Atrasentan offers potential long-term kidney protection in IgA nephropathy
Final 2.5-year ALIGN results show atrasentan may slow eGFR decline in IgA nephropathy vs placebo (−7.5 vs −9.9 ml/min/1.73 m2; difference 2.4 ml/min/1.73 m2; P=0.057), with notable benefit in the SGLT2 subgroup; early data showed no acute eGFR loss after starting atrasentan. Overall, atrasentan appears to offer non-immunosuppressive renoprotection, though long-term safety remains to be fully established.