Grand Rounds Takeaways: Nephrology KOL Expects ~20/30/50 Sibe/Ataci/Pove Share Split in IgAN After ERA, While Also Incorporating Filspari in FSGS and Optimistic on Gazyva in PMN

Research evidence excerpt

Grand Rounds Takeaways: Nephrology KOL Expects ~20/30/50 Sibe/Ataci/Pove Share Split in IgAN After ERA, While Also Incorporating Filspari in FSGS and Optimistic on Gazyva in PMN

. Of his roughly 50 patients with

biopsy-confirmed FSGS, about 20 are primary or genetic and 30 secondary, with another 20

to 30 clinically suspected but not biopsied, a group the label now gives him reason to biopsy.

In IgAN, he is now reserving the ERAs like Filspari for a later hemodynamic layer behind the

immune-modifying agents like Voyxact that he prioritizes at diagnosis, especially if payers

push back on patients being on two novel branded and relatively expensive therapies.

• On the Early Pipeline, Climb’s Novel Anti-APRIL Sweeper and Biohaven’s

Immune-Sparing Degrader Look Promising in IgAN, While Travere’s BTK Inhibitor

Civorebrutinib Faces a Field Shifting to Obinutuzumab in PMN: Dr. Nigwekar described

Climb Bio's (CLYM) CLYM116, an anti-APRIL sweeper antibody with a pH-dependent bind-

and-release mechanism that degrades APRIL and recycles the antibody, as novel, and

commented that its initial Phase 1 safety data showed no serious adverse events. He

also sees Biohaven's (BHVN) Gd-IgA1 degrader BHV-1400 as mechanistically attractive

for sparing the immune system, citing data in PMN as possible precedent. In PMN itself

he viewed Travere's oral BTK inhibitor civorebrutinib as a potential way to overcome the

infusion, neutropenia, and infection burdens of rituximab, but noted Roche’s obinutuzumab

(Gazyva), with impressive data freshly published in NEJM, is poised to replace rituximab as

the standard, leaving how the BTK compares against obinutuzumab as an open question.

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