disease

Use this IgG4-Related Disease clinical trial finder to see the 17 studies recruiting patients and 11 opening soon in the United States and worldwide, with eligibility criteria in plain English. These studies play a critical role in advancing care for autoimmune & inflammatory conditions and may offer access to treatments not yet widely available. Each trial below is sourced directly from ClinicalTrials.gov, with eligibility criteria translated into plain English to help patients and caregivers evaluate whether a study may be a fit.

TrialsSite mapPipeline timeline

Note: Trial recruitment statuses on ClinicalTrials.gov may not immediately reflect recent FDA decisions, sponsor announcements, or enrollment changes. Always confirm a trial's current status directly with the study coordinator before making plans.

33 active trials worldwide
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RECRUITINGPHASE3Recently updatedNCT07190196

A 52-week Study of Rilzabrutinib Efficacy and Safety Compared to Placebo in Adults Diagnosed With IgG4-related Disease

Intervention: Rilzabrutinib, Placebo, Glucocorticoid

Sponsor: Sanofi

This is a Phase 3, parallel group, 2-arm, randomized, double blind, placebo-controlled, 52-week treatment study to assess the efficacy and safety of rilzabrutinib as a treatment for adult patients with active IgG4-RD.

Ages 18 Years+92 locations
Started Sep 2025Updated 6 days agoEst. Jun 2028 (~1y 9m)
NOT YET RECRUITINGEARLY_PHASE1Recently updatedNCT07806045

Nebulized UC-EVs for Recurrent or Refractory IMIDs With Lung Involvement

Intervention: nebulized human umbilical cord mesenchymal stromal cell-derived extracellular vesicles

Sponsor: Qiubai Li · Shandong Qilu Stem Cells Engineering Co., Ltd.

Immune-mediated inflammatory diseases (IMIDs) are systemic inflammatory disorders driven by dysregulated immune responses that can affect multiple organs, including the lungs. Examples include Behçet disease, IgG4-related disease, and systemic sclerosis (SSc). IMID-related lung i...

Ages 18 Years – 80 Years1 location
Started Oct 2026Updated 3 weeks agoEst. Jul 2028 (~1y 10m)
NOT YET RECRUITINGNARecently updatedNCT07793903

BCT301 in Treating Refractory/Recurrent IgG4-related Disease

Intervention: BCT301 Cell Injection

Sponsor: Peking University Third Hospital

This is an investigator initiated trial to assess the safety and efficacy of BCT301 cell Injection (CAR-iT cells derived from chemically induced pluripotent stem cells) in patients with refractory/recurrent IgG4-related disease.

Ages 18 Years – 75 Years
Started Oct 2026Updated 4 weeks agoEst. Jun 2028 (~1y 9m)
NOT YET RECRUITINGPHASE2Recently updatedNCT07222553

Study to Evaluate the Pharmacokinetics, Pharmacodynamics, Safety, and Tolerability of Inebilizumab in Pediatric Participants With IgG4-RD

Intervention: Inebilizumab

Sponsor: Amgen

The primary objectives of this study are to characterize the pharmacokinetics (PK) and pharmacodynamics (PD), as well as to assess the safety and tolerability, of inebilizumab in pediatric participants with IgG4-RD.

Ages 2 Years – 18 Years14 locations
Started Oct 2026Updated 1 month agoEst. Jun 2031 (~4y 8m)
NOT YET RECRUITINGPHASE3Recently updatedNCT07719543

Efficacy and Safety of Lenalidomide in Patients With IgG4-Related Disease

Intervention: Lenalidomide, Placebo

Sponsor: Chinese PLA General Hospital

Immunoglobulin G4-related disease (IgG4-RD) is a chronic immune-mediated disorder characterized by inflammation, fibrosis, and involvement of multiple organs. Although glucocorticoids can effectively induce remission, many patients experience disease relapse after glucocorticoid ...

Ages 18 Years – 75 Years3 locations
Started Aug 2026Updated 2 months agoEst. Dec 2030 (~4y 3m)
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Active trial locations22 cities in the US
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Trial Pipeline

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Data from ClinicalTrials.gov, U.S. National Library of Medicine.
Always talk to your doctor before considering a clinical trial.

Patient Communities

Connect with other IgG4-Related Disease patients, caregivers, and advocacy groups across Facebook groups, Reddit communities, and YouTube channels. These patient communities offer peer support, shared experiences, caregiver resources, and real-time discussion about IgG4-Related Disease treatments, clinical trial participation, and day-to-day disease management.

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Related Autoimmune & Inflammatory Conditions

Other rare diseases in the autoimmune & inflammatory category. Patients with IgG4-Related Disease may find relevant research, shared treatment pathways, or overlapping clinical trials among these related conditions.

Companies Developing IgG4-Related Disease Treatments

2 pharmaceutical companies have IgG4-Related Disease in their rare disease portfolio

Frequently Asked Questions About IgG4-Related Disease